Re: LONGEVITY: Social Factors

Robin Hanson (
Tue, 18 Aug 1998 10:48:37 -0700

Damien Broderick writes:
>I'll be interested to hear comments from Robin and any other health experts.

OK, I'll bite.

It's clear that being poor is a very big hit on health, that it mostly isn't due to spending less on health care, nor to the poor having worse behavior like smoking, lack of excercise. eating fats, etc. A big part of it may well be due to higher stress among poorer people, including cars that break down more often, less savings to last through unemployment, living in higher crime areas, etc. Another big part of it may be a correlation between being poor and having less social support from friends and family.

The article acknowledges this, but seems to equivocate regarding policy. They admit money isn't the big issue on health, but then complain about how much money Bill Gates has. They admit that "these problems won't be solved with a little 1960s-style income redistribution," but then complain "we are ready to throw a century's worth of social welfare measures in the trash."

There is a big leap between health observations and supporting a welfare state. 1) Even if monetary insurance against being poor were a great idea, private insurance is possible if allowed and not displaced by public insurance. 2) Even if health were just a matter of monetary wealth, non-linearities in that relation may account for all the dependence between average nation health and national wealth inequalities.
3) Many nations have higher wealth inequality not because of lacking a welfare state, but because they encompass a wider divergence in cultures, ethnicities, etc.
4) Wealth transfer probably doesn't address most of the reasons the poor have worse health.

I do think this literature has important lessons for people trying to be healthy. You should pay a lot of attention to getting lots of social supports, and to reducing the chance of events that could really stress you, like crime, unemployment, divorce, etc. Don't be so focused on whether you are overweight or smoke.

Robin Hanson RWJF Health Policy Scholar, Sch. of Public Health 510-643-1884 140 Warren Hall, UC Berkeley, CA 94720-7360 FAX: 510-643-2627