C‘is a number that is more striking than others: nine years. It is the average difference in life expectancy between the poorest and wealthiest elderly people. This is highlighted by a recent analysis conducted by National Council on Aging (NCOA) of the United States together with the LeadingAge Long-Term Services and Supports Center from the University of Massachusetts at Boston, based on data fromHealth and Retirement StudyAmerica’s National Study of Health and Retirement. According to what was reported in the press release, those over 60 with an annual income of less than $20,000 they die much earlier than their peers with incomes equal to or higher than $120,000. A gap that does not only concern the economy, but which translates into a real biological disadvantage.
When income becomes a risk factor
Between 2018 and 2022, the death rate among the most economically disadvantaged seniors in the United States reached 21%against the 10.7% of those with high resources. “It is this difference of almost ten percentage points that translates the impact of poverty on life into concrete terms,” he explains Dario Leoscopresident of MR (Italian Society of Gerontology and Geriatrics) and full professor of Geriatrics at the Federico II University of Naples.
The key point is that poverty does not just reduce access to care: enters the body. Low income, limited education and poor housing conditions generate a condition of chronic stresswhich can promote systemic inflammation, weakened immune system and increased risk of cardiovascular, neurodegenerative and oncological diseases. The result is a reduction not only in the years of life, but also in those lived in good health.
A problem that is also growing in Europe
If the data comes from the United States, the message also closely concerns Europe – and Italy. Leosco recalls how already in 2017 a large international study published on British Medical Journalwithin the European project LifePathhad demonstrated that a disadvantaged socio-economic position reduced the life expectancy of the elderly by 4-7 yearsan impact comparable to known risk factors such as smoking, diabetes and sedentary lifestyle.
Today, however, the situation appears to have worsened. The increase in income inequality and absolute povertywhich in Italy concerns approximately one million over 65s according to ISTAT data, it makes the problem even more urgent.
Public health under pressure
Italy remains one of the longest-lived countries in the world, thanks to a universal healthcare system that has guaranteed access to treatment, prevention and basic medicine for decades. But, as Leosco underlines in the press release, one Public healthcare increasingly “restricted”accompanied by growing privatization – with a share of “out-of-pocket” healthcare spending exceeding 15% of the total – risks creating new economic barriers. The danger is clear: if access to care becomes a question of income, even longevity ceases to be a universal right.
Every political choice is a health choice
The final message is strong and clear: economic and social policies are also health policies. Investing in equity, welfare and access to services means directly impacting collective health outcomes and the quality of aging. «Building a more just society – concludes Leosco – is the most effective public health policy». Why living longer should not depend on your bank account, but on a system capable of taking care of everyone, at every age.