Poor and Healthy

Published in Sueddeutsche Zeitung
(Germany) on 4 January 2016
by Matthias Tertilt (link to originallink to original)
Translated from by Sandra Alexander. Edited by Victoria Branca.
Costa Ricans live longer than Americans. A new study shows how much the income distribution in the U.S. endangers the health of its poorest citizens.

Income differentials have a greater influence on the health of the population in the U.S. than in Costa Rica. That is what is reported by William Dow of the University of Berkeley together with his colleague Luis Rosero-Bixby from the University of Costa Rica in the professional journal PNAS. The researchers calculate that the mortality rate in the U.S. would fall by around 25 percent if there were no income differentials. In Costa Rica, it would only be 9 percent.

The life expectancy in Costa Rica stands at 78.5 years — about one year above that of Americans. At the same time, per capita income as well as expenditures for the health care system in the U.S. are many times higher. Analysis of health care data from the years 1984 to 2011, however, shows that the poorest 25 percent of Americans have, for example, almost a three times higher risk of dying from lung cancer than the upper quarter of the income distribution.

In Costa Rica, the lung cancer risk for the poorest [citizens] is less than twice as great as that of the richest. The researchers attribute that primarily to differences in health care. Thus, public health care in the U.S. only applied to those aged 65 and above in the time frames studied. In Costa Rica, the national insurance system has long since reached almost all citizens.


Costa Ricaner leben länger als US-Amerikaner. Eine neue Studie zeigt, wie sehr die Einkommensverteilung der USA die Gesundheit ihrer ärmsten Bürger gefährdet.


Einkommensunterschiede haben in den USA einen größeren Einfluss auf die Gesundheit der Bevölkerung als in Costa Rica. Das berichtet William Dow von der Universität Berkeley zusammen mit seinem Kollegen Luis Rosero-Bixby von der Universität Costa Ricas im Fachmagazin PNAS. Die Sterblichkeitsrate in den USA würde um 25 Prozent sinken, wenn es keine Einkommensunterschiede gäbe, haben die Forscher berechnet. In Costa Rica wären es nur neun Prozent.

Die Lebenserwartung in Costa Rica liegt bei 78,5 Jahren und damit gut ein Jahr über der amerikanischen. Dabei sind sowohl das Pro-Kopf-Einkommen als auch die Ausgaben für das Gesundheitssystem in den USA um ein Vielfaches höher. Auswertungen von Gesundheitsdaten der Jahre 1984 bis 2011 zeigen jedoch, dass die ärmsten 25 Prozent der Amerikaner beispielsweise ein fast dreimal so hohes Risiko haben, an Lungenkrebs zu sterben, als das obere Viertel der Einkommensverteilung.

In Costa Rica ist das Lungenkrebsrisiko für die Ärmsten weniger als doppelt so groß wie das der Reichsten. Die Forscher führen das vor allem auf Unterschiede in der Krankenversorgung zurück. So griff die öffentliche Krankenversicherung in den USA während des untersuchten Zeitraums erst ab dem 65. Lebensjahr. In Costa Rica erreicht das nationale Versicherungssystem seit langem fast alle Bürger.
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