Building wealth and income among people who have long lacked opportunity is essential—and possible—for improving health equity.
Substantial evidence links greater wealth with better health. Longitudinal studies have documented strong, pervasive links between income and multiple health indicators across the life span. Although the relationship between wealth and health has been less frequently studied, a growing body of evidence reveals that greater levels of wealth also predict better health outcomes.
In 2007, a systematic review of 29 studies found that people with greater wealth generally live longer and have lower rates of chronic disease and better functional status throughout life. More recent studies have found longitudinal associations between greater wealth and many favorable health outcomes, including lower mortality, higher life expectancy, and decreased risks of obesity, smoking, hypertension, and asthma.
Produced in partnership with the University of California, San Francisco, this report examines the links between wealth and health equity, with data from recent studies showing how a country’s overall health is linked not only with its overall level of wealth, but also with how wealth is distributed. The authors describe promising strategies for building wealth among groups of people for whom access to wealth-generating opportunities have been historically limited.
Evidence links greater wealth with better health. Wealth and income provide material benefits, such as healthier living conditions and access to health care, and protect people from chronic stress.
Parents’ wealth shapes their children’s educational, economic and social opportunities, which in turn shape their children’s health throughout life. Both poor health and economic disadvantage can compound over a person’s lifetime and across generations. Challenges young children face today—and into adulthood—can reflect their parents’ lack of opportunities
How wealth is distributed matters. Countries where wealth and income gaps are smaller are also generally healthier. Although the United States is one of the world’s most affluent nations, it is also the most economically unequal. This large wealth gap may be one reason why Americans are less healthy than people in other affluent nations, including many that are not as wealthy as the United States.
The distribution of wealth in the United States has become increasingly unequal. The percentage of U.S. households with zero or negative wealth has increased to 21.2 percent (in 2016). A growing number of families have no cushion to fall back on if faced with job loss or unexpected expenses.
A long history of discrimination and structural racism explains the wealth gap among people in America. Race-based unfair treatment built into institutions, policies, and practices—such as residential segregation in impoverished neighborhoods; discrimination in bank lending to residents of largely minority neighborhoods; and discriminatory policing and sentencing practices—continue to play a major role in wealth inequality between people of color and white people in the United States.
Building wealth where opportunities have been historically limited is essential for advancing health equity. Closing the wealth gap in this country will require new policies and programs at the state and national levels, and across sectors, including in education, housing, banking, and the justice system.
The full report includes a listing of existing wealth-building initiatives, such as providing a living wage, job training, rental and homebuyer assistance, microloans to start or grow small businesses, and adult financial education and coaching. These strategies and more are described and can help reduce the growing gaps in wealth and health.
What is Health Equity?
Consensus around the definition of health equity can help bridge divides and foster productive dialogue among diverse stakeholder groups.