Mortality / Policy

Wealth vs. Health: The Cost of Being Well

Ralph Waldo Emerson stated that “the first wealth is health.” The inverse, however, is also true: health is wealth. Or, more accurately, health is related to wealth, according to the latest statistics released from Measure of America, a project of the Social Science Research Council.

The big news from the Measure of America report is that Connecticut ranks highest on the American Human Development Index, causing Mark Vanhoenacker of Slate’s culture blog Browbeat to exclaim, “Curse you, Land of Steady Habits!” The American Human Development Index, based on the United Nation’s Human Development Index, is a composite statistic of health, education, and income. You can spend hours teasing out the geographic, racial and ethnic disparities glaringly revealed by the index. However, today I want to focus more closely on the health index and what it means in Connecticut.

Picture taken from measureofamerica.orgThe health index is based on one indicator: life expectancy at birth. Connecticut scores third highest on this index, with an average life expectancy at birth of 80.4 years. Why? In part because the state’s performance on many other indices of health is equally good. For example, CT residents have some of the lowest rates in the country of smoking, diabetes and obesity. Infant and child mortality are also low, and there are large numbers of practicing physicians who can provide critical opportunities for child immunizations, two other indicators on which CT performs quite well. Importantly, only 11% of CT residents do not have health insurance, which puts us among the best insured states in the nation (although Massachusetts, with its health insurance mandate and state exchange courtesy of Governor Romney, has an incredibly low rate of 6% uninsured residents).

Unfortunately, all of this good health comes at a cost: the cost of providing and supporting well-being through a variety of private and public mechanisms (taxes being the most obvious). Of course, Connecticut is a wealthy state, and it ranks third highest in the nation for median personal earnings and per capita GDP (Gross Domestic Product). Consequently, Connecticut invests substantially in the policies, factors and social programs that contribute to good health, such as education (we have the third highest ranking for educational attainment and enrollment), state Medicaid spending, and a high minimum wage. However, the flip side of this wealth is that CT can be a prohibitively expensive state in which to live, especially for individuals on the lower end of the income spectrum. For example, CT has an unusually high number of marginally attached workers; that is, workers who want to and can work but have stopped trying to find employment. Connecticut also has the 6th highest level of renters with severe housing-cost burden, defined as spending more than 50% of their income on rent and utilities. Similarly, almost 50% of our renters and 40% of our homeowners spend more than a third of their income on housing, contributing to a trend of long commute times as employees seek to balance affordable housing options with lucrative job locations.

Therefore, while wealth contributes to health, and health certainly represents a type of wealth, I wonder if this apparently direct relationship begins to blur for state residents who are in the lower income brackets. Do the health benefits of living in a wealthy state diminish as median earnings decline?


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