By now, we should all be comfortably settled into 2024. With new year ambitions come reassessment, renewal, and… resolutions! Inevitably, we’ve all had a goal of pursuing optimal health and wellbeing on our list of resolutions. Most recently, I’ve seen a growing trend, mostly for those in places of wealth and boundless resources: not only pursuing optimal health but also pursuing longevity. And this trend, in my opinion, creates another disparity for those without the financial means and other resources to live longer, healthier lives.
From pharaohs to contemporary billionaires, the pursuit of longevity has defined what it is to be powerful. In a world where time is the ultimate currency, the wealthy elite have transcended the limitations of mortality, turning the age-old adage “time is money” into reality. I want to make a broader case for why societal health and wellness – and by consequence – a longer lifespan, are all our responsibilities and more specifically for those in positions of leadership and governance.
At the turn of the 20th century, people started to live longer largely due to public health measures. Improved sanitation practices, higher-quality living conditions, widespread vaccination campaigns, technological advancements, and scientific breakthroughs continue to reshape the boundaries of human existence. But today, we are witnessing the greatest disparities in life expectancy with Black and Alaska Native/American Indian communities experiencing a lower life expectancy than all other racial groups. Similarly, the disparity in wealth mirrors the life expectancy trend with American Indian and Alaska Native, Black, and Hispanic communities facing higher poverty rates than all other races. These disparities are stark against the fact that in 2023, the top ten percent of earners in the United States held 69 percent of the country’s total wealth. This disparity in wealth highlights a stark divide between those who can afford to elongate their existence and those burdened with social determinants of health, which can affect a wide range of health and quality of life outcomes.
As the Founding Dean and Director of UC Irvine’s Program in Public Health and an expert with more than 25 years of experience researching racial and ethnic inequities in cardiovascular disease and stroke care, I can say that without a doubt, where people work, where they live, and what they eat, have a direct correlation to how long they live.
Addressing social determinants of health to extending life expectancy to us all
Tackling the social determinants of health (SDOH) that cripple our communities is crucial in challenging the monopoly on life expectancy. The environment we live in, work in, and play in all impact our lives whether we realize it or not. Some examples many of us know about like forever chemical toxicants in our drinking water and air pollution exacerbating respiratory-related illnesses are being tackled by public health practitioners throughout the U.S. But other examples our society may not recognize is how disproportionate neighborhood urban planning can impact access to grocery stores for healthy food options, safe walking lanes, and exposure to soil lead contamination in communities of color. A mountain of evidence proves that low-income communities and communities of color are more likely to pay for the biological and economic consequences of SDOH. Every individual in the U.S., regardless of immigration status, race/ethnicity, or gender, deserves to have their basic needs met and then some.
As a society, we can vote for policies that promote universal access to life-extending measures like healthcare so that we can shift the focus from catering to the affluent few to serving the broader populace. We have an opportunity to build a world where the privilege of a longer life is not exclusive to the wealthy and those with a higher socioeconomic status, but a shared aspiration for all of humanity. The goal is to add years to our lives and optimize our health earlier. It is a matter of good economics to invest in our health when we are younger instead of being financially burdened by poor health later.
This effort must be shared on every level. From government programs increasing support for supplemental nutrition programs to employers investing in workplace wellness programs, safe working environments, and health incentives for their employees. Our resolution for the new year should continue to be on improving individual health and wellbeing but with an awareness that we must break down the barriers that lie in our way of pursuing optimal population health, wellbeing, and longevity.
Let us focus on preventative health measures like access for all to healthy and nutritious food, clean air and water, safe working environments, and effective health policy measures. Together, we can move the paradigm from pursuing longevity for the few to achieving optimal health and wellbeing for all.
