Poverty one of the nation’s leading killers, study finds

The close link between poverty, poor health and high mortality rates has long been known. Now a new study quantifies the relationship more precisely and finds that long-term poverty is one of the nation’s leading causes of death.

The study’s authors looked at mortality’s relationships with what they term current poverty—being in poverty for a single year— and cumulative poverty, defined as being always in poverty for 10 years. Using international research-based standards they defined poverty as being less than 50% of median household income. Unlike most previous studies, their measure of household income included income sources such as cash and near-cash transfers, taxes, and tax credits, adjusted for household size.

Mortality statistics were derived from analyzing Panel Study of Income Dynamics 1997-2019 data merged with the Cross-National Equivalent File, which they validated with the National Death Index.

They found that in 2019, among Americans age 15 or older, 6.5% of deaths, or about 183,000, were associated with current poverty. Cumulative poverty was associated with an estimated 295,431 deaths, or 14.4% of the total.

When compared with other leading causes of death cumulative poverty ranked fourth, trailing only heart disease, cancer and smoking. Current poverty was seventh, also trailing dementia and obesity, and was responsible for 10 times more deaths than homicide, 4.7 times more than firearms, 3.9 times as many as suicide, and 2.6 times as many as drug overdose.

The authors note that with its relatively high poverty rate, the links between poverty and mortality help explain the U.S.’s lower life expectancy compared to other industrialized countries. And since mortality-associated poverty carries substantial economic costs, they say, “benefit-cost calculations of property-reducing social policies should incorporate the benefits of lower mortality.”

The study, “Novel Estimates of Mortality Associated With Poverty in the US” was published online April 17 as a Research Letter in JAMA Internal Medicine.