Income, employment and wealth
About
Employment is the condition of having paid work, which provides income and often benefits such as health insurance and paid sick leave. Employment, and the income and benefits it provides, shape our choices about housing, child care, medical care and more. Wealth, or the accumulation of assets, makes it easier for people to manage job changes, emergencies, education costs and retirement. As employment, income and wealth increase or decrease for individuals, families and communities, so do opportunities for health.
Relationship to health and equity
Everyone deserves to earn enough to thrive, not just survive. Yet there are millions of employed workers who live near or below the federal poverty line, many people who cannot find jobs, and many people who are unable to work. People of color are more likely to provide essential services as home health care workers, agriculture works and laborers, yet these positions tend to be low-wage and provide poor working conditions. Lower-income workers are less likely to have health insurance and work in hazardous jobs than those with higher incomes. Under-resourced and disenfranchised communities, including racial and gender minorities and those with disabilities, are more likely to have high unemployment, have limited incomes and wealth, and are at greater risk for poor health outcomes like chronic illness, childhood sickness and poor birth outcomes. All of these outcomes are worse in lower-income families. Adults in the highest income brackets live significantly longer than those with the lowest incomes: the top 1% live up to 15 years longer than the bottom 1% and that gap is growing.
Relationship to systems and structures
Corporate and government institutional practices, as well as social prejudices and discrimination, have resulted in income and wealth inequality in the U.S., particularly along racial, gender and ability lines. These gaps continue to increase. Every community should have the opportunity to build long-term assets and economic security, which are essential for lifetime health. As a result of policies like redlining, today Black wealth is less than one-tenth that of white households, and Hispanic families fare only slightly better. Government and corporate discriminatory policies and practices create significant unfair obstacles to building wealth, from excluding Black WWII veterans from GI bill benefits to today’s predatory lending and higher interest rates on bank loans in communities of color.
Communities can make changes and advocate for policies that help reduce and prevent poverty, now and for future generations.
Additional Reading
- Antonisse, L., & Garfield, R. (2018). The relationship between work and health: Findings from a literature review. KFF. https://www.kff.org/medicaid/issue-brief/the-relationship-between-work-and-health-findings-from-a-literature-review/
- Khullar, D., & Chokshi, D. A. (2018). Health, income, & poverty: Where we are & what could help. https://www.healthaffairs.org/do/10.1377/hpb20180817.901935/full/
- Woolf, S. H., Simon, S. M., Aron, L., Zimmerman, E., Dubay, L., & Luk, K. X. (2015). Income and Health Initiative: Brief 1. How are income and wealth linked to health and longevity? Urban Institute and VCU Center on Society and Health. https://www.urban.org/sites/default/files/publication/49116/2000178-How-are-Income-and-Wealth-Linked-to-Health-and-Longevity.pdf
- Hanks, A., Solomon, D., & Weller, C. E. (2018). Systematic inequality: How America’s structural racism helped create the Black-white wealth gap. Center for American Progress. https://www.americanprogress.org/article/systematic-inequality/
- Congressional Research Service. (2021). The growing gap in life expectancy by income: Recent evidence and implications for the Social Security Retirement Age. https://crsreports.congress.gov/product/pdf/R/R44846