The wealthiest men in San Diego County can expect to live almost a decade longer than their poorest counterparts.
That’s one of the findings from the Health Inequality Project, a report written by researchers from Stanford, Harvard and MIT. In 2014, the most recent year available, a 40-year-old San Diego County man in the top quarter of income earners could expect to live to almost 90. A man of the same age in the bottom quarter of income would only expect to live to 80.
That gap is narrower for women: Almost 90 years for the top income and slightly less than 86 years for the women at the bottom of the income scale.
Despite the gap, the San Diego region ranked as the sixth-best area in the country on life expectancy for the bottom quarter of income earners based on a 14-year average.
Robert Fluegge is a pre-doctoral fellow with the Equality of Opportunity Project at Stanford University, which produced the income and life expectancy analysis. He said income can be a good, if not necessarily direct, predictor of health.
“It’s not like I wake up one day $10,000 richer and all of a sudden I have no cholesterol anymore,” he said. “Income is sort of a proxy for … your environment, the way you live your life, the access to some services that you may have or information that you may have.”
Nationwide, according to the Health Inequality Project, men and women in the top 1 percent of income live 15 and 10 years longer, respectively, than their counterparts in the bottom 1 percent of income. And the gap is growing. From 2001 to 2014 the top income earners gained about three years in life expectancy, while the bottom earners stayed stagnant.
Steven Eldred with the California Endowment has been working to address those environmental factors that impact health in the San Diego community of City Heights. (The California Endowment funds the KPBS Speak City Heights project.) His work is part of a holistic 10-year project to address a variety of environmental factors in 14 California communities.
“In some neighborhoods mixed-used zoning might allow for a chrome-plating shop or an auto-repair business to be right next door to a single-family residence or apartment buildings or to a school,” he said.
Chemicals from chrome shops can lead to higher rates of asthma in the surrounding area, which can be exacerbated by mold in lower quality housing. Long-term stresses such as food and shelter insecurity and violence can also have lasting health consequences. A seminal 1998 study by Kaiser Permanente in San Diego tracked the impact of what the researchers called adverse childhood experiences on health.
“The study then showed a very strong correlation between the number of these adverse childhood experiences that they’ve had and then the rates of heart diseases or diabetes or other health conditions later in life,” Eldred said.
Geography of health
The Health Inequality Project also looked at how outcomes changed depending on where someone lives.
“For two people that maybe would have the same income level, how do their life expectancies differ whether they grow up in, say, Texas versus in Seattle,” he said.
Six California cities rank among the top 10 in the country for low-income life expectancy based on a 14-year average. Still, there are some gaps between regions. A 40-year old man at the bottom of the income scale in San Jose would live almost three years longer than his counterpart in Bakersfield.
Meanwhile, the wealthiest men in San Jose live about a year longer than the wealthiest Bakersfield men.
The California Endowment does its own analysis of life expectancy based on geography within California. For example, it found that the average life expectancy in Point Loma is three years longer than in City Heights.
Eldred said those differences aren’t just happenstance, they’re tied to income and specific policies.
“Your economic situation can impact where you live and the differences in conditions from one neighborhood to another don’t occur naturally,” he said. “They’re generally the result of policies and practices, and sometimes those are based on discriminatory beliefs or values.”
For example, in 1979 San Diego wanted to encourage infill development in City Heights, turning single-family homes into apartment buildings with six units each.
A 1984 San Diego Union Tribune article detailed how tax changes with Proposition 13 and a recession cut the money available for street repairs, lighting and other infrastructure. Together, these factors created a situation where overcrowded communities strained the limited infrastructure.
Although those policies weren’t discriminatory the way the notorious redlining of neighborhoods was in the 1930s, it had long-term implications for City Heights.
Addressing inequality
One of the more high-profile efforts to address that neighborhood disparity is the push to create a skatepark in City Heights, a neighborhood that already struggles with a lack of parks. The community advocated for years to build a skatepark in City Heights and in Linda Vista.
“Skateboarding is a pretty popular both recreational activity and a way that kids get to and from school,” Eldred said.
Giving those kids a safe place to skateboard helps them get some exercise while staying off sidewalks or away from the front of businesses. And helping the community build its own park helps residents gain the confidence to address long-standing environmental challenges.
“They weren’t just people who didn’t have a skatepark because of what somebody else was doing,” Eldred said. “They became people who have a skatepark because of the actions that they took.”
