Life Expectancy and Inequality: The Case Study of America

Why do some people tend to live longer than others? Is it due to genetics, personal choices, or something socially constructed like race, gender, and economic status? Life expectancy is not only a biological outcome; it is also a product of systemic inequality. Across the world, and especially in America, factors like race, socioeconomic status (SES), and gender determine who lives longer and who faces higher risks of illnesses and early death. These differences are not random or natural; they are the result of structural inequalities embedded in society. Although medical advancements have increased global life expectancy, deep-rooted inequalities are still causing marginalized communities to die early. Poor people, African Americans, and certain gender groups experience worse health outcomes due to poverty, racism, and sex- and gender-related health issues. For instance, the life expectancy gap between Black Americans and White Americans is 4.18 years at the national level (Silva, 2023).  This essay will explore how SES, gender, and race contribute to health disparities by explaining them and exploring how these factors combine and shape life expectancy outcomes. At the end, it will also discuss upstream interventions that could improve health equity and reduce disparities.

Socioeconomic status (SES) comprises two words, ‘socio,’ meaning Society, and ‘Economic,’ meaning financial. SES refers to a person’s financial standing in society. SES is not solely comprised of earnings but also education level, type of job, and social position. It affects the quality of life and the availability of opportunities. SES is also a determinant of psychological outcomes like mental health and stress levels (America Psychological Association, 2023) .
Generally, Sociologists believe that there is a direct correlation between SES and health outcomes. People with the lowest income and education levels have the lowest SES and experience the worst health outcomes. However, even those in the middle class (with a college education) face more health struggles like access to healthcare, education, etc., compared to the wealthy (Braveman, 2010). Individuals with higher SES are more likely to have greater access to healthcare and vice versa. A lower financial situation results in a lack of health insurance or sometimes a bad one, which leads to delayed medical intervention, causing unnecessary suffering and sometimes leading to chronic illnesses (Qureshi, 2019).
Similarly, people with low SES are more exposed to hazardous environments, both in the workplace and at home, like pollution and poor sanitation. Lower SES individuals are also exposed to more stress due to various factors, including food insecurity and status anxiety. Food insecurity can be defined as the inaccessibility to adequate food or the quality of food. It is another major issue in the U.S., reported at 13.5% in 2023 (ODPHP, 2023). Malnourishment causes illnesses, and the pursuit of obtaining it leads to stress. Moreover, the U.S. is the most unequal society among the developed nations, with a Gini coefficient of approximately 0.40 (Pickett, 2024). The Gini coefficient is a measure of inequality in a particular country. The rate of anxiety and stress is higher in an unequal society, especially among the poor, who have low social positions. This is how SES determines life expectancy.

Race is a social construct used to categorize people based on their physical traits, social status, and cultural heritage (NHGRI, 2025). The concept of Race in the past was used to establish a social hierarchy, and this led to racism.  Race has been used to create division within society, and it has affected people’s rights and access to basic necessities like healthcare, jobs, and education. For instance, according to the New York Times, during COVID-19, life expectancy dropped over three years for Black Americans (71.5 years) and four years for Hispanic Americans (77.9 years), while White Americans saw a smaller 1.4-year decline (77.4 years). This was mainly because of high-risk jobs, that Black Americans had, like bus driving.
People of color have often been denied proper medical care, with their symptoms being undermined and ignored. Many doctors falsely believe that black patients have higher pain tolerance than white patients, causing them to experience unnecessary pain. This is how racism is embedded in the system (Hoffman, 2016). Similarly, the media also plays a powerful role in shaping racial stereotypes on how people view health. Sociologist Abigail Saguy, in her work, explained how a white girl from a wealthy family was portrayed as the face of anorexia, gaining sympathy, while a Black mother and son were featured in an article on obesity, reinforcing blame. This promotes determinism in marginalized communities, causing more stress and leading to worse health and shorter lives (Abigail, 2014). They just accept their fates, believing that nothing can be changed in their lives. 

Another social factor impacting life expectancy is Gender and sex. Gender is defined as the roles and behaviors society expects you to perform, while sex refers to biological differences like chromosomes and body structure (Snow, 2007). Gender influences how people are treated in society, unlike sex, which is based on the body. Gender inequality explains differences in treatment between men and women. Many diseases that impact women are not well-researched, misdiagnosed, undermined, or sometimes ignored because medical studies focus more on men (Snow, 2007).
A major problem in healthcare is the confusion between sex and gender, which causes unfair treatment. Women often don’t get proper pain relief or the right treatment for heart disease because their symptoms look different from men’s, but medical guidelines and treatments are based on men’s bodies. For example, women are more likely to have heart diseases in small arteries and less likely to be prescribed heart medications compared to men (Gaggin & Oseran, 2020). 
Gender inequalities in work and family life further worsen women’s health, leading to long-term consequences. Sociologists Ann Oakley, Delphy, and Leonard explain that women face a dual burden, meaning they must juggle both paid jobs and unpaid housework, leading to stress, exhaustion, and poor health. Similarly, Fran Ansley explains that women often absorb men’s frustration, leading to higher rates of domestic violence. This creates constant stress, weakens the body over time, and contributes to lower life expectancy among women. World Health Organization (WHO) reports that globally, 1 in 3 women has faced physical or sexual violence in their life. But the real number is probably even higher because many cases go unreported because of poverty and social stigma. Exposure to long-term stress and violence increases the risk of heart disease, depression, and chronic illnesses, causing a decline in life expectancy.

Personal choices are not the only reason behind health disparities; systemic inequalities in race, gender, and socioeconomic status play a crucial role. A strong upstream intervention would be to match healthcare access to job risks and make medical policies fair for everyone. People with physically hard jobs should get better healthcare that is more inclined towards physical health, and those with stressful jobs should have mental health support. Another strong upstream intervention is to design gender-neutral medical guidelines and treatments to maximize benefits and minimize harm. Last but not least, every medical policy should assess its impact on low-income groups. If a policy negatively affects them, there should be an alternative plan to ensure fair access. Studying the case of America makes it clear that economic development alone does not guarantee health equity; addressing social inequalities is essential for a truly healthier society.

Ali Arshad

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