TAX WHAT YOU DON'T WANT:

Poor New Yorkers Tend to Live Longer Than Other Poor Americans (Margot Sanger-Katz, APRIL 11, 2016, NY Times)

New York is one of the country's most unequal and expensive cities, where the poor struggle to find affordable housing and the money and time to take care of themselves.

But the research found that New York was, in many ways, a model city for factors that seem to predict where poor people live longer. It is a wealthy, highly educated city with a high tax base. The local government spends a lot on social services for low-income residents. It has low rates of smoking and has many immigrants, who tend to be healthier than native-born Americans.

The research seems to suggest that living in proximity to the preferences -- and tax base -- of wealthy neighbors may help improve well-being. New York is not just a city of rich and poor, but also one of walkable sidewalks, a trans-fat ban and one of the most aggressive anti-tobacco agendas of any place in the United States.

"Even with income inequality as big as it is, there are things that government can do to help the poor be healthier and live longer lives," said Dr. Thomas Farley, who was New York's health commissioner during the Bloomberg administration and now runs Philadelphia's health department.

"It's about combating the things that are killing people."

The findings underscore public health research showing that healthy habits matter. The JAMA paper found that several measures of access to medical care had no clear relationship with longevity among the poor. But there were correlations with smoking, exercise and obesity.

"There remains this misconception in our society that health is determined by health care," said Dr. Steven Woolf, a professor and director of the Center on Society and Health at Virginia Commonwealth University, who wrote an editorial commending the research but offering some methodological criticisms. "Behaviors have a huge influence on health outcomes."

The beauty of HSAs is that you get the psychological security blanket without wasting the money on health care you don't need.


Posted by Orrin Judd at April 11, 2016 4:01 PM

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