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The death toll of inequality

Nov 7, 2019 • 15m48s

In Australia, the gap in life expectancy between the rich and poor has reached 10 years – the outcome of “savage capitalism”.

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The death toll of inequality

116 • Nov 7, 2019

The death toll of inequality

[Theme music]

ELIZABETH:

From Schwartz Media, I’m Elizabeth Kulas. This is 7am.

There is a widening gap in Australia between the life expectancy of the rich and the poor. On some figures it is as much as 10 years. Mike Seccombe on the death toll of inequality.

[Theme ends]

Archival tape — Joe Hockey

“You know, there's great news on the horizon for Australia. I mean, the fact that we are living longer is great news. And, you know, it's quite kind of remarkable. But somewhere in the world today, it is highly probable that a child has been born that's going to live to 150.”

ELIZABETH:

So Mike, life expectancy… It sort of feels like one of those headline figures that always seems to be going up. And whenever you hear it in the news, you hear kind of the same message. We're living longer and longer. How true is that actually?

MIKE:

Well, it has been true for a very long time, for over 100 years. You know, our life expectancy has been consistently rising and Australia has one of the highest life expectancies in the world. Only last week, we had new figures out from the Australian Bureau of Statistics boasting that Australia had achieved new record highs in life expectancy and that a child born today could expect to live round 83 years on average.

ELIZABETH:

Mike Seccombe is The Saturday Paper’s National Correspondent.

MIKE:

But that's the average. And the details are a lot more complicated than that. Lots of factors influence that life expectancy figure. And one of them is who had actually applies to. So, you know, it can be the case that if some people are doing a lot better and other people are doing a bit worse, it can appear to go up even though it is not doing so for some people. And that's the essence of my story here, is that life expectancy is not increasing across the board and that, in fact, wealthier people are living longer than poorer people. And that gap is widening over time.

ELIZABETH:

So what are the figures there?

MIKE:

So at the moment, the bottom 20 per cent of the population, the bottom quintile, as they call it, enjoys around six years less life than people in the top quintile. And that's a statistic that comes to me from Philip Clark, who's a professor at the School of Population Health at Melbourne University. And he says that, that not only is that age gap there, but it's getting bigger at quite a rate of knots. If you go down to the bottom 10 per cent of the population, the life expectancy gap is about 10 years, which is a lot of life to miss out on.

ELIZABETH:

So tell me about why this doesn't get more attention, because that seems like a big deal, that there’s this almost a decade long gap in life expectancy.

MIKE:

Right, well, it doesn't get attention because essentially Australia doesn't have very good data on the subject. Like I said, the official ABS data just looks at the averages. But there are some academics doing studies into this. Torrens University has been looking at the rates of premature deaths, as they call them, premature meaning people who die before the age of 75. So you know, who die earlier than the average life expectancy. And they've been looking at that over the past 25 years. And between 1987 and 2015, premature mortality dropped sharply across the board. So 40 per cent on average. But once again, that decline wasn't equal. And once again, the gap between the rich and the poor grew. So we know that in the late 1980s, the most disadvantaged 20 per cent of the population was 60 per cent more likely to die prematurely. They were almost 100 per cent more likely to die prematurely. So so, you know, it almost doubled. And a similar trend was measured for women.

ELIZABETH:

So is our life expectancy then going backwards in Australia?

MIKE:

Well, not yet. Not on average, but we seem to be heading in that direction. If you have a look at the ah, the long term trends, they're definitely flattening out. And over the past couple of reports from the Bureau of Statistics, we have seen in some cohorts in some states, life expectancy has actually declined marginally. But in other countries, it's a much more pronounced trend in the United States. People are actually living shorter lives now than they were several years ago.

Archival tape — Unidentified Man #1:

“For the third year in a row, life expectancy in the US has on average dropped…”

Archival tape — Unidentified Woman #1:

“The centres for disease control say that’s because 8 of the 10 leading causes of death got even deadlier…”

Archival tape — Unidentified Man #2:

“There’s now a 13 year life gap between the richest American men and the poorest American men. The gap for women is 14 years.”

MIKE:

US life expectancy has been declining for three or four years now. And what they find in the United States is that the decline in the overall life expectancy has been driven by increasing mortality rates for one group in particular, which is some largely white, working class, middle aged people, not very well educated, finished high school, but haven't done any post school qualifications. And their mortality rates have increased so dramatically that it skews the average for the entire nation. And they're dying. What have been called, rather dramatically, ‘deaths of despair’ by the researchers. The causes of death tend to be substance abuse, alcohol-related disease, suicide and various other lifestyle related diseases.

ELIZABETH:

Hmm.

MIKE:

The most notable research in this area is Sir Angus Deaton, who won the Nobel Prize three years ago for research in this area. And his theory is that this is the result of what he calls cumulative disadvantage over decades. So in the labor market, in marriage ability, in child outcomes. So in other words, as economic inequality has increased in the United States, schools have suffered. And so people have been less educated, they've become less marriageable. The sorts of jobs that they used to do have been disappearing, they’ve been off-shored. So in the United States, it's fallen and it's fallen, particularly since the global financial crisis. And the same is true to a slightly lesser extent in Britain, among the same group and for the same reasons and of the same causes.

ELIZABETH:

And what about here in Australia? How far away are we from seeing a similar thing happen?

MIKE:

Well, that's hard to say, because there's quite a lack of usable data in this area. But definitely the preconditions are here evident already. Flat wages decline in the availability of low skill jobs, declining social services driven by government austerity, increased rates of long term unemployment. Contrary to what the government says, most people who are long term unemployed are not work shy young people. They're people in their middle years who lose a job and find they can't get one again. The fastest growing cohorts of the unemployed are people in their 50s and 60s. So all of that should be sounding a big warning for our politicians that we're on the cusp of potentially a similar phenomenon occurring here.

ELIZABETH:

We’ll be right back.

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ELIZABETH:

Mike, we're talking about this picture emerging in Australia where how much money you have determines how long you will live. What do we know about why and when this gap started to emerge in Australia?

MIKE:

Well, the mortality gap began widening several decades ago, so it's been happening for a while. And it seems to have coincided with the opening up of the global economy. Back in the Keating years when we opened ourselves up to the world and that changed a lot of things. And academics I spoke to said that was the only cause that they could see, was that it was the economic system that we had adopted, this sort of neoliberal trickle down, globalized economic system had basically left a whole cohort of people behind. And as a result, they were dying, those deaths of despair that I spoke about earlier. So just to give you some examples of how this manifests itself, data from the Australian Institute of Health and Welfare shows that between 2001 and 2016, illicit drug use jumped among people in their 40s, not among younger people, and also increased somewhat for people in their 50s, it almost doubled. And it's been declining everywhere else. In 1997, three point five of every 100000 Australian men in their 40s died from drug overdoses. Two decades later, that's grown to 18. So 3.5 to 18, which is a pretty sharp jump.

ELIZABETH:

Huge increase, yeah.

MIKE:

Yeah, huge increase. And suicide rates have also been increasing significantly among both men and women in their 40s and 50s. And the median age of suicide is now 44. And in terms of the number of years of potential life lost, it is now the, the leading cause.

ELIZABETH:

Mike, I know the data is, is patchy in this area, but is there anything else that we know about this trend? What, what information do we have available?

MIKE:

All sorts of lifestyle related diseases have been correlated with lower incomes, you know, smoking rates, obesity rates, lack of exercise, things like that, all of all of which impact on people's health in the long term. So the data's there, but it's it's not well collated, I guess you could say, into a you know, for want of a better term, a poverty line, a health poverty line. At this stage, we can see the symptoms, but we can't really see the overall picture. Economic inequality is clearly a major factor in health inequality and of course, vice versa because, you know, people with poor health are less capable of looking after themselves economically. People in the bottom 20 per cent have seven fewer teeth on average than people in the top 20 per cent, which of course, has an impact on their employment prospects. You know, you're not going to get a job in the service sector if every time you open your mouth, people wince. It's also a driver of addiction, especially to painkillers, because in this country, you can't get dental health on Medicare, but you can go along to the doctor and get yourself some drugs. It contributes to stresses which increase smoking rates. Poor people tend to have long commutes by vehicles, so they spend a lot of their days in the car. They don't have much time to exercise. They don't have as much green space in which to do it. So there's all sorts of indicators.

ELIZABETH:

And is anyone pushing back against this or proposing do anything about it?

MIKE:

There is one politician in particular who's who's been right at the forefront of this area of investigation. And that's Andrew Leigh from the Labor Party.

Archival tape — Andrew Leigh:

“Deputy speaker, egalitarianism is a great Australian value and over the last generation inequality in Australia has been rising.”

MIKE:

He's also professor of economics at the Australian National University and he previously worked with with Professor Clark on this issue a few years ago. They were the first ones to quantify this, this life expectancy gap, the six year gap. And Lee says this is a massive issue.

Archival tape — Andrew Leigh:

“We’ve seen wages rising much more rapidly at the top than at the bottom. We’ve got a time now where inequality in Australia is at a 75 year high.”

MIKE:

The politics of this are particularly interesting, which is that, you know, this is not an issue that you can blame wholly on one side of politics. You know, it's it's grown under both Democrats and Republicans in America. It's grown under Labor and the Tories in Britain and under Labor and the Coalition in this government right back to the times of Hawke and Keating. One of the interesting aspects of of this is that unlike in, say, Britain, where the issue is heavily politicised because health poverty skews heavily towards Labor voters -- in this country, health poverty exists in roughly equal measure on both sides of politics. And that's because while people aligned with the Liberal Party tend to enjoy better health and longer lives, those aligned with the Nationals don't. So a number of the experts I was talking to suggested that perhaps this is an issue in which the Nats should be making common cause with Labor because both their constituencies are heavily negatively affected by this. And Andrew Leigh, at the end of of talking about all this stuff, asks the simple question how much would most of us be willing to give up to have one more year of healthy life? You know, let alone six of them.

ELIZABETH:

If you happen to be in the bottom 10 percent.

MIKE:

Or 10, you know, 10, 10 more birthdays, 10 more years with the grandchildren, 10 more Christmases and so on. So, you know, it's it's a big, big question.

ELIZABETH:

And what does the answer seem to be to Leigh’s question about what we’d be willing to give up to extend life expectancy for everyone?

MIKE:

Well, I guess in the first instance, I would answer the question with another question, which is, would we as a nation be prepared to give up on an economic model that um as deemed a whole cohort of people to be surplus to requirements? I guess I guess you would say that's the essence of it. I mean, it is clearly being driven by increasing economic inequality. The temptation is to blame the victims of this inequality, you know, for their unfortunate lot. Really, we have to start looking at the underlying causes. And the underlying causes is simply that we're practising a fairly heartless and savage form of capitalism at the moment. So the evidence suggests that we have to rethink things in a fairly big way and redistribute perhaps the benefits of progress in a somewhat more even fashion. We're pretty close to flatlining in life expectancy now. It is not growing very fast at all, so it's entirely likely that without change, we will see ourselves go in the same direction that I just mentioned in the United States in the nearish future.

ELIZABETH:

Mike, thank you so much.

MIKE:

Thank you.

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ELIZABETH:

Elsewhere in the news:

More than 11,000 scientists from around the world have signed a scientific paper declaring a clear and unequivocal climate change emergency. The paper, published in the Journal of BioScience, is urging six actions, including the end of fossil fuel extraction, stabilising population growth, and greatly reducing meat consumption to mitigate the crisis. If not acted upon, the paper warns that the world’s people face quote “untold suffering.”

And NSW Police Minister David Elliott has defended the practice of strip searching minors, saying that he would want officers to strip-search his own children. His statement follows the release of new data revealing that 122 underage girls have been strip-searched by NSW police since 2016. Two of those girls were 12-years-old, and eight of them were 13. While acknowledging that the searches are not always appropriately conducted, Elliott backed his claims saying quote, “Having been minister for juvenile justice, we have 10-year-olds involved in terrorism activity.”

This is 7am. I’m Elizabeth Kulas. See you Friday.

There is a widening gap in Australia between the life expectancy of the rich and the poor. On some figures it is as much as 10 years. Mike Seccombe on the death toll of inequality.

Guest: National correspondent for The Saturday Paper Mike Seccombe.

Background reading:

The fatal cost of Australia’s rising inequality in The Saturday Paper
The Saturday Paper
The Monthly

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7am is hosted by Elizabeth Kulas. The show is produced by Emile Klein, Ruby Schwartz, Atticus Bastow and Elle Marsh, with Michelle Macklem. Our editor is Erik Jensen. Our theme music is by Ned Beckley and Josh Hogan of Envelope Audio.

This episode was produced in part by Elle Marsh, features and field producer, in a position supported by a grant from the Judith Neilson Institute for Journalism and Ideas.

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116: The death toll of inequality