A new study from the Stockholm School of Economics reveals that disparities in income, lifestyle choices, and health shocks are the primary reasons behind the gap in life expectancy between individuals with different educational backgrounds in the United States. The research finds that while improved access to health insurance does increase preventive medical spending, it has minimal impact on reducing the longevity gap.

The study, conducted by Johanna Wallenius from the Department of Economics at SSE and Panos Margaris from Concordia University, introduces a life cycle model that considers both financial (pecuniary) and time-based (non-pecuniary) investments in health. They find that even when health insurance coverage is extended to all through a Medicare-for-all type policy, individuals’ incentives to adopt healthier behaviors remain largely unchanged.

“Our results suggest that simply improving access to healthcare may not be enough to close the gap in life expectancy,” says Johanna Wallenius. “Differences in lifestyle choices and resources available for long-term investments in health are crucial factors that policy interventions must consider.”

The study shows that college graduates – who typically earn more – spend more time engaging in health-promoting activities like exercise and preventive care. Conversely, high school graduates are less likely to make these non-pecuniary investments, contributing to poorer long-term health outcomes. The researchers emphasize that promoting healthier lifestyles and early health interventions may be key to reducing the socioeconomic gap in life expectancy.

Key findings on health investments

• Despite being healthier, college graduates spend as much on healthcare as their less-educated counterparts but allocate more to preventive care.

• Time spent on exercise, doctor visits, and self-care is consistently higher among college graduates.

• Extending public health insurance to all individuals does not significantly close the life expectancy gap, as individuals do not automatically increase time spent on healthy behaviors.

“Addressing the gap requires a broader strategy that includes promoting preventive care and encouraging lifestyle changes, particularly among lower-income groups,” adds Wallenius.