The United States is in the midst of a 40-year-long population health crisis. Life expectancy has declined since 2014, an unprecedented event that has followed on the heels of a decades-long slowing in secular gains in longevity in the US relative to peer countries. These adverse population health trends appear to be primarily driven by worsening health among working-age individuals of lower socioeconomic status.
A growing body of research suggests that worsening economic outcomes—e.g., fading employment opportunities and increasing economic insecurity—may be a primary causal driver of adverse health trends among low-income and less-educated working-age US residents.
Evidence-based public policies to address widening gaps in economic and health outcomes include expanding early childhood health and educational investments, increasing the scope of programs that assist displaced workers in developing new skills and finding new jobs, reinforcing the social safety net, and improving the reach of public health efforts to help moderate the health consequences of adverse economic shocks.
Policymakers will also need to consider and rigorously evaluate new approaches, such as basic income grants, investments to direct automation toward complementing rather than replacing the work force, or job guarantee programs.
The size and scope of the population health challenges that have arisen with the changing economy highlight the importance of new data sources and evidence-based engagement by policymakers.