The Death Gap

There’s no injustice more frightening – more definitive, more irredeemable – than inequality of life expectancy: a form of discrimination whereby years, sometimes decades, are stolen from the majority and given to a select few, based solely on their wealth and social class.

Indeed, the most important form of ‘social distance’ imposed by the pandemic was not spatial, not a matter of meters. It was the temporal distance between rich and poor, between those who could escape the worst effects of the virus and those whose lives were abbreviated by it. Modernity established a biopolitical chasm – a social distancing of death – that was widened and accentuated by the Covid-19 crisis. This was demonstrated by a litany of studies across various countries. For instance:

In this retrospective analysis of 1,988,606 deaths in California during 2015 to 2021, life expectancy declined from 81.40 years in 2019 to 79.20 years in 2020 and 78.37 years in 2021. Life expectancy differences between the census tracts in the highest and lowest income percentiles increased from 11.52 years in 2019 to 14.67 years in 2020 and 15.51 years in 2021.

Many political and scientific discussions are rooted in calculations of life expectancy at birth. But though this criterion holds for modern Western societies, where infant mortality is almost irrelevant, it is misleading when applied to other geographical regions or historical periods. If the average lifetime lasts 70 years, to compensate for every infant death another seven people must live to 80. This is why life expectancy is often calculated at age 40 or 50: a historically more reliable indicator in its exclusion of infant mortality, as well as war deaths, car accidents (more frequent amongst young people) and maternal fatalities in childbirth.

Here is life expectancy at 40 against household income in the United States, as outlined in a study published by The Harvard Gazette in 2016:

As you can see, the gap between the richest and poorest 1% is just over 10 years for women and 15 years for men: ‘roughly equivalent to the life expectancy difference between the United States and Sudan. For women, the 10-year difference between richest and poorest is equivalent to the health effects from a lifetime of smoking’.

Another notable phenomenon, to which we’ll return later, is the fact that the graph never flattens, regardless of one’s income level:

While researchers have long known that life expectancy increases with income, Cutler and others were surprised to find that trend never plateaued: “There’s no income [above] which higher income is not associated with greater longevity, and there’s no income below which less income is not associated with lower survival”, he said. “It was already known that life expectancy increased with income, so we’re not the first to show that, but…everyone thought you had to hit a plateau at some point, or that it would plateau at the bottom, but that’s not the case.”

The difference between the lifespans of different classes wasn’t always so abyssal. It has increased progressively in recent centuries, such that it has now become a constant of modern civilization. The gulf is plainly visible in the below graph, which shows life expectancy at 65 for male workers, divided into categories of higher and lower-earners:

We can see how, in 1912, poorer workers could expect to live to just under 80, while their wealthier counterparts could expect to live to just over that. In 1941, the margin dilates: the former could expect to live around a year longer than in 1921, while the latter gained a full six years (average life expectancy increases with the age at which it is calculated: at 30 it’s higher than at birth, at 50 it’s longer than at 30, and at 65 it’s even longer, because at every step you discount all deaths that occurred prior to that age and contributed to the original average. This is why, in 1912, the life expectancy of the poorer half of 65-year-olds almost reached 80, whereas life expectancy at birth was only 55).

The picture is even more stark if you divide society not into two, but into five different income classes. These graphs, taken from a Congressional study in 2006, show the average life expectancy growing massively for the richest quintile (20% of the population) and rising meagrely for the poorest:

A closer look gives us an astonishing picture. For males in the lowest income quintile, those born in 1930 could expect to live 26.6 years at age 50, while those born in 1960, after World War II, could expect to live 26.1 years: counterintuitively half a year less! The phenomenon was even more pronounced for the poorest women: those born in 1930 at the age of 50 had an average of 32.3 years ahead of them, while those of the next generation had 28.3: almost four years less life: while life in general was getting longer, for the poorest women it was getting shorter, and by quite a lot.

The music changes for the highest income quintile: those born in 1960 can expect to live 38.8 years (i.e. to reach 88 years and nine months), a full 7.1 years longer than their predecessors born in 1930 who had a life expectancy of 31.7 years. The same trend is true for rich women born in 1960 who can expect to live 41.9 years (i.e. to 91 years and 10 months), more than rich women born thirty years earlier whose life expectancy was 36.2 years, i.e. 5.7 years less: between the two generations, while for poor women life expectancy shortens, for rich women it lengthens.

In the thirty years between 1930 and 1960, the income gap had thus widened frighteningly. Whereas among men born in 1930 the richest lived 5.1 years longer than their poorest peers, for the generation born in 1960 the gap had widened to an astonishing 12.7 years. The gap among women was even more pronounced: whereas for the 1930 generation the richest could hope to live 4.0 years longer than their poorer peers, for the 1960 generation the gap had widened to 13.6 years.

Since we the segmented data on household income to extend this analysis further back in time, we must make do with a few scattered clues. If we take the dynasties of Italian nobles during the Renaissance (the Estes, Gonzagas, Medicis), we find that princes were generally outlived by their artists, chancellors and courtiers. This is understandable. Without truly effective medical sciences and developed systems of hygiene (such as sewers and running water), there was no reason for the rich to live longer than the poor – and there is a strong indication that their habits (overeating, alcohol consumption) made them more fragile.

The first great fractures occurred precisely with the introduction of sewage systems and running water, which sanitized the homes of the rich, where they were first installed. Child mortality eased first amongst the more comfortable classes. Dietetics taught the wealthy to better nourish themselves and do more exercise (hence the diffusion of sport: physical exertion whose end was neither profit nor sustenance). And then, naturally, the gap widened even further with the medical advances of the twentieth century. Modern medicine – especially when privatized and dependant on discriminatory insurance regimes – became an accelerator of inequality.

We are now living the world described by Rousseau, where inequality is created and then sharpened by civilization:

the origin of society and law, which bound new fetters on the poor, and gave new powers to the rich; which irretrievably destroyed natural liberty, eternally fixed the law of property and inequality, converted clever usurpation into unalterable right, and, for the advantage of a few ambitious individuals, subjected all mankind to perpetual labour, slavery and wretchedness.

The arts and sciences – ‘progress’, in other words – does nothing but exacerbate inequality and the struggle for property. Immiseration for the poor, fortification for the rich. How could this fail to lengthen the life of the powerful and shorten (relatively speaking) that of their subjects?

Of course, if inequalities in life continue to multiply year-on-year, one would expect the same of inequalities in death. The aforementioned researchers at Harvard were shocked by the fact that in the US, the life expectancy/income gap didn’t seem to plateau, neither at the top nor the bottom of the scale. In France, however, the curve flattens, as shown by this graph:

There, as in the USA, data for life expectancy at birth presents a marked gap between classes: a difference of almost 13 years for men and over 8 for women. But unlike in the US, the curve slows rapidly, almost plateauing over the threshold of €2,500 per month in net income (after taxes and social security). Gross income is usually around double this figure, so it’s at the threshold of €60,000 per year that we see this change, with the line becoming almost horizontal above a monthly net income of €3,500.

The only possible explanation seems to lie in the fact that the French public health system is easier to navigate the higher one’s level of education (with all the income and lifestyle differentials that implies):

Here, too, the curve flattens visibly above the €2,000 mark (we can assume that few of those who earn a yearly income of €60,000 don’t possess at least a secondary school diploma). This is despite the fact that there is an increasing gap between those with an undergraduate degree and those without a diploma (a difference of a little under three years for the same income group of under €1,000 per month, and nearly four and a half at net income of €3,500). In short, studying earns you almost three years of life. Perhaps if children were told this they would strive for better grades.

Until now we’ve discussed life in quantitative rather than qualitative terms. But what kind of life are we talking about? In the UK, researchers have developed separate metrics for life expectancy (lifespan) and the expected length of a healthy life (healthspan). Here are their findings:

‘Heathy life experience’, they conclude,

has also increased over time, but not as much as life expectancy, so more years are spent in poor health. Although a male in England could expect to live 79.4 years in 2018-20, his average healthy life expectancy was only 63.1 years – ie, he would have spent 16.3 of those years (20%) in ‘no good’ health.  In 2018–20 a female in England could expect to live 83.1 years, of which 19.3 years (23 per cent) would have been spent in ‘not good’ health. And although females live an average of 3.7 years longer than males, most of that time (3 years) is spent in poor health.

Not only do the poor live shorter lives than the rich (around 74 years versus 84 for men; 79 and 86 for women). Of this shorter existence, a larger part is lived in weakness and infirmity (for men, 26.6 years compared to 14; for women, 26.4 years compared to 15.8). The result is that the poor enjoy 18 fewer healthy years.

In an effort to extend the length of life, then, we’ve prolonged the length of death. The masters of the earth – those whose fortunes exceed the GDP of several nation states – have clearly realized this. Mark O’Connell’s To Be a Machine (2017) documents the frantic, infantile fantasies of these Lords of the Cosmos, who strive to achieve immortality through financing both the development of cryopreservation projects such as Alcor Life Extension Foundation, ‘where clients sign up to be frozen on dying in the hope not just of resuscitation but rejuvenation’ – as well as research into technology that would allow one to download one’s brain onto a hard disk or a cloud, so as to reincarnate, perhaps even as a computer, with all one’s memory intact.

In the absence of such technological breakthroughs, though, the masters of the universe have now dedicated considerable resources to realizing the more mundane aim of extending their lives by a few years, or perhaps a few decades. Since 2013, Jeff Bezos, Larry Page & co. have been investing in businesses developing anti-aging pharmaceuticals:

With just two short sentences posted on his personal blog in September 2013, Google co-founder Larry Page unveiled Calico, a ‘health and wellbeing company’ focused on tackling ageing. Almost a year earlier he had persuaded Arthur Levinson, the driving force behind the biotech giant Genentech and chairman of Apple, to oversee the new business and lined up $1.5bn in funding pledges – half from Google, the balance from AbbVie, the pharmaceutical company.

In 2022 the venture capital firm Arc Venture Partner, Jeff Bezos and another billionaire Yuri Milner, invested $3 billion in Altos Lab, whose self-declared mission is to ‘restore cell health and resilience through cellular rejuvenation programming to reverse disease, injury, and the disabilities that can occur throughout life’. The billionaires of Silicon Valley believe their money can enable them not only to live longer, but to live well, while preserving the prospect of immortality for their offspring.

Once this is achieved, they will finally have a rejoinder to Max Weber’s famous remark in The Protestant Ethic and the Spirit of Capitalism (1905). To the pre-capitalist subject, he writes,

that anyone should be able to make it the sole purpose of his life-work, to sink into the grave weighed down with a great material load of money and goods, seems explicable only as the product of a perverse instinct, the auri sacra fames.

To this, the lords of the universe will reply: ‘There is no grave we will sink into!’

Translated by Francesco Anselmetti

Read on: Marco D’Eramo, ‘Celebrity Thaumaturge’, NLR 74.