America: equity and equality in health

Lancet_CoverThe Lancet devotes special issue to growing U.S. health inequality

Leading British medical journal The Lancet has published a series of papers exploring persistent and growing health inequality in the United States. The series was published in the April 8, 2017 issue of The Lancet, and was curated by PNHP co-founders Drs. David Himmelstein and Steffie Woolhandler, along with Dr. Samuel Dickman.

"America: equity and equality in health" explores the effects of racial segregation, mass incarceration, economic inequality, and a lack of universal health care in the U.S. It comes at an important time in the national health care debate, as policymakers are grappling with the failure of the GOP "repeal and replace" bill, the American Health Care Act, and citizens are demanding a better health care system; one that addresses the gaps that remain after implementation of the Affordable Care Act.

Below, you can access links to the series papers; various interviews and events; national media coverage of the series; and an extensive infographic.

To read PNHP's news release on the series, click here. The full series can be accessed for free (registration required) at


Series Papers

Paper 1: Inequality and the health-care system in the USA
By Samuel L. Dickman, M.D., David U. Himmelstein, M.D., and Steffie Woolhandler, M.D., M.P.H.

Paper 2: The Affordable Care Act: implication for health-care equity
By Adam Gaffney, M.D. and Danny McCormick, M.D.

Paper 3: Structural racism and health inequities in the USA: evidence and interventions

By Zinzi D. Bailey, Sc.D., Nancy Krieger, Ph.D., Madina Agénor, Sc.D., Jasmine Graves, M.P.H., Natalia Linos, Sc.D., and Mary T. Bassett, M.D.

Paper 4: Mass incarceration, public health, and widening inequality in the USA

By Christopher Wildeman, Ph.D. and Emily A. Wang, M.D.

Paper 5: Population health in an era of rising income inequality in the USA: 1980-2015
By Jacob Bor, Sc.D., Gregory H. Cohen, M.Phil., and Sandro Galea, M.D.

Editorial: America, all things not being equal
By The Lancet

Comment: An agenda to fight inequality
By Sen. Bernie Sanders


Interviews & Events

Lancet Podcast: America, equity and equality in health
Interview with David Himmelstein, M.D. and Steffie Woolhandler, M.D., M.P.H.

Lancet Podcast: America, equity and equality in health
Interview with Samuel L. Dickman, M.D.

Symposium: Income Inequality and Health in America
Boston University School of Medicine, April 10, 2017
Panel featuring Zinzi D. Bailey, Sc.D., Jacob Bor, Sc.D., Samuel L. Dickman, M.D., Adam Gaffney, M.D., and Steffie Woolhandler, M.D., M.P.H.

Symposium: Inequality and Health in the U.S.
Harvard Medical School, April 24, 2017
Panel featuring Adam Gaffney, M.D., Samuel L. Dickman, M.D., Jacob Bor, Sc.D., Christopher Wildeman, Ph.D., and Mary T. Bassett, M.D., M.P.H. Panel moderated by Joan Reede, Harvard Medical School. Virtual welcome and remarks by Sen. Elizabeth Warren.

Symposium: Equity and Equality in Health
Roosevelt House, Public Policy Institute at Hunter College, May 1, 2017
Program featuring Mary T. Bassett, M.D., M.P.H., Paul Krugman, Ph.D., and David Himmelstein, M.D. Discussion moderated by Lilliam Barrios-Paoli, Ph.D.


Media Coverage

Inequality is a life and death matter
By Steffie Woolhandler, M.D., M.P.H. and David Himmelstein, M.D.

HuffPost, May 8, 2017
The Republican effort to gut the Affordable Care Act threatens a health care catastrophe. But blocking a backward move isn’t enough. The overall U.S. death rate is rising. The survival gap between rich and poor is widening. Continue reading...

The cost of economic inequality to the nation’s physical health
By Jacob Bor, Sc.D. and Sandro Galea, M.D.
The Boston Globe, April 25, 2017
After its unsuccessful push to reconfigure the U.S. health care system, the Trump administration has signaled that it will turn its attention to tax reform. While the details of the administration’s plan are still unclear, President Trump has indicated in the past a willingness to embrace measures that would greatly favor the wealthy. Continue reading...

Rich Americans live up to 15 years longer than poor peers, studies find
By Jessica Glenza
The Guardian, April 6, 2017
You can’t buy time – except, it seems, in America. Increasing inequality means wealthy Americans can now expect to live up to 15 years longer than their poor counterparts, reports in the British medical journal the Lancet have found. Continue reading...

Rich Americans Live 15 Years Longer Than Poor Counterparts: Study
By Anthony Cuthbertson

Newsweek, April 7, 2017
Wealth and health are intrinsically linked in the United States, with rich Americans living between 10 to 15 years longer than their poor counterparts, a study has found. A series of five papers published in the medical journal The Lancet found that a widening income gap, structural racism and mass incarceration are fueling growing health inequalities. Continue reading...

The Richest Americans Live 10 Years Longer than the Poorest
By Alice Park

Time Magazine, April 6, 2017
Money may not buy you happiness, but it may help buy you health, and ultimately a longer life. Researchers analyzing data on income disparities and health outcomes in the U.S. found that health gaps between the rich and poor are widening, and that’s translating to bigger differences in how long people live. Continue reading...

Want to Live Longer? Be Rich
By Jesse Singal

New York Magazine, April 7, 2017
You probably already know that health care in the United States is a bit of a disaster. That’s one of the primary reasons a single piece of bad luck can be ruinous for so many Americans. Continue reading...

Three Insights About Inequality in American Health Care
By Jesse Singal

New York Magazine, April 11, 2017
Lately, it has felt like the debate over Obamacare has masked some of the bigger questions swirling around the U.S. health system. Obamacare is important, yes, but America’s issues on this front run much, much deeper than the presence or absence of that one law. Continue reading...

What we know about the 30 million Americans who are still uninsured
By Julia Belluz

Vox, April 7, 2017
The size of the uninsured group is well-known, but less clear is what this group looks like. A new series in the Lancet on health inequality paints a pretty good picture. People who go without insurance in America are not refusing coverage for ideological reasons: They simply can’t afford to pay. Continue reading...

Lancet series puts spotlight on health inequity in the U.S.

By Paige Minemyer
Fierce Healthcare, April 7, 2017
Societal issues in the U.S., including systemic racism, poverty and mass incarceration, contribute to health inequity, a new series of studies has found. The Lancet released a five-part look at health inequity in the U.S., titled the “United States of Health." Continue reading...

You Can Thank Racism, Mass Incarceration, and Our Health System for the Survival Gap Between the Rich and Poor
By Nick Keppler

Vice News, April 11, 2017
The United States' for-profit healthcare system not only fails miserably to offer the same life-extending treatments to the poor as it does the rich, but it also reinforces racial and socioeconomic disparities, according to a wide-ranging five-part series published in the medical journal The Lancet. Continue reading...

The Prison-Health Paradox
By Olga Khazan

The Atlantic, April 7, 2017
A recent review of the impacts of incarceration on health published Thursday in The Lancet hints at a surprising upshot: Getting out of jail can be miserable, but going to jail can temporarily protect health—at least for some men. Continue reading...

When a man goes to prison, his children’s health suffers, too, study finds
By Max Blau

STAT, April 6, 2017
Researchers found that children of incarcerated men have higher rates of asthma, obesity, substance misuse, and behavioral and mental health problems. And the impact can linger for years, even into their adulthood. Continue reading...

Children Of Incarcerated Fathers Often Suffer Health Issues That Can Last Through Adulthood
By Cameron Norsworthy

Romper, April 6, 2017
Incarceration affects families emotionally and socially, and new research shows that there are long-lasting physical complications as well. According to a recent study, the children of incarcerated fathers often suffer health issues to intense degrees, and these health issues are often chronic conditions that can last all the way through adulthood. Continue reading...

Rich black people have worse health than rich white people
By Jessica Hamzelou
New Scientist, April 6, 2017
America’s health is in poor shape. The health gap between the rich and poor is now far bigger than the difference in income – that’s one of the messages from a series of papers published in The Lancet today. But wealth is only part of the problem. Continue reading...

Senator Bernie Sanders' Health Policy Advisors on Causes and Solutions to Healthcare Inequality in America
By Tori Rodriguez, M.A., L.P.C.
Clinical Pain Advisor, December 4, 2017
Income inequality in the United States has increased steadily in recent years, and is now at its highest level since the 1920s. Mexico, Chile, and Turkey are the only members of the Organization for Economic Cooperation and Development (OECD) with higher levels of income inequality. Continue reading...