The purpose of this survey was to better understand the different experiences of Americans across all income groups.
While income inequality increases, a survey done by NPR, the Harvard T.H. Chan School of Public Health and the Robert Wood Johnson Foundation finds that the life experiences of Americans differ drastically across income groups.
Life Experiences and Income Inequality in the United States explores the hardships of affording basic needs, but also Americans’ outlook on future economic opportunity. While many middle- and lower-income individuals struggle with financial setbacks, affording health care, and are discontent with their financial situation, they believe that current financial status does not determine future economic success.
Ninety-three percent of the top 1 percent highest-income adults, 89 percent of middle-income adults, and 87 percent of lower-income adults believe that hard work is the most important factor to achieve economic success in America.
Only 8 percent of adults with the top 1 percent highest incomes say their families have experienced serious problems paying for medical bills, dental bills, or prescription drugs in the past few years; nearly half of middle-income adults and a majority of lower-income adults say this.
Twenty-seven percent of the top 1 percent believe it should be a very important priority for government to reduce income differences between people with high incomes and those with lower income, compared to the forty-two percent of lower-income adults who share this view.
Eighty percent of the top 1 percent highest income adults believe that their children or grandchildren will achieve the American Dream compared to 78 percent of middle-income adults and 70 percent of lower-income adults.
The purpose of the Life Experiences and Income Inequality in the United States was to better understand the different experiences of Americans across all income groups.
Affordability of Health Care
A major outcome of this survey was that Americans across income groups have drastically different experiences with health care. Seven in 10 Americans across all income categories believe having a higher income allows people to get better health care. Medical bill debt burdens those with lower incomes. Fifty-seven percent of low-income adults and 48 percent of middle-income adults report serious problems paying medical bills, compared to 8 percent of adults in the top income tier. Additionally, nearly half of the top 1 percent and more than half of lower-income adults say it is unfair that people with higher incomes can get better health care. In fact, a majority across all income groups say it should be a priority for the government to make health insurance available to everyone living in the United States.
Food Insecurity and Unaffordable Housing
Reliable housing and food are a challenge for many Americans due to financial constraints. Housing is unaffordable for many; more than one-third (35%) of lower-income adults and more than one in five (22%) of middle-income adults report serious problems finding an affordable place to live compared to 4 percent of the highest earners. In addition, 24 percent of low-income adults and 19 percent of middle-income adults struggle with rent/housing payments, compared to top earners. Moreover, food insecurity is a serious problem; three in 10 low-income adults (30%) and 13 percent of middle-income adults say they face “serious problems” paying for food compared to less than 1 percent of the highest earners.
Overall, these findings illustrate that adults in the top 1 percent highest income bracket have dramatically different life experiences than those with middle- and lower-incomes when it comes to financial problems, health care, life satisfaction, and problems with prescription drug costs. These findings also raise important concerns about the American middle-class as they find it difficult to pay off unforeseen expenses and afford health care bills. While the majority of Americans believe that economic success is achievable, the current income gap makes it challenging to meet basic needs to attain the American dream and a healthy life for many.
About the survey
Researchers surveyed adults from July 17–August 19, 2019, among a nationally representative, probability-based telephone sample of 1,995 adults ages 18 or older living in the United States. The surveyed adults are split into four income categories: those in the top 1 percent highest income households (earning at least $500,000/year), those in higher-income households (earning $100,000–$499,999/year), those in middle-income households (earning $35,000–$99,999/year), and those in lower-income households (earning less than $35,000/year). Due to heterogeneity of incomes in the higher income category, analyses in this report focus on differences between the top 1 percent highest income adults compared to middle- and lower-income adults, though results are included for all income groups.
Experts Discuss Life Experiences and Income Inequality in the U.S.
On January 27, 2020, an online Forum at Harvard School of Public Health brought together a panel of experts to discuss findings from the 2020 Life Experiences and Income Inequality in the United States survey conducted in collaboration with NPR and RWJF.
Achieving Health Equity
As health disparities in the United States continue to grow, RWJF provides resources, data, and examples of communities working to achieve better health for all.