Scurvy in the Age of Billionaires

Once banished to history books, scurvy is making a comeback in wealthy countries thanks to soaring economic inequality. While the rich swim in spirulina kombucha and kale smoothies, the poor are skipping out on oranges and broccoli.

In the United States, scurvy rates among children have more than tripled in recent years, from 8.2 per 100,000 people in 2016 to 26.7 per 100,000 in 2020. (William West / AFP via Getty Images)

Scurvy, a disease often associated with eighteenth-century seafarers, is making a resurgence in the United States, Canada, and the United Kingdom. Medical research has identified a clear culprit: growing economic inequality.

Scurvy results from a deficiency in vitamin C deficiency, which is found in fruits and vegetables, specifically citrus fruits like oranges, lemons and grapefruit, as well as cruciferous vegetables such as broccoli, brussels sprouts, and spinach. In the United States, scurvy rates among children have more than tripled in recent years, from 8.2 per 100,000 people in 2016 to 26.7 per 100,000 in 2020, according to a July 2024 study in the Journal of the American Academy of Orthopaedic Surgeons, which analyzed data from over 19 million pediatric patients.

The study found that 36.5 percent of pediatric patients with scurvy were from the lowest income quartile, compared to 29.2 percent of the pediatric population. Similarly, 56.5 percent of patients with scurvy were on Medicaid, compared to 48.3 of all inpatients.

A 2008 study in the Journal of Health found that poor vitamin C levels are common among “materially deprived” adults in the UK, with 25 percent of men and 16 percent of women in lower socioeconomic groups suffering from Vitamin C deficiency.

The Wealth Gap Health Crisis

Pointing to a broader trend of food insecurity among scurvy patients, the 2024 US survey found that more than half also suffered from vitamin D deficiency, which is attributable in part to a lack of protein-rich foods, including egg yolks, mushrooms and certain types of fish. Another key source of vitamin D is sunlight, which people who work multiple jobs to pay their bills are naturally less likely to receive.

The problems resulting from food insecurity are not limited to scurvy. Dr. Andrew Boozary, a primary care physician at the University of Toronto’s Dalla Lana School of Public Health, told the CBC that food insecurity is a risk factor for many chronic illnesses, including cardiovascular disease and mental health issues.

“There is a real continuum of serious health conditions that food insecurity really exacerbates,” Boozary said in an interview with the public broadcaster.

Statistics Canada data released in May 2024 shows that food insecurity, which ranges from compromising on food quality to reducing food consumption to save money, is on the rise. In 2021, 12.9 percent of Canadian households were identified as food insecure. By 2022, a year when only 9.9 percent of Canadians were identified as living in poverty, that figure was 16.9 percent, meaning food insecurity is increasingly a middle-class problem.

A separate StatsCan report found that economic inequality in Canada has reached its highest-recorded level. The 20 percent of Canadians, earning on average $2.47 million USD per household, own two-thirds of the country’s wealth. Meanwhile, the bottom 40 percent of Canadians collectively own just 2.8 percent of Canada’s wealth.

When asked about this by a CBC reporter, Finance Minister Chrystia Freeland acknowledged a “tendency in the global economy towards more inequality,” but vowed to stay the course “with very specific policies designed to support middle-class Canadians and people working hard to join the middle class.”

Income Inequality Kills

Freeland, who was a journalist before she entered politics, wrote the 2012 book Plutocrats: The Rise of the New Global Super-Rich and the Fall of Everyone Else. The volume contained surprisingly positive assessments of the super-rich alongside a tepid ask for them to pay slightly more in income taxes to reduce inequality. Evidently, this approach hasn’t worked.

While the Liberals initially reduced poverty from 14.5 percent in 2015 to 6.4 percent in 2020, that number crept back up during the COVID-19 pandemic. And merely being above the poverty line now offers little relief as food and housing prices continue to soar.

The average life expectancy in Canada’s largest city, Toronto, where Freeland’s electoral district is located, is 80.9 years. However, analysis by Tai Huynh in The Local, a Toronto-based publication, reveals stark disparities in life expectancy depending on neighborhood, often correlated to income.

In affluent neighborhoods, like Bridle Path (home to Drake’s mansion), Bayview Village, and Willowdale, life expectancy exceeds eighty-four years, surpassing even Japan, the country with the highest life expectancy in the world.

“Meanwhile,” Huynh points out, “in less affluent parts of the city, such as Rexdale, Oakridge, and Moss Park, death comes more than a decade earlier — on par with countries like Tunisia and Nicaragua.” This trend is by no means unique to Toronto or even Canada. In 2015, researchers from Virginia Commonwealth University and the Robert Wood Johnson Foundation found similar life expectancy disparities across neighborhoods in New York, Chicago, Atlanta, and Richmond, Virginia.

Poverty Kills More Than Tobacco

A study published in the American Journal of Preventive Medicine analyzed data from 86,000 participants aged forty to seventy-nine recruited across twelve southeastern US states between 2002 and 2009. By the time the researchers conducted their analysis from February 2022 to January 2023, 19,749 of those participants had died.

The report, published in May 2024, revealed that participants earning less than $15,000 a year were 3.3 times more likely to have died than those who earned more than $50,000 a year. The study also found that life expectancy among the low-income group was shorter by an average of a decade.

“Tobacco smoking is the leading cause of death in the US. However, we found that in this low-income population excess risk of death due to poverty is greater in magnitude than tobacco smoking,” said epidemiologist Dr Wei Zheng, one of the study’s authors.

The study found that poor people who, despite their constraints, lived a healthy lifestyle were less likely to die than rich people who were unhealthy. However, it ultimately concluded that “efforts to improve income equality are crucial in reducing mortality and health disparities among low-income Americans.”

While biological and behavioral factors contribute to death, poverty is its great accelerant. People can’t be expected to make healthy lifestyle choices that will prolong their time on Earth when they’re forced to choose between food and rent.

Instead of offering milquetoast fixes while the rich continue to grow richer — an approach favored by the Democrats in the United States, Labour in the UK, and the Liberals in Canada — left-wing parties and leaders must confront the reality that economic inequality is quite literally killing us.

Once the scale of the problem is acknowledged, there can be democratic deliberation about how to approach solving it. Otherwise, there’s a very real risk of empowering right-wing demagogues who recognize and acknowledge that the system is broken, but will implement “solutions” that will only make the crisis worse.