You can be healthy even if you're poor
Exploring health at different income levels and strategies to optimize longevity
Top of the morning, sapien. Welcome to Common Sense Medicine, where I try and keep you up to date on the latest and greatest in longevity science.
This week, I’ve been thinking about how you can be healthy at different income levels. The idea came to me after watching a Ramit Sethi video on optimizing your finances no matter how much you make. It got me reflecting—I’ve heard a lot about social determinants of health and how income can impact healthcare, but I haven’t really explored what practical strategies people can use to stay healthy at both low and high income levels.
Outside of that, it’s been a solid week. I went to the gym, ate well, and felt like I was doing a better job overall. I didn’t hit the gym every day, but I’m reminding myself that it’s about consistency, not perfection. I’m wrapping up my current training program, and if all goes well, I’ll kick off half marathon prep by the end of April.
THE WEEKLY DOSE
There’s tiers to this
Your income has everything to do with your health—but not in the way you think.
Making $35K, $75K, or $100K+ requires completely different health strategies. Choose incorrectly, and you'll either waste money or miss out on the most impactful health upgrades available to you.
The biggest mistake people make isn't ignoring their health—it's not knowing how to maximize it given their income level. Here's the truth: How you should approach nutrition, fitness, and medical care varies dramatically based on your income bracket. Following strategies meant for a different financial tier leads to wasted resources or neglecting what matters most.
Let's break down the most effective health strategies for each income tier, focusing on four simple strategies: Nutrition, Fitness, Healthcare, and Mental Health.
TIER 1: The $35K Health Plan
If you're making around $35,000 a year, your take-home pay is roughly $2,500 per month. The biggest mistake in this bracket? Assuming good health is expensive and either overspending on unsustainable options or giving up entirely.
The truth is, the most effective health strategies at this level are actually the simplest.
Strategy #1: Master Budget Nutrition
Forget overpriced organic everything. Whole, minimally processed foods deliver the same nutritional benefits at a fraction of the cost. Follow this simple rule: If it had a face or grew from the ground, it's probably good for you.
Focus on beans, lentils, frozen vegetables, eggs, and canned fish. Buy in bulk and batch cook. Instead of expensive takeout or pre-packaged meals, meal prepping just twice a week can cut food costs and improve your diet instantly. Sites like Budget Bytes offer meals for less than $10.
Strategy #2: Exercise Without a Gym
Walking is free, bodyweight workouts require zero equipment. Resistance bands—one of the best home workout tools—cost less than $20, and thousands of free workout videos are available online.
With just $20, you can get resistance bands ($10-$20), a jump rope ($5), and access to free, high-quality workout channels like FitnessBlender on YouTube.
Focus on consistency over perfection, and you'll get results without an expensive fitness plan.
Strategy #3: Use the Healthcare System to Your Advantage
One of the biggest health risks at this income level? Avoiding doctors because of cost. Here are solutions:
Preventive Care: Many states offer free annual check-ups and vaccines. These preventative services should be covered for all adults without copayments. Always ask your physician what preventive services are covered.
Community Health Centers: Federally Qualified Health Centers (FQHCs) provide low-cost or free care and accept most health insurance. Locate one at HRSA.gov.
Generic Medications: Always ask your doctor for generic options—they're often 80-90% cheaper than brand-name drugs.
Medicaid Eligibility: Depending on your state, you might qualify for comprehensive coverage. Check your eligibility at Medicaid.gov.
Strategy #4: Budget-Friendly Mental Health
Take advantage of free meditation apps like Insight Timer and Smiling Mind. Make lifestyle changes such as maintaining a regular sleep schedule, taking nature walks, and nurturing social connections that have profound mental health benefits.
Free therapy alternatives are available through NAMI. At this income level, focus on stability and prevention.
Any time not spent on health should be invested in increasing your income to create a more stable foundation for healthcare. Unfortunately, optimizing health can be challenging at this income level.
TIER 2: The $75K health plan
At $75K, you have more options but still need to be strategic. The mistake in this bracket is thinking more money automatically means better health—often leading to wasted spending on trendy but ineffective options.
Strategy #1: Strategic Nutrition Upgrades
Now you can afford higher-quality protein sources and more organic produce when it matters. Consider time-saving options like healthy meal-prep services for busy weeks.
Make smart splurges: Focus on the "dirty dozen" for organic purchases (Strawberries, Spinach, Kale, Collard and Mustard Greens, Grapes, Peaches, Pears, Nectarines, Apples, Bell and Hot Peppers, Cherries, Blueberries, and Green Beans) but save on the "clean fifteen." Invest in nutrition tools like LoseIt or MacroFactor for tracking nutrients and kitchen gadgets that make healthy cooking easier. Consider affordable meal services like EveryPlate ($5 per meal).
Strategy #2: Effective Fitness Investments
Gym memberships can be worth it at this income level—if you actually use them. Group fitness classes provide both motivation and proper form guidance. Try Planet Fitness for a $10/month option, or consider building a simple but effective home gym for under $500.
Fitness technology like activity trackers can improve compliance with your exercise routine. Devices like Fitbit or Apple Watch enhance tracking and motivation.
Strategy #3: Optimizing Healthcare Access
Learn how to actually use your employer-sponsored health insurance effectively. Maximize HSA/FSA savings for significant tax benefits. Consider which additional preventive screenings are worth paying for beyond the basics. Invest in extra tests like cholesterol panels (i.e., Lp(a) and apoB) and vitamin D levels.
For medication management, explore mail-order pharmacies, prescription discount cards, and manufacturer assistance programs. Use GoodRx for significant medication savings.
Strategy #4: Mid-Range Mental Health Care
Digital options like therapy apps and online counseling offer professional help at reduced rates. Invest in evidence-based courses and workshops for self-improvement. Create boundaries and routines that support mental wellbeing.
BetterHelp or Talkspace offer affordable, professional mental health support. Programs like MindValley can support growth. Check if your insurance offers no-cost therapy options.
TIER 3: THE $100K+ HEALTH PLAN
At $100K+, your focus shifts from access to optimization. However, beware the trap of expensive 'wellness' treatments that have little evidence behind them.
Strategy #1: Personalized Nutrition
Now you can afford personalized meal plans based on your specific needs and goals. Opt for organic, local, and farm-to-table options that genuinely improve nutritional quality.
Consider testing & optimization through food sensitivity testing, metabolic analysis, and nutritional deficiency screening. Work with a registered dietitian or service like InsideTracker.
Strategy #2: Premium Fitness Solutions
Personal trainers who create customized programs can help you maximize your fitness results. Boutique fitness studios cater to specific goals or preferences. Advanced recovery techniques like sauna, cryotherapy, and massage therapy can improve performance and reduce injury risk.
Performance testing and biomechanical analysis can help identify and address potential issues before they become problems. Labs like DexaFit analyze body composition and metabolism, and you can also pay for a sports lab testing to find any imbalances in stability while exercising.
Strategy #3: Concierge Healthcare
Concierge medicine offers personalized attention and same-day appointments. Annual executive physicals and advanced preventive testing can catch issues early. Premium health insurance plus supplemental coverage can fill any gaps in care.
Healthcare advocates who can navigate complex medical systems can save you time and stress.
Strategy #4: High-End Mental Wellness
Regular sessions with top specialists can address specific mental health concerns. Executive coaching can help with performance and life optimization. Immersive experiences like wellness retreats and mindfulness programs offer deep reset opportunities. A lot of these aren’t available publically, but are found when you hit a high net worth.
Creating optimal living and working spaces designed for mental health can have ongoing benefits.
CONCLUSION
The right health strategy isn't about spending the most—it's about spending wisely for your income level. Regardless of income, consistency beats perfection, prevention beats treatment, and mindset beats everything.
Start where you are with what you have—even one small change in the right direction can significantly impact your health. No matter your income, investing in your health is the best decision you can make.
THE PRESCRIPTION
Q1 2025: Hypertrophy Cycle Progress
The upshot: I’m not too concerned about the downtrend. I think it’s just a carryover from last week, but I’m still staying consistent to myself. Let’s see if I can push up the weight over the next week. Still keeping myself honest.
REMEMBER, IT’S JUST COMMON SENSE.
Thanks so much for reading! Let me know what you thought by replying to this email.
See you next week,
Shree (@shree_nadkarni)