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Rising Geographic Disparities in US Mortality

Rising Geographic Disparities in US Mortality AbstractThe twenty-first century has been a period of rising inequality in both income and health. In this paper, we find that geographic inequality in mortality for midlife Americans increased by about 70 percent between 1992 and 2016. This was not simply because states like New York or California benefited from having a high fraction of college-educated residents who enjoyed the largest health gains during the last several decades. Nor was higher dispersion in mortality caused entirely by the increasing importance of “deaths of despair,” or by rising spatial income inequality during the same period. Instead, over time, state-level mortality has become increasingly correlated with state-level income; in 1992, income explained only 3 percent of mortality inequality, but by 2016, state-level income explained 58 percent. These mortality patterns are consistent with the view that high-income states in 1992 were better able to enact public health strategies and adopt behaviors that, over the next quarter-century, resulted in pronounced relative declines in mortality. The substantial longevity gains in high-income states led to greater cross-state inequality in mortality. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Journal of Economic Perspectives American Economic Association

Rising Geographic Disparities in US Mortality

Journal of Economic Perspectives—Volume 35, Number 4—Fall 2021—Pages 123–146 Rising Geographic Disparities in US Mortality Benjamin K. Couillard, Christopher L. Foote, Kavish Gandhi, Ellen Meara, and Jonathan Skinner ntil ntil recently recently, , Americans Americans could could expect expect to to live live longer longer than than their their parents. parents. Overall Overall US life expectancy US life expectancy rose steadily rose steadily from the from the 1960s 1960s through through the early the early U U 2000s. As 2000s. As Figure 1 Figure 1 shows, the 1.5-year shows, the 1.5-year drop in life expectancy in 2020 drop in life expectancy in 2020 signaled a sharp reversal; indeed, it was the largest decline since W signaled a sharp reversal; indeed, it was the largest decline since World W orld War II. ar II. But even before the Covid-19 pandemic, US life expectancy was essentially flat for But even before the Covid-19 pandemic, US life expectancy was essentially flat for about a decade and had even declined slightly after 2014. Public health officials and about a decade and had even declined slightly after 2014. Public health officials and health researchers have become increasingly concerned about this plateau, and, as health researchers have become increasingly concerned about this plateau, and, as they studied it, another important fact has emerged: disparities in mortality have they studied it, another important fact has emerged: disparities in mortality have become increasingly apparent among different groups in the population. become increasingly apparent among different groups in the population. Much of the recent research on life expectancy focuses on particularly worri- some mortality trends for persons at midlife, defined as ages 25–64. A recent report from the National Academy of Sciences, Engineering, and Medicine (2021) reviews this work and links high and rising midlife mortality rates to two main factors. First,...
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References (64)

Publisher
American Economic Association
Copyright
Copyright © 2021 © American Economic Association
ISSN
0895-3309
DOI
10.1257/jep.35.4.123
Publisher site
See Article on Publisher Site

Abstract

AbstractThe twenty-first century has been a period of rising inequality in both income and health. In this paper, we find that geographic inequality in mortality for midlife Americans increased by about 70 percent between 1992 and 2016. This was not simply because states like New York or California benefited from having a high fraction of college-educated residents who enjoyed the largest health gains during the last several decades. Nor was higher dispersion in mortality caused entirely by the increasing importance of “deaths of despair,” or by rising spatial income inequality during the same period. Instead, over time, state-level mortality has become increasingly correlated with state-level income; in 1992, income explained only 3 percent of mortality inequality, but by 2016, state-level income explained 58 percent. These mortality patterns are consistent with the view that high-income states in 1992 were better able to enact public health strategies and adopt behaviors that, over the next quarter-century, resulted in pronounced relative declines in mortality. The substantial longevity gains in high-income states led to greater cross-state inequality in mortality.

Journal

Journal of Economic PerspectivesAmerican Economic Association

Published: Nov 1, 2021

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