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Mortality Inequality: The Good News from a County-Level Approach

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  • Janet Currie
  • Hannes Schwandt

Abstract

In this essay, we ask whether the distributions of life expectancy and mortality have become generally more unequal, as many seem to believe, and we report some good news. Focusing on groups of counties ranked by their poverty rates, we show that gains in life expectancy at birth have actually been relatively equally distributed between rich and poor areas. Analysts who have concluded that inequality in life expectancy is increasing have generally focused on life expectancy at age 40 to 50. This observation suggests that it is important to examine trends in mortality for younger and older ages separately. Turning to an analysis of age-specific mortality rates, we show that among adults age 50 and over, mortality has declined more quickly in richer areas than in poorer ones, resulting in increased inequality in mortality. This finding is consistent with previous research on the subject. However, among children, mortality has been falling more quickly in poorer areas with the result that inequality in mortality has fallen substantially over time. We also show that there have been stunning declines in mortality rates for African Americans between 1990 and 2010, especially for black men. Finally we offer some hypotheses about causes for the results we see, including a discussion of differential smoking patterns by age and socioeconomic status.

Suggested Citation

  • Janet Currie & Hannes Schwandt, 2016. "Mortality Inequality: The Good News from a County-Level Approach," Journal of Economic Perspectives, American Economic Association, vol. 30(2), pages 29-52, Spring.
  • Handle: RePEc:aea:jecper:v:30:y:2016:i:2:p:29-52
    Note: DOI: 10.1257/jep.30.2.29
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    References listed on IDEAS

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    Blog mentions

    As found by EconAcademics.org, the blog aggregator for Economics research:
    1. Sam Watson’s journal round-up for 18th July 2016
      by Sam Watson in The Academic Health Economists' Blog on 2016-07-18 16:00:27

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    Cited by:

    1. Michele Fioretti & Hongming Wang, 2019. "Subsidizing Inequality: Performance Pay and Risk Selection in Medicare," Sciences Po Economics Discussion Papers 2019-15, Sciences Po Departement of Economics.
    2. Chorniy, Anna & Currie, Janet & Sonchak, Lyudmyla, 2018. "Exploding asthma and ADHD caseloads: The role of medicaid managed care," Journal of Health Economics, Elsevier, vol. 60(C), pages 1-15.
    3. Nicolas Berman & Lorenzo Rotunno & Roberta Ziparo, 2020. "Sweet child of mine: Parental income, child health and inequality," Working Papers halshs-02499192, HAL.
    4. Haan, Peter & Kemptner, Daniel & Lüthen, Holger, 2017. "The Rising Longevity Gap by Lifetime Earnings: Distributional Implications for the Pension System," IZA Discussion Papers 11121, Institute of Labor Economics (IZA).
    5. repec:bin:bpeajo:v:49:y:2019:i:2018-01:p:89-150 is not listed on IDEAS
    6. repec:cpr:ceprdp:14444 is not listed on IDEAS
    7. Olivia S. Mitchell, 2018. "Enhancing risk management for an aging world," The Geneva Papers on Risk and Insurance Theory, Springer;International Association for the Study of Insurance Economics (The Geneva Association), vol. 43(2), pages 115-136, September.
    8. Hilary W. Hoynes & Diane Whitmore Schanzenbach, 2018. "Safety Nets Investments in Children," Brookings Papers on Economic Activity, Economic Studies Program, The Brookings Institution, vol. 49(1 (Spring), pages 89-150.
    9. Dow, Wiiliam H & Godoey, Anna & Lowenstein, Christopher A & Reich, Michael, 2019. "Can Economic Policies Reduce Deaths of Despair? Working Paper #104-19," Institute for Research on Labor and Employment, Working Paper Series qt14f015df, Institute of Industrial Relations, UC Berkeley.
    10. Alan J. Auerbach & Kerwin K. Charles & Courtney C. Coile & William Gale & Dana Goldman & Ronald Lee & Charles M. Lucas & Peter R. Orszag & Louise M. Sheiner & Bryan Tysinger & David N. Weil & Justin W, 2017. "How the Growing Gap in Life Expectancy May Affect Retirement Benefits and Reforms," The Geneva Papers on Risk and Insurance - Issues and Practice, Palgrave Macmillan;The Geneva Association, vol. 42(3), pages 475-499, July.
    11. Marcella Alsan & Marianne Wanamaker, 2018. "Tuskegee and the Health of Black Men," The Quarterly Journal of Economics, Oxford University Press, vol. 133(1), pages 407-455.
    12. Schlee, Edward E. & Smith, V. Kerry, 2019. "The welfare cost of uncertainty in policy outcomes," Journal of Environmental Economics and Management, Elsevier, vol. 98(C).
    13. Conti, Gabriella & Mason, Giacomo & Poupakis, Stavros, 2019. "Developmental Origins of Health Inequality," IZA Discussion Papers 12448, Institute of Labor Economics (IZA).
    14. Amy Finkelstein & Matthew Gentzkow & Heidi L. Williams, 2019. "Place-Based Drivers of Mortality: Evidence from Migration," NBER Working Papers 25975, National Bureau of Economic Research, Inc.
    15. Alexander, Diane & Currie, Janet, 2017. "Is it who you are or where you live? Residential segregation and racial gaps in childhood asthma," Journal of Health Economics, Elsevier, vol. 55(C), pages 186-200.
    16. Monica Alexander & Emilio Zagheni & Magali Barbieri, 2017. "A Flexible Bayesian Model for Estimating Subnational Mortality," Demography, Springer;Population Association of America (PAA), vol. 54(6), pages 2025-2041, December.
    17. Libertad González & Ana Rodriguez-Gonzalez, 2018. "Changes in Inequality in Mortality: New Evidence for Spain," Working Papers 1050, Barcelona Graduate School of Economics.
    18. Chloe N. East & Sarah Miller & Marianne Page & Laura R. Wherry, 2017. "Multi-generational Impacts of Childhood Access to the Safety Net: Early Life Exposure to Medicaid and the Next Generation’s Health," NBER Working Papers 23810, National Bureau of Economic Research, Inc.
    19. William J. Collins & Michael Q. Moody, 2017. "Racial Differences in American Women's Labor Market Outcomes: A Long-Run View," NBER Working Papers 23397, National Bureau of Economic Research, Inc.
    20. Vinish Shrestha, 2019. "Maternal Education and Infant Health Gradient: New Answers to Old Questions," Working Papers 2019-03, Towson University, Department of Economics, revised Aug 2019.
    21. William H. Dow & Anna Godøy & Christopher A. Lowenstein & Michael Reich, 2019. "Can Economic Policies Reduce Deaths of Despair?," NBER Working Papers 25787, National Bureau of Economic Research, Inc.

    More about this item

    JEL classification:

    • D63 - Microeconomics - - Welfare Economics - - - Equity, Justice, Inequality, and Other Normative Criteria and Measurement
    • I12 - Health, Education, and Welfare - - Health - - - Health Behavior
    • I14 - Health, Education, and Welfare - - Health - - - Health and Inequality
    • J10 - Labor and Demographic Economics - - Demographic Economics - - - General

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