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Rising Geographic Disparities in US Mortality

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  • Benjamin K. Couillard
  • Christopher L. Foote
  • Kavish Gandhi
  • Ellen Meara
  • Jonathan Skinner

Abstract

The 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.

Suggested Citation

  • Benjamin K. Couillard & Christopher L. Foote & Kavish Gandhi & Ellen Meara & Jonathan Skinner, 2021. "Rising Geographic Disparities in US Mortality," Journal of Economic Perspectives, American Economic Association, vol. 35(4), pages 123-146, Fall.
  • Handle: RePEc:aea:jecper:v:35:y:2021:i:4:p:123-46
    DOI: 10.1257/jep.35.4.123
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    3. Ashlesha Datar & Nancy Nicosia & Anya Samek, 2022. "Heterogeneity in Place Effects on Health: The Case of Time Preferences and Adolescent Obesity," NBER Working Papers 29935, National Bureau of Economic Research, Inc.
    4. Adriana Lleras‐Muney, 2022. "Education and income gradients in longevity: The role of policy," Canadian Journal of Economics/Revue canadienne d'économique, John Wiley & Sons, vol. 55(1), pages 5-37, February.

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    More about this item

    JEL classification:

    • D31 - Microeconomics - - Distribution - - - Personal Income and Wealth Distribution
    • I12 - Health, Education, and Welfare - - Health - - - Health Behavior
    • I14 - Health, Education, and Welfare - - Health - - - Health and Inequality
    • I24 - Health, Education, and Welfare - - Education - - - Education and Inequality

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