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Mortality, inequality and race in American cities and states

  • Deaton, Angus
  • Lubotsky, Darren

A number of studies have found that mortality rates are positively correlated with income inequality across the cities and states of the US. We argue that this correlation is confounded by the effects of racial composition. Across states and Metropolitan Statistical Areas (MSAs), the fraction of the population that is black is positively correlated with average white incomes, and negatively correlated with average black incomes. Between-group income inequality is therefore higher where the fraction black is higher, as is income inequality in general. Conditional on the fraction black, neither city nor state mortality rates are correlated with income inequality. Mortality rates are higher where the fraction black is higher, not only because of the mechanical effect of higher black mortality rates and lower black incomes, but because white mortality rates are higher in places where the fraction black is higher. This result is present within census regions, and for all age groups and both sexes (except for boys aged 1-9). It is robust to conditioning on income, education, and (in the MSA results) on state fixed effects. Although it remains unclear why white mortality is related to racial composition, the mechanism working through trust that is often proposed to explain the effects of inequality on health is also consistent with the evidence on racial composition and mortality.

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Article provided by Elsevier in its journal Social Science & Medicine.

Volume (Year): 56 (2003)
Issue (Month): 6 (March)
Pages: 1139-1153

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Handle: RePEc:eee:socmed:v:56:y:2003:i:6:p:1139-1153
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  1. Jennifer M. Mellor & Jeffrey Milyo, 1999. "Re-Examining the Evidence of an Ecological Association between Income Inequality and Health," Discussion Papers Series, Department of Economics, Tufts University 9922, Department of Economics, Tufts University.
  2. Victor R. Fuchs & Mark B. McClellan & Jonathan S. Skinner, 2004. "Area Differences in Utilization of Medical Care and Mortality among U.S. Elderly," NBER Chapters, in: Perspectives on the Economics of Aging, pages 367-414 National Bureau of Economic Research, Inc.
  3. Angus Deaton, 2001. "Relative Deprivation, Inequality, and Mortality," NBER Working Papers 8099, National Bureau of Economic Research, Inc.
  4. Christopher J. Ruhm, 1996. "Are Recessions Good For Your Health?," NBER Working Papers 5570, National Bureau of Economic Research, Inc.
  5. Michael Grossman, 1976. "The Correlation between Health and Schooling," NBER Chapters, in: Household Production and Consumption, pages 147-224 National Bureau of Economic Research, Inc.
  6. David A. Jaeger & Susanna Loeb & Sarah E. Turner & John Bound, 1998. "Coding Geographic Areas Across Census Years: Creating Consistent Definitions of Metropolitan Areas," NBER Working Papers 6772, National Bureau of Economic Research, Inc.
  7. Alberto Alesina & Reza Baqir & William Easterly, 1999. "Public Goods And Ethnic Divisions," The Quarterly Journal of Economics, MIT Press, vol. 114(4), pages 1243-1284, November.
  8. Douglas Miller & Christina Paxson, 2001. "Relative Income, Race, and Mortality," Working Papers 269, Princeton University, Woodrow Wilson School of Public and International Affairs, Center for Health and Wellbeing..
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