IDEAS home Printed from
   My bibliography  Save this book chapter

Mortality, Income, and Income Inequality over Time in Britain and the United States

In: Perspectives on the Economics of Aging


  • Angus S. Deaton
  • Christina Paxson


We investigate age-specific mortality in Britain and the United States since 1950. Neither trends in income nor in income inequality provide plausible explanations. Britain and the US had different patterns of income growth but similar patterns of mortality decline. Patterns of income inequality were similar in both countries, but adult and elderly mortality rates declined most rapidly during the period when inequality increased. Changes in the rate of mortality decline in the US led changes in Britain by about four years, most notably for infant and older adult mortality where there have been significant technical improvements in treatment. British mortality is lower, but the schedules cross at around age 65. This pattern was established before Medicare, and most likely comes from rationing by age in Britain. Merged income, income inequality, and mortality data on an age/year (or cohort/year) basis show no evidence that income has any effect on mortality in Britain. Education is protective, but less so than in the US. Understanding the effect of income on mortality presents many puzzles, between countries, and between analyses at different levels of aggregation. Our results suggest an important role for medical technology in determining the rate of mortality decline since 1950.
(This abstract was borrowed from another version of this item.)

Suggested Citation

  • Angus S. Deaton & Christina Paxson, 2004. "Mortality, Income, and Income Inequality over Time in Britain and the United States," NBER Chapters,in: Perspectives on the Economics of Aging, pages 247-286 National Bureau of Economic Research, Inc.
  • Handle: RePEc:nbr:nberch:10345

    Download full text from publisher

    File URL:
    Download Restriction: no

    Other versions of this item:

    References listed on IDEAS

    1. Deininger, Klaus & Squire, Lyn, 1996. "A New Data Set Measuring Income Inequality," World Bank Economic Review, World Bank Group, vol. 10(3), pages 565-591, September.
    2. Christopher J. Ruhm, 2000. "Are Recessions Good for Your Health?," The Quarterly Journal of Economics, Oxford University Press, vol. 115(2), pages 617-650.
    3. Deaton, Angus & Lubotsky, Darren, 2003. "Mortality, inequality and race in American cities and states," Social Science & Medicine, Elsevier, vol. 56(6), pages 1139-1153, March.
    4. Gottschalk, Peter & Smeeding, Timothy M., 2000. "Empirical evidence on income inequality in industrialized countries," Handbook of Income Distribution,in: A.B. Atkinson & F. Bourguignon (ed.), Handbook of Income Distribution, edition 1, volume 1, chapter 5, pages 261-307 Elsevier.
    5. Richard Blundell & Ian Preston, 1998. "Consumption Inequality and Income Uncertainty," The Quarterly Journal of Economics, Oxford University Press, vol. 113(2), pages 603-640.
    6. Michael D. Hurd & Daniel McFadden & Angela Merrill, 2001. "Predictors of Mortality among the Elderly," NBER Chapters,in: Themes in the Economics of Aging, pages 171-198 National Bureau of Economic Research, Inc.
    7. Gerdtham, Ulf-G. & Jonsson, Bengt, 2000. "International comparisons of health expenditure: Theory, data and econometric analysis," Handbook of Health Economics,in: A. J. Culyer & J. P. Newhouse (ed.), Handbook of Health Economics, edition 1, volume 1, chapter 1, pages 11-53 Elsevier.
    8. Orazio P. Attanasio & Carl Emmerson, 2003. "Mortality, Health Status, and Wealth," Journal of the European Economic Association, MIT Press, vol. 1(4), pages 821-850, June.
    9. Anne Case & Darren Lubotsky & Christina Paxson, 2002. "Economic Status and Health in Childhood: The Origins of the Gradient," American Economic Review, American Economic Association, vol. 92(5), pages 1308-1334, December.
    10. Atkinson, A.B. & Brandolini, A., 2000. "Promise and Pitfalls in the Use of 'Secondary' Data -Sets: Income Inequality in OECD Countries," Papers 379, Banca Italia - Servizio di Studi.
    Full references (including those not matched with items on IDEAS)


    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.

    Cited by:

    1. David M. Cutler & Adriana Lleras-Muney & Tom Vogl, 2008. "Socioeconomic Status and Health: Dimensions and Mechanisms," NBER Working Papers 14333, National Bureau of Economic Research, Inc.
    2. David Cutler & Angus Deaton & Adriana Lleras-Muney, 2006. "The Determinants of Mortality," Journal of Economic Perspectives, American Economic Association, vol. 20(3), pages 97-120, Summer.
    3. Bhalotra, Sonia, 2006. "Childhood Mortality and Economic Growth," WIDER Working Paper Series 079, World Institute for Development Economic Research (UNU-WIDER).
    4. Dushi, Irena & Friedberg, Leora & Webb, Tony, 2010. "The impact of aggregate mortality risk on defined benefit pension plans," Journal of Pension Economics and Finance, Cambridge University Press, vol. 9(04), pages 481-503, October.
    5. Angus Deaton, 2004. "Health in an Age of Globalization," NBER Working Papers 10669, National Bureau of Economic Research, Inc.
    6. Bhalotra, Sonia, 2010. "Fatal fluctuations? Cyclicality in infant mortality in India," Journal of Development Economics, Elsevier, vol. 93(1), pages 7-19, September.
    7. Leigh, Andrew & Jencks, Christopher, 2007. "Inequality and mortality: Long-run evidence from a panel of countries," Journal of Health Economics, Elsevier, vol. 26(1), pages 1-24, January.
    8. Aakvik, Arild & Holmås, Tor Helge, 2004. "The Relationship Between Economic Conditions, Access to Health Care, and Health Outcomes," Working Papers in Economics 06/04, University of Bergen, Department of Economics.
    9. Gardner, Jonathan & Oswald, Andrew, 2004. "How is mortality affected by money, marriage, and stress?," Journal of Health Economics, Elsevier, vol. 23(6), pages 1181-1207, November.
    10. Owen O'Donnell & Eddy Van Doorslaer & Tom Van Ourti, 2013. "Health and Inequality," Tinbergen Institute Discussion Papers 13-170/V, Tinbergen Institute.
    11. Gregory, Christian A. & Deb, Partha, 2015. "Does SNAP improve your health?," Food Policy, Elsevier, vol. 50(C), pages 11-19.
    12. Meer, Jonathan & Miller, Douglas L. & Rosen, Harvey S., 2003. "Exploring the health-wealth nexus," Journal of Health Economics, Elsevier, vol. 22(5), pages 713-730, September.
    13. Srinivas, Goli, 2014. "Demographic convergence and its linkage with health inequalities in India," MPRA Paper 79823, University Library of Munich, Germany, revised 05 Dec 2014.
    14. George Atsalakis & Dimitrios Nezis & George Matalliotakis & Camelia Ioana Ucenic & Christos Skiadas, 2008. "Forecasting Mortality Rate Using a Neural Network with Fuzzy Inference System," Working Papers 0806, University of Crete, Department of Economics.
    15. Goldman, Dana & Smith, James P., 2011. "The increasing value of education to health," Social Science & Medicine, Elsevier, vol. 72(10), pages 1728-1737, May.
    16. Giacometti, Rosella & Bertocchi, Marida & Rachev, Svetlozar T. & Fabozzi, Frank J., 2012. "A comparison of the Lee–Carter model and AR–ARCH model for forecasting mortality rates," Insurance: Mathematics and Economics, Elsevier, vol. 50(1), pages 85-93.
    17. Andreea Balan-Cohen, 2008. "Healthy, Wealthy, and Wise? The Impact of the Old Age Assistance Program on Elderly Mortality in the United States," Discussion Papers Series, Department of Economics, Tufts University 0719, Department of Economics, Tufts University.
    18. Liu, Gordon G. & Dow, William H. & Fu, Alex Z. & Akin, John & Lance, Peter, 2008. "Income productivity in China: On the role of health," Journal of Health Economics, Elsevier, vol. 27(1), pages 27-44, January.
    19. Nanak Kakwani & Hyun H. Son, 2015. "Income inequality and social well-being," Working Papers 380, ECINEQ, Society for the Study of Economic Inequality.
    20. Rajeev Dehejia & Adriana Lleras-Muney, 2003. "The Timing of Births: Is the Health of Infants Counter-Cyclical?," NBER Working Papers 10122, National Bureau of Economic Research, Inc.
    21. Chen, Hua & Cummins, J. David, 2010. "Longevity bond premiums: The extreme value approach and risk cubic pricing," Insurance: Mathematics and Economics, Elsevier, vol. 46(1), pages 150-161, February.
    22. Pham-Kanter, Genevieve, 2009. "Social comparisons and health: Can having richer friends and neighbors make you sick?," Social Science & Medicine, Elsevier, vol. 69(3), pages 335-344, August.
    23. B. d'Hombres & L. Rocco & M. Suhrcke & M. McKee, 2010. "Does social capital determine health? Evidence from eight transition countries," Health Economics, John Wiley & Sons, Ltd., vol. 19(1), pages 56-74.
    24. Jere Behrman & Hans-Peter Kohler & Vibeke Jensen & Dorthe Pedersen & Inge Petersen & Paul Bingley & Kaare Christensen, 2011. "Does More Schooling Reduce Hospitalization and Delay Mortality? New Evidence Based on Danish Twins," Demography, Springer;Population Association of America (PAA), vol. 48(4), pages 1347-1375, November.

    More about this item

    JEL classification:

    • I12 - Health, Education, and Welfare - - Health - - - Health Behavior


    Access and download statistics


    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:nbr:nberch:10345. See general information about how to correct material in RePEc.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: (). General contact details of provider: .

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service hosted by the Research Division of the Federal Reserve Bank of St. Louis . RePEc uses bibliographic data supplied by the respective publishers.