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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 21st century has been a period of rising inequality in both income and health. In this study, we find that geographic inequality in mortality for midlife Americans increased by about 70 percent from 1992 to 2016. This was not simply because states such as 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," Working Papers 21-9, Federal Reserve Bank of Boston.
  • Handle: RePEc:fip:fedbwp:93545
    DOI: 10.29412/res.wp.2021.09
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    2. Datar, Ashlesha & Nicosia, Nancy & Samek, Anya, 2023. "Heterogeneity in place effects on health: The case of time preferences and adolescent obesity," Economics & Human Biology, Elsevier, vol. 49(C).
    3. Hasan, Iftekhar & Krause, Thomas & Manfredonia, Stefano & Noth, Felix, 2022. "Banking market deregulation and mortality inequality," Bank of Finland Research Discussion Papers 14/2022, Bank of Finland.
    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.
    5. Bishop, Kelly C. & Kuminoff, Nicolai V. & Mathes, Sophie M. & Murphy, Alvin D., 2024. "The marginal cost of mortality risk reduction: Evidence from housing markets," Journal of Urban Economics, Elsevier, vol. 139(C).
    6. Angus Deaton, 2022. "The great divide: education, despair, and death," Business Economics, Palgrave Macmillan;National Association for Business Economics, vol. 57(4), pages 161-168, October.
    7. 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.
    8. Lleras-Muney, Adriana & Price, Joseph & Yue, Dahai, 2022. "The association between educational attainment and longevity using individual-level data from the 1940 census," Journal of Health Economics, Elsevier, vol. 84(C).

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    More about this item

    Keywords

    health; health policy; mortality;
    All these keywords.

    JEL classification:

    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets
    • I12 - Health, Education, and Welfare - - Health - - - Health Behavior
    • I14 - Health, Education, and Welfare - - Health - - - Health and Inequality
    • I15 - Health, Education, and Welfare - - Health - - - Health and Economic Development
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health

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