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Changes in the Age Distribution of Mortality Over the 20th Century

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  • David Cutler
  • Ellen Meara

Abstract

Mortality has declined continuously in the United States over the course of the 20th century, and at relatively constant rates. But the constancy of mortality reductions masks significant heterogeneity by age, cause, and source. Using historical data on death by age and cause, this paper describes the characteristics of mortality decline over the 20th century. Early in the 20th century, mortality declines resulted from public health and economic measures that improved peoples' ability to withstand disease. Because nutrition and public health were more important for the young than the old, mortality reductions were concentrated at younger ages. By mid-century, medical care became more significant and other factors less so. Penicillin and sulfa drugs brought the first mortality reductions at older ages, which were coupled with continuing improvements in health at younger ages. The pattern of mortality reduction was relatively equal by age. In the latter part of the 20th century, death became increasingly medicalized. Cardiovascular disease mortality was prevented in significant part through medical intervention. Most of the additional years added to life in the last few decades of the 20th century were at older ages.

Suggested Citation

  • David Cutler & Ellen Meara, 2001. "Changes in the Age Distribution of Mortality Over the 20th Century," NBER Working Papers 8556, National Bureau of Economic Research, Inc.
  • Handle: RePEc:nbr:nberwo:8556
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    1. Angus Deaton, 2001. "Relative Deprivation, Inequality, and Mortality," NBER Working Papers 8099, National Bureau of Economic Research, Inc.
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    5. Samuel H. Preston, 1996. "American Longevity: Past, Present, and Future," Center for Policy Research Policy Briefs 7, Center for Policy Research, Maxwell School, Syracuse University.
    6. David M. Cutler & Ellen Meara, 2000. "The Technology of Birth: Is It Worth It?," NBER Chapters,in: Frontiers in Health Policy Research, Volume 3, pages 33-68 National Bureau of Economic Research, Inc.
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    Cited by:

    1. Rodrigo R. Soares, 2007. "On the Determinants of Mortality Reductions in the Developing World," Population and Development Review, The Population Council, Inc., vol. 33(2), pages 247-287.
    2. Gilad Sorek, 2006. "Advancing Medical Technology, Aging Population, and Economic Growth," DEGIT Conference Papers c011_046, DEGIT, Dynamics, Economic Growth, and International Trade.
    3. 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.
    4. Aakvik, Arild & Holmas, Tor Helge, 2006. "Access to primary health care and health outcomes: The relationships between GP characteristics and mortality rates," Journal of Health Economics, Elsevier, vol. 25(6), pages 1139-1153, November.
    5. Maarten Lindeboom & France Portrait & Gerard J. van den Berg, 2003. "Individual Mortality and Macro-Economic Conditions from Birth to Death," Tinbergen Institute Discussion Papers 03-072/3, Tinbergen Institute, revised 14 Oct 2003.
    6. Volker Grossmann & Holger Strulik, 2015. "Optimal Social Insurance and Health Inequality," CESifo Working Paper Series 5604, CESifo Group Munich.
    7. Law, Marc T. & Kim, Sukkoo, 2005. "Specialization and Regulation: The Rise of Professionals and the Emergence of Occupational Licensing Regulation," The Journal of Economic History, Cambridge University Press, vol. 65(03), pages 723-756, September.
    8. Martin Gaechter & Peter Schwazer & Engelbert Theurl, 2012. "Stronger Sex but Earlier Death: A Multi-level Socioeconomic Analysis of Gender Differences in Mortality in Austria," DANUBE: Law and Economics Review, European Association Comenius - EACO, issue 1, pages 1-23, March.
    9. Rodrigo R. Soares, 2009. "Life expectancy and welfare in Latin America and the Caribbean," Health Economics, John Wiley & Sons, Ltd., vol. 18(S1), pages 37-54, April.
    10. Martin Gächter & Engelbert Theurl, 2010. "Socioeconomic Environment and Mortality: A two-level Decomposition by Sex and Cause of Death," NRN working papers 2010-10, The Austrian Center for Labor Economics and the Analysis of the Welfare State, Johannes Kepler University Linz, Austria.
    11. Marcel Erlinghagen, 2007. "Die Beteiligung an ehrenamtlicher Arbeit und informeller Hilfe nach dem Renteneintritt: Analysen mit dem Sozio-oekonomischen Panel," SOEPpapers on Multidisciplinary Panel Data Research 27, DIW Berlin, The German Socio-Economic Panel (SOEP).
    12. Martha J. Bailey & Andrew Goodman-Bacon, 2015. "The War on Poverty's Experiment in Public Medicine: Community Health Centers and the Mortality of Older Americans," American Economic Review, American Economic Association, vol. 105(3), pages 1067-1104, March.
    13. 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.
    14. McKinlay, John & Marceau, Lisa, 2008. "When there is no doctor: Reasons for the disappearance of primary care physicians in the US during the early 21st century," Social Science & Medicine, Elsevier, vol. 67(10), pages 1481-1491, November.
    15. Willem Heeringa & A.L. Bovenberg, 2009. "Stabilizing pay-as-you-go pension schemes in the face of rising longevity and falling fertility: an application to the Netherlands," DNB Working Papers 220, Netherlands Central Bank, Research Department.
    16. Sherry Glied & Adriana Lleras-Muney, 2008. "Technological innovation and inequality in health," Demography, Springer;Population Association of America (PAA), vol. 45(3), pages 741-761, August.
    17. David Bishai & Divya Nair & Taghreed Adam, 2012. "Economics of Public Health Interventions for Children in Developing Countries," Chapters,in: The Elgar Companion to Health Economics, Second Edition, chapter 5 Edward Elgar Publishing.
    18. Sally C. Stearns & Edward C. Norton, 2004. "Time to include time to death? The future of health care expenditure predictions," Health Economics, John Wiley & Sons, Ltd., vol. 13(4), pages 315-327.
    19. Grimm, Michael, 2017. "Rainfall risk, fertility and development: Evidence from farm settlements during the American demographic transition," Ruhr Economic Papers 718, RWI - Leibniz-Institut für Wirtschaftsforschung, Ruhr-University Bochum, TU Dortmund University, University of Duisburg-Essen.

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    JEL classification:

    • I1 - Health, Education, and Welfare - - Health
    • J1 - Labor and Demographic Economics - - Demographic Economics

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