Unbiased Analysis of Today's Healthcare Issues

Inequality in mortality is not as bad as you think

Written By: Jason Shafrin - Dec• 03•17

There have been numerous articles (e.g., Krugman in the NY Times) stating that disparities in life expectancy is growing.  It is known that income inequality has grown in recent decades but some claim that health inequality is also growing.  Janet Currie argues that the truth is not as bad as you think in a forthcoming article in Contemporary Economic Policy.

The main point here is that for the group with less than 12 years of education, life expectancy seems to be falling precipitously, whereas for the other groups, it is going up, so therefore, you have increased inequality in life expectancy. What is the problem with that? The problem is that…the population denominator is not staying the same, so you have a huge reduction in the share of White females who have less than 12 years of education.

Focusing on this particular subgroup is somewhat like taking a good news story, that is, that in the United States we now have many fewer high school dropouts in the White female population than we had in the past, and reporting it as a bad news story.

Currie also makes some technical arguments regarding how the U.S. Census’ decision to allow respondents to code multiple races has changed the reported racial composition of the country over time.  It may be more accurate, but racial definitions in the Census data have changed over time (which clearly any one individuals race is fixed in time). Currie investigates county level mortality rates and conducts a sensitivity analysis using 1990 racial definitions and 2100 Census racial definition plus combination racial individuals.  She finds that although mortality does increase with poverty, over this 20 year period:

…there is a strong reduction in mortality across the county-poverty spectrum. There are very large reductions for African-Americans, and those are even larger when multiple-race people are included. The reductions are largest in the poorest counties, which implies decreasing inequality in mortality for children.

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