Rising Geographic Disparities in US Mortality

Area of Science:

• Public Health
• Sociology
• Demography

Background:

• The 21st century is characterized by increasing income and health disparities.
• Geographic variations in health outcomes and mortality rates are a growing concern.

Purpose of the Study:

• To analyze trends in geographic inequality of mortality among midlife Americans between 1992 and 2016.
• To investigate the correlation between state-level income and mortality inequality over time.

Main Methods:

• Analysis of mortality data for midlife Americans from 1992 to 2016.
• Statistical examination of the relationship between state-level income and mortality inequality.

Main Results:

• Geographic inequality in mortality for midlife Americans increased by approximately 70% from 1992 to 2016.
• The correlation between state-level income and mortality significantly strengthened, with income explaining 58% of mortality inequality by 2016, up from 3% in 1992.
• These trends were not solely driven by educational attainment or "deaths of despair."

Conclusions:

• State-level income became a dominant factor in explaining mortality inequality among midlife Americans.
• Higher-income states' ability to implement effective public health strategies and adopt beneficial behaviors led to greater longevity gains and increased cross-state mortality disparities.