Variation in Black and White Life Expectancy Across State Policy Groups, 1990-2019: A Research Note.

Area of Science:

• Public Health
• Sociology
• Health Policy

Background:

• Life expectancy trends in the U.S. show disparities between racial groups.
• State-level policy liberalism has been hypothesized to influence health outcomes.
• Understanding these dynamics is crucial for targeted public health interventions.

Purpose of the Study:

• To examine the relationship between U.S. state policy liberalism and life expectancy trends from 1990-2019.
• To document life expectancy differences between Black and White men and women.
• To identify age groups and causes of death contributing to policy-related life expectancy advantages.

Main Methods:

• Analysis of life expectancy data (1990-2019) for Black and White populations.
• Grouping states by policy liberalism trajectories over 60 years.
• Estimation of age group and cause-of-death contributions to life expectancy differences.

Main Results:

• A life expectancy advantage for liberal states emerged, reaching 2.5-3.8 years by 2018-2019.
• By 2018-2019, Black women in liberal states had higher or equal life expectancy compared to White individuals in conservative states.
• Policy gradients were clearer for White populations; Black life expectancy showed advantage concentrated in the most liberal states.
• Drivers of the liberal advantage varied by age and race, including HIV/AIDS and homicide for Black men, chronic diseases for White adults, and nervous system disorders for women.
• Drug-related mortality negatively impacted life expectancy, particularly for men, offsetting gains.

Conclusions:

• U.S. state policy liberalism is associated with significant gains in life expectancy, particularly for Black populations.
• The impact of policy liberalism on life expectancy is complex and varies by race, sex, age, and cause of death.
• Addressing drug-related mortality is essential for maximizing the benefits of liberal policies on longevity.