The gap gets bigger: Changes in mortality and life expectancy, by education, 1981-2000

Health Affairs

Volumn 27, Issue 2, 2008, Pages 350-360

  Meara, Ellen R ^a   Richards, Seth ^b   Cutler, David M ^c  

^a HARVARD MEDICAL SCHOOL   (United States)

^b UNIVERSITY OF PENNSYLVANIA   (United States)

^c HARVARD UNIVERSITY   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

ADULT; AGED; ARTICLE; CONTROLLED STUDY; FEMALE; HEALTH EDUCATION; HUMAN; LIFE EXPECTANCY; MALE; MORTALITY; RACE DIFFERENCE; SEX DIFFERENCE; SMOKING HABIT; SOCIOECONOMICS;

ADULT; AFRICAN CONTINENTAL ANCESTRY GROUP; AGED; AGED, 80 AND OVER; CHRONIC DISEASE; EDUCATIONAL STATUS; EUROPEAN CONTINENTAL ANCESTRY GROUP; FEMALE; HUMANS; LIFE EXPECTANCY; MALE; MIDDLE AGED; MORTALITY; SEX FACTORS; SMOKING; UNITED STATES;

EID: 41749085490     PISSN: 02782715     EISSN: 02782715     Source Type: Journal    
DOI: 10.1377/hlthaff.27.2.350     Document Type: Article

References (57)

1. E.M. Kitagawa and P.M. Hauser, Differential Mortality in the United States: A Study in Socioeconomic Epidemiology (Cambridge, Mass.: Harvard University Press, 1973);
2. U.S. Department of Health and Human Services, Report of the Secretary's Task Force on Black and Minority Health (Washington: DHHS, 1985);
3. and DHHS, Health Status of Minorities and Low-Income Groups (Washington: U.S. Government Printing Office, 1985).
4. B.D. Smedley, A.Y. Stith, and A.R. Nelson, eds., Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care (Washington: National Academies Press, 2003);
5. and DHHS, Healthy People 2010: Understanding and Improving Health (Washington: U.S. Government Printing Office, 2000).
6. Agency for Healthcare Research and Quality, National Healthcare Disparities Report (Rockville, Md.: AHRQ, various years).
7. Centers for Medicare and Medicaid Services, "Medicaid Program - General Information: Technical Summary," 2005, http://www.cms.hhs.gov/ MedicaidGenInfo/03_TechnicalSummary.asp (accessed 28 March 2006).
8. Institute of Medicine, The Future of the Public's Health in the Twenty-first Century (Washington: National Academies Press, 2003).
9. S. Harper et al., "Trends in the Black-White Life Expectancy Gap in the United States, 1983-2003," Journal of the American Medical Association 297, no. 11 (2007): 1224-1232;
10. and C.J. Murray et al., "Eight Americas: Investigating Mortality Disparities across Races, Counties, and Race-Counties in the United States," PLoS Medicine 3, no. 9 (2006): e260.
11. E.M. Crimmins and Y. Saito, "Trends in Healthy Life Expectancy in the United States, 1970-1990: Gender, Racial, and Educational Differences, " Social Science and Medicine 52, no. 11 (2001): 1629-1641;
12. C.C. Lin et al., "A Further Study of Life Expectancy by Socioeconomic Factors in the National Longitudinal Mortality Study," Ethnicity and Disease 13, no. 2 (2003): 240-247;
13. G. Pappas et al., "The Increasing Disparity in Mortality between Socioeconomic Groups in the United States, 1960 and 1986," New England Journal of Medicine 329, no. 2 (1993): 103-109;
14. and J.J. Feldman et al., "National Trends in Educational Differentials in Mortality," American Journal of Epidemiology 129, no. 5 (1989): 919-933.
15. See the area-level analyses in G.K. Singh and M. Siahpush, "Widening Socioeconomic Inequalities in U.S. Life Expectancy, 1980-2000," International Journal of Epidemiology 35, no. 4 (2006): 969-979;
16. and Murray et al., "Eight Americas."
17. K. Steenland, J. Henley, and M. Thun, "All-Cause and Cause-Specific Death Rates by Educational Status for Two Million People in Two American Cancer Society Cohorts, 1959-1996," American Journal of Epidemiology 156, no. 1 (2002): 11-21.
18. M.D. Wong et al., "Contribution of Major Diseases to Disparities in Mortality," New England Journal of Medicine 347, no. 20 (2002): 1585-1592.
19. National Center for Health Statistics, Mortality Data, Multiple Cause-of-Death Public-Use Data Files (Hyattsville, Md.: NCHS, 1993 and 2003);
20. and S. Ruggles et al., "Integrated Public Use Microdata Series: Version 3.0 [Machine-Readable Database]," 2004, http://www.ipums.org (accessed 28 June 2007).
21. P.D. Sorlie and N.J. Johnson, "Validity of Education Information on the Death Certificate," Epidemiology 7, no. 4 (1996): 437-439.
22. E. Rogot et al., A Mortality Study of One Million Persons by Demographic, Social, and Economic Factors: 1979-1981 Follow-Up (Bethesda, Md.: National Institutes of Health, 1988).
23. For details, see the online Technical Appendix at http://content. healthaffairs.org/cgi/content/full/27/2/350/DC1.
24. Sorlie and Johnson, "Validity of Education Information."
25. See Table A6 in the online Technical Appendix, as in Note 14.
26. E. Arias, "United States Life Tables, 2002," National Vital Statistics Reports 53, no. 6 (2004): 1-39.
27. For details, see the online Technical Appendix, as in Note 14.
28. NCHS, Health, United States, 2003, with Chartbook on Trends in the Health of Americans (Hyattsville, Md.: NCHS, 2003), 144.
29. For lung cancer, as for COPD, the smoking-attributable fraction of deaths exceeds 80 percent. DHHS, The Health Consequences of Smoking: A Report of the Surgeon General (Washington: DHHS Office on Smoking and Health, 2004).
30. Regarding cause-of-death categories, see J.M. McGinnis and W.H. Foege, "Actual Causes of Death in the United States," Journal of the American Medical Association 270, no. 18 (1993): 2207-2212;
31. and A.H. Mokdad et al., "Actual Causes of Death in the United States, 2000," Journal of the American Medical Association 291, no. 10 (2004): 1238-1245.
32. See the online Technical Appendix, as in Note 14.
33. G.W. Oehlert, "A Note on the Delta Method," American Statistician 46, no. 1 (1992): 27-29.
34. See Table A7 in the online Technical Appendix, as in Note 14.
35. See Tables A8 and A9, ibid.
36. Harper et al., "Trends in the Black-White Life Expectancy Gap," documents declining unintentional injury deaths among young black men, as well as substantial drops in HIV deaths and homicides.
37. DHHS, The Health Consequences of Smoking.
38. R.F. Schoeni et al., "Persistent and Growing Socioeconomic Disparities in Disability among the Elderly: 1982-2002," American Journal of Public Health 95, no. 11 (2005): 2065-2070;
39. and B. Goesling, "The Rising Significance of Education for Health?" Social Forces 85, no. 4 (2007): 1621-1644.
40. Harper et al., "Trends in the Black-White Life Expectancy Gap."
41. Ibid.
42. DHHS, Smoking and Health: Report of the Advisory Committee to the Surgeon General of the Public Health Service (Washington: DHHS, 1964);
43. and D. DeWalque, "Education, Information, and Smoking Decisions: Evidence from Smoking Histories, 1940-2000," Policy Research Working Paper WPS3362 (Washington: World Bank, 2004).
44. W.N. Evans et al., "Do Workplace Smoking Bans Reduce Smoking?" American Economic Review 89, no. 5 (1999): 729-747;
45. and American Lung Association, "Smoking Policies in the Workplace Fact Sheet," September 2007, http://www.lungusa.org/site/pp.asp?c= dvLUK9O0E&b=36000 (accessed 15 November 2007).
46. W. Orzechowski and R.C. Walker, The Tax Burden on Tobacco: Historical Compilation, vol. 39 (Arlington, Va.: Orzechowski and Walker, 2004).
47. M. Susser et al., Sociology in Medicine (New York: Oxford University Press, 1985).
48. B.G. Link and J.C. Phelan, "McKeown and the Idea That Social Conditions Are Fundamental Causes of Disease," American Journal of Public Health 92, no. 5 (2002): 730-732.
49. Harper et al., "Trends in the Black-White Life Expectancy Gap";
50. and Murray et al., "Eight Americas."
51. J. Currie and J. Gruber, "Saving Babies: The Efficacy and Cost of Recent Medicaid Expansions of Eligibility for Pregnant Women," Journal of Political Economy 104, no. 6 (1996): 1263-1296.
52. J. Heckman and D. Masterov, "The Productivity Argument for Investing in Young Children,"NBER Working Paper no. 13016 (Cambridge, Mass.: National Bureau of Economic Research, 2007).
53. DHHS, The Health Consequences of Smoking, 171-258.
54. Link and Phelan, "McKeown."
55. Mokdad et al., "Actual Causes of Death";
56. S.J. Olshansky et al., "A Potential Decline in Life Expectancy in the United States in the Twenty-first Century," New England Journal of Medicine 352, no. 11 (2005): 1138-1145;
57. and K.M. Flegal et al., "Excess Deaths Associated with Underweight, Overweight, and Obesity," Journal of the American Medical Association 293, no. 15 (2005): 1861-1867.