Please use this identifier to cite or link to this item: https://hdl.handle.net/10419/250726 
Year of Publication: 
2021
Series/Report no.: 
Working Papers No. 21-9
Publisher: 
Federal Reserve Bank of Boston, Boston, MA
Abstract: 
The 21st century has been a period of rising inequality in both income and health. In this study, we find that geographic inequality in mortality for midlife Americans increased by about 70 percent from 1992 to 2016. This was not simply because states such as New York or California benefited from having a high fraction of college-educated residents who enjoyed the largest health gains during the last several decades. Nor was higher dispersion in mortality caused entirely by the increasing importance of "deaths of despair," or by rising spatial income inequality during the same period. Instead, over time, state-level mortality has become increasingly correlated with state-level income; in 1992 income explained only 3 percent of mortality inequality, but by 2016 state-level income explained 58 percent. These mortality patterns are consistent with the view that high-income states in 1992 were better able to enact public health strategies and adopt behaviors that, over the next quarter-century, resulted in pronounced relative declines in mortality. The substantial longevity gains in high-income states led to greater cross-state inequality in mortality.
Subjects: 
mortality
health
health policy
JEL: 
I11
I12
I14
I15
I18
Persistent Identifier of the first edition: 
Document Type: 
Working Paper

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