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Economic Perspectives on Premature Death in the United States

Paper Session

Sunday, Jan. 8, 2017 3:15 PM – 5:15 PM

Hyatt Regency Chicago, Grand Ballroom AB
Hosted By: American Economic Association
  • Chair: Jonathan Skinner, Dartmouth College

Dying to Be Equal? Women's Work, Smoking, and the Growing Gap in U.S. - European Female Life Expectancy

Elizabeth Brainerd
,
Brandeis University
David Cutler
,
Harvard University

Abstract

Since 1980 a growing gap has emerged between female life expectancy in the U.S. and much of Europe. In the late 1970s, American women lived as long as women in France, Spain, and Italy; today, women in those countries live about 4.5 years longer than do American women. This paper considers the reasons for this growing longevity gap. In the first part of the paper, we examine causes of death to determine proximate reasons for the growing disparity. We show that the emergence of the life expectancy gap is associated with increasing smoking-related deaths among U.S. women. Using national health surveys across multiple countries, we document that U.S. women began smoking three to four decades before European women. The second part of the paper explores possible explanations for the early smoking initiation of American women. We find that smoking increases are closely tied to women working. In areas and time periods where more women work, smoking rates increase.

Midlife Mortality Differences Between the United States and Europe: Why Did the United States Leave the Herd?

Anne Case
,
Princeton University
Angus Deaton
,
Princeton University

Abstract

In wealthy countries, midlife mortality rates declined throughout the second half of the 20th Century, with only short periods of exception. This progress, an annual average rate of decline of 2 percent per year in the US and Europe, became so regular that it came to be expected. In the new century, while the midlife mortality decline has continued at that rate in Europe, the US has witnessed a mortality reversal for a large portion of its population-midlife white non-Hispanics. In this paper, we disaggregate mortality changes by country, by cause-providing an accounting of how the US left the herd-and use variation across countries across time in economic and social policy to assess potential explanations for why whites in the US have fallen behind.

Drug Mortality and Lost Life Years Among Prime-Age US Adults

Christopher Ruhm
,
University of Virginia

Abstract

Between 1982 and 2014, the number of deaths due to drug poisoning rose 622%, from 6,518 to 47,055. Increases in fatal overdoses are the most important reason the mortality rates of non-Hispanic whites increased by around 0.5% per year between 1999 and 2013 (Case & Deaton, 2015). Although we do have some knowledge about changes in the specific sources of these overdose deaths (i.e. the drugs involved), we know much less about the reasons why the patterns differ so sharply across groups with, for example, much more rapid increases in fatal drug poisonings for whites than nonwhites. These questions will be investigated using death certificate data on the universe of deaths involving U.S. residents between the years 1999 and 2015. The analysis will focus on years of potential life lost (YPLL), documenting changes from 1999-2015, differences by age, sex and race-ethnicity, and the causes of death that help to explain these differences. The analysis indicates that YPLL increases are largest for relatively young (e.g. 20-39 year olds) non-Hispanic whites, particularly males, and that increases in fatal overdoses involving illicit and prescription opioids are the most important causes of these increases. Other external causes also play a role for older (40-56 year old) prime-age whites, with decreases in YPPL for most other groups that are driven by reductions in mortality rates due to internal causes of death.

The Shape of Mortality: Implications for Economic Analysis

Adriana Lleras-Muney
,
University of California-Los Angeles
Flavien Moreau
,
University of California-Los Angeles

Abstract

How do economic factors affect the evolution of health and mortality rates over the lifetime? To answer this question, we build a structural model that combines a simple age-dependent process with a random health hazard. A key insight of the model is that population mortality rates place constraints on the evolution of the underlying distribution of (unobserved) health, and can be used to infer how health has evolved over time and across countries. Using cohort life tables provided in the Human Mortality Database, we estimate our model and trace out the evolution of structural parameters since 1850. We use the model to understand how unexpected shocks, like wars, affect the age-profile of health and mortality; and investigate implications for SES gradients and optimal health care expenditures.
Discussant(s)
Claudia Olivetti
,
Boston College and NBER
Jonathan Skinner
,
Dartmouth College
Christopher Carpenter
,
Vanderbilt University
JEL Classifications
  • I1 - Health
  • J1 - Demographic Economics