February 22, 2017
Inequality in Mortality Over the Life Course:
Why Things Are Not as Bad as You Think
Janet Currie
Chair, Department of Economics, Princeton University
Miquelon Weyeneth and Janet Currie
Minutes of the 21st Meeting of the 75th Year
Jock McFarlane called the meeting to order in the Andlinger Center at 10:15 a.m. Ninety-eight members attended. Joan Fleming led the invocation. Guests included Judy and Bob Rawson, former chairman of Princeton University’s board of trustees, and Scott Magargee.
The minutes of the Feb. 15 meeting were read by Ralph Widner. Miquelon Weyeneth introduced our speaker, Janet Currie. Professor Currie has a bachelor’s and master’s degree from the University of Toronto and a Ph.D. from Princeton, where she is the chair of the Economics Department and co-director of the Center for Health and Wellbeing. Professor Currie has also taught at the University of California, Los Angeles, M.I.T. and Columbia.
She introduced her talk by saying that she is partly responding to various articles in The New York Times from 2012 thru 2016 that concluded that mortality for lower income whites, age 50 and above, was increasing. Professor Currie’s research showed, however, that that wasn’t accurate. If you look at birth-to-death statistics, mortality is actually decreasing across the board.
In education attainment, she said, statistics do show that life expectancy is decreasing for those with fewer than 12 years of schooling. But that statistic is suspect because today there are 66 percent fewer high school dropouts, so the comparison with past years is faulty.
She gave another measure of mortality as questionable -- wealthy counties in the United States vs. poor ones. She compared Fairfax County, Va., a wealthy county, with McDowell, County, W.Va. Statistics show that the latter has a higher mortality rate. But that doesn’t take into consideration that the West Virginia county also has a significantly decreasing population. In other words, those who can leave poor counties do leave, skewing the numbers. For an accurate comparison, she said, you need to look at poor counties whose population is not declining.
Professor Currie presented graphs using census data from 1990, 2000 and 2010. They showed increasing life expectancy for all groups for that 20-year period. One complicating factor was that, in 2010, people could list more than one racial/ethnic group. The mortality was declining significantly for the poor up to 4 years old. Also seen is the huge decline in mortality for African-Americans.
One of her charts showed that, for white women aged 20 to 49, the diseases of despair -- depression, alcoholism, drug use, etc. -- have reduced life expectancy. Ironically, this group has traditionally had the lowest mortality.
Another chart showed that mortality is declining faster for the poor than for the wealthy, except for those aged 50-plus, where the wealthy do better than the poor.
She put forth that the following assumption is not true -- that increasing economic inequality has lead to increasing mortality for the poor. The reason for that is that policies have been implemented that have led to decreasing the wealthy vs. poor mortality gap. Those policies include:
Other positives were changes in smoking habits and pollution reduction.
Professor Currie pointed out that smoking for men correlates with an education gap. The less educated man is more likely to smoke than the better educated man. And the latter have had a much steeper drop-off rate. For women, the better educated were smoking at higher rates, which may have led to mortality increases for white women aged 20 to 49. But they too have a big smoking drop-off rate.
Tightening of pollution control has definitely had its effect on mortality rates, especially among the poor. Recent decreases in carbon monoxide have had a positive effect on the birth weight of babies. Since lower-income people tend to live in more polluted areas, the decreases have affected them more positively than the more affluent.
Other points Professor Currie made about the state of the current birth and mortality rates:
Professor Currie’s conclusion is that things are a lot brighter than they may appear in the news.
Points From the Q&A
Respectively submitted,
Al Kaemmerlen
The minutes of the Feb. 15 meeting were read by Ralph Widner. Miquelon Weyeneth introduced our speaker, Janet Currie. Professor Currie has a bachelor’s and master’s degree from the University of Toronto and a Ph.D. from Princeton, where she is the chair of the Economics Department and co-director of the Center for Health and Wellbeing. Professor Currie has also taught at the University of California, Los Angeles, M.I.T. and Columbia.
She introduced her talk by saying that she is partly responding to various articles in The New York Times from 2012 thru 2016 that concluded that mortality for lower income whites, age 50 and above, was increasing. Professor Currie’s research showed, however, that that wasn’t accurate. If you look at birth-to-death statistics, mortality is actually decreasing across the board.
In education attainment, she said, statistics do show that life expectancy is decreasing for those with fewer than 12 years of schooling. But that statistic is suspect because today there are 66 percent fewer high school dropouts, so the comparison with past years is faulty.
She gave another measure of mortality as questionable -- wealthy counties in the United States vs. poor ones. She compared Fairfax County, Va., a wealthy county, with McDowell, County, W.Va. Statistics show that the latter has a higher mortality rate. But that doesn’t take into consideration that the West Virginia county also has a significantly decreasing population. In other words, those who can leave poor counties do leave, skewing the numbers. For an accurate comparison, she said, you need to look at poor counties whose population is not declining.
Professor Currie presented graphs using census data from 1990, 2000 and 2010. They showed increasing life expectancy for all groups for that 20-year period. One complicating factor was that, in 2010, people could list more than one racial/ethnic group. The mortality was declining significantly for the poor up to 4 years old. Also seen is the huge decline in mortality for African-Americans.
One of her charts showed that, for white women aged 20 to 49, the diseases of despair -- depression, alcoholism, drug use, etc. -- have reduced life expectancy. Ironically, this group has traditionally had the lowest mortality.
Another chart showed that mortality is declining faster for the poor than for the wealthy, except for those aged 50-plus, where the wealthy do better than the poor.
She put forth that the following assumption is not true -- that increasing economic inequality has lead to increasing mortality for the poor. The reason for that is that policies have been implemented that have led to decreasing the wealthy vs. poor mortality gap. Those policies include:
- Food stamps
- Pre-K and school lunch programs
- Medicaid availability for any child born after Sept. 1, 1983. Between 1996 and 2004, the number of poor children on Medicaid increased from 20 percent to more than 50 percent. For older children, the increase was from 15 percent to 40 percent. And there was a big drop in hospitalizations for those covered.
Other positives were changes in smoking habits and pollution reduction.
Professor Currie pointed out that smoking for men correlates with an education gap. The less educated man is more likely to smoke than the better educated man. And the latter have had a much steeper drop-off rate. For women, the better educated were smoking at higher rates, which may have led to mortality increases for white women aged 20 to 49. But they too have a big smoking drop-off rate.
Tightening of pollution control has definitely had its effect on mortality rates, especially among the poor. Recent decreases in carbon monoxide have had a positive effect on the birth weight of babies. Since lower-income people tend to live in more polluted areas, the decreases have affected them more positively than the more affluent.
Other points Professor Currie made about the state of the current birth and mortality rates:
- There has been a decline in teen birth rates.
- The health of people, especially the poor, has improved. Thus the reduction in mortality of the poor.
- The huge African-American decline in mortality has been largely ignored.
- An increase in mortality among middle-age white women is an exception.
- There has been a reduction in risky behaviors like smoking.
Professor Currie’s conclusion is that things are a lot brighter than they may appear in the news.
Points From the Q&A
- Turns out obesity in the young is declining.
- Teen abortions are not increasing.
- Most people who are eligible for the Earned Income Tax Credit do get it.
- The New York Times was not interested in Professor Currie’s analysis until it appeared in The Economist. News organizations have little interest in good news.
- What about comparison with the work of Angus Deaton? His emphasis is on pain and opioids, with a focus on whites.
- Change in 2008: Hispanics being taken out of white numbers lead to higher mortality rates for whites.
- What about the diet of low-income people who use food stamps. What about lack of fruit and vegetables? The poor use the same amount of sodas as everyone else. Generally the diet of all Americans is appalling. Vegetables for low-income children are often only potatoes and catsup. Poor people may have a lousy diet but it’s not very different from everyone else.
- The opioid problem begins with physicians prescribing them.
- CNN longevity stats have Korea on top. The United States is way down the list. Reasons: Korea has good childhood nutrition, low blood pressure, low smoking percentage and good access to health care.
- The Women Equality Empowerment Project (for women and children) is very positive.
Respectively submitted,
Al Kaemmerlen