title: Measuring Recent Apparent Declines In Longevity: The Role Of Increasing Educational Attainment.
abstract: Independent researchers have reported an alarming decline in life expectancy after 1990 among US non-Hispanic whites with less than a high school education. However, US educational attainment rose dramatically during the twentieth century; thus, focusing on changes in mortality rates of those not completing high school means looking at a different, shrinking, and increasingly vulnerable segment of the population in each year. We analyzed US data to examine the robustness of earlier findings categorizing education in terms of relative rank in the overall distribution of each birth cohort, instead of by credentials such as high school graduation. Estimating trends in mortality for the bottom quartile, we found little evidence that survival probabilities declined dramatically. We conclude that widely publicized estimates of worsening mortality rates among non-Hispanic whites with low socioeconomic position are highly sensitive to how educational attainment is classified. However, non-Hispanic whites with low socioeconomic position, especially women, are not sharing in improving life expectancy, and disparities between US blacks and whites are entrenched. Findings underscore the urgency of an agenda to equitably disseminate new medical technologies and to deepen knowledge of social determinants of health and how that knowledge can be applied, to promote the objective of achieving population health equity.
authors.affiliation: John Bound is a professor in the Department of Economics at the University of Michigan, in Ann Arbor.
authors.forename: John
authors.initials: J
authors.lastname: Bound
authors.affiliation: Arline T. Geronimus is a professor in the School of Public Health at the University of Michigan.
authors.forename: Arline T
authors.initials: AT
authors.lastname: Geronimus
authors.affiliation: Javier M. Rodriguez is a health researcher at Mathematica Policy Research in Ann Arbor.
authors.forename: Javier M
authors.initials: JM
authors.lastname: Rodriguez
authors.affiliation: Timothy A. Waidmann (twaidmann@urban.org) is a senior fellow in the Health Policy Center at the Urban Institute, in Washington, D.C.
authors.forename: Timothy A
authors.initials: TA
authors.lastname: Waidmann
mesh_terms: D000328:Adult; D001741:Black or African American; D000368:Aged; D000369:Aged, 80 and over; D016208:Databases, Factual; D004522:Educational Status; D005260:Female; D006801:Humans; D008017:Life Expectancy / Q000639:trends*; D008297:Male; D008875:Middle Aged; D014481:United States
keywords: Demography; Disparities; Epidemiology