Trends in Spatial Inequality in Mortality in the United States

Yana Vierboom , University of Pennsylvania
Samuel Preston, University of Pennsylvania

Problematic trends in US life expectancy have been accompanied by rising inequality on some measures. In this paper, we use Multiple Cause of Death files and Census population estimates to examine inequality in age-specific mortality across 40 spatial units between 1990-2016, considering trends in both the Index of Dissimilarity and in the variance of mortality rates across geographic units for each 5-year age group. Our units of analysis are combinations of metropolitan status and geographic region. We additionally examine inequality by cause of death and consider factors that may explain the age-pattern of inequality. For both sexes, spatial inequality in all-cause mortality above age 20 rose between 2002-04 and 2014-16. Spatial inequality in mortality from HIV/AIDS, homicide, and suicide/drugs/alcohol decreased for both sexes ages 50-54, although declines were larger among men. Inequality in lung cancer/respiratory diseases, however, rose substantially over the period in this age interval, particularly for women.

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 Presented in Session 86. Spatial Distribution of Diseases and Deaths