Widening health inequalities among U.S. military retirees since 1974

Abstract

I explore trends in mortality among U.S. military retirees using a new dataset of payroll records that include pay grade. Trends in mortality by pay grade reveal that health inequalities steadily widened between 1974 and 2004. Additive differentials in mortality rates remained stable, but since mortality declined exponentially, by a factor of about one third, proportional differentials in mortality and thus additive differentials in life expectancy have widened. The advantage in life expectancy enjoyed by retired officers grew roughly from 3 to 4 years. The sources of these trends remain unclear and are beyond the ability of the data to inform, but the results bear implications for trends in inequality and for policy.

Figure 1. Mortality Among Retired Officers and Among Retired Enlisted Men

Notes: Each of the four panels shows data for the year specified in its title. In each panel, the three dashed lines depict the 2.5 percentile, median, and 97.5 percentile of the distribution of log mortality rates for retired male officers, while the three dotted lines depict the same centiles for retired enlisted men. Mortality rates are estimated using DMDC payroll data from1974, 1984, 1994, and 2004 as described in the text. The distributions of age-specific mortality rates are generated using Monte Carlo simulations of 1,000 independent draws for each rate, constructed as described in the text.

Figure 2. Proportional and Additive Differences in Mortality Between Retired Officers and Enlisted Men

Notes: The top panel shows differences in log mortality rates between retired enlisted men retired officers in 1974, 1984, 1994, and 2004. A positive number represents a higher mortality rate among enlisted retirees by that percentage. The bottom panel shows level differences in mortality rates between the two groups. In each panel, the thick black line depicts the average over all years in the sample. Military retiree rates are estimated by the author using DMDC payroll data.

Figure 3. Age-Adjusted Mortality Rates Among Military Retirees by Pay Percentile in 1974 and 2004

Notes: The data are age-adjusted mortality rates (y-axis) plotted against midpoints of groups’ percentile rankings in the pay distribution. Groups are listed in Table 2 and are composed as follows: (1) E-1 through E-5; (2) E-6; (3) E-7; (4) O-1, W-1, and E-8; (5) O-2, W-2, E-9, and W-3; (6) W-4, O-3, W-5, and O-4; (7) O-5; and (8) O-6 through O-10. Pay grades are grouped according to their pay after 20 years, as shown in Table 2. The SII is the slope of a weighted regression line through points, with population shares as the weights. I construct age-standardized mortality rates for each group by applying the average age structure for all groups combined over the entire sample period to each group’s age-specific mortality rates.

Figure 4. Period Life Expectancy Among Military Retirees by Rank since 1974

Notes: In each panel of the figure, the set of 3 thin dashed lines show the median and 95 percent confidence intervals around life expectancy for retired officers, while the set of 3 dotted lines show the equivalent for retired enlisted men. Life expectancies for military retirees are constructed from mortality rates estimated using DMDC payroll data for 1974–1976, 1982–1986, 1992–1995, and 2000–2004. Confidence intervals are constructed using Monte Carlo techniques, Bernoulli uncertainty, and uniformly distributed uncertainty about whether undocumented losses are deaths.

Figure 5. Period Life Expectancy at 40 Among Military Retirees by Pay Percentile in 1974 and 2004

Notes: See notes to Figure 3. These data are period life expectancy at 40 (y-axis).