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. 2015 Dec;34(12):2167-73.
doi: 10.1377/hlthaff.2015.0481.

Measuring Recent Apparent Declines In Longevity: The Role Of Increasing Educational Attainment

John Bound  1 , Arline T Geronimus  2 , Javier M Rodriguez  3 , Timothy A Waidmann  4
Affiliations

Measuring Recent Apparent Declines In Longevity: The Role Of Increasing Educational Attainment

John Bound et al. Health Aff (Millwood). 2015 Dec.

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.

Keywords: Demography; Disparities; Epidemiology.

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Figures

Exhibit 1
Exhibit 1
Percent Of Adults Completing Twelfth Grade, By Race, Sex, And Birth Year, 1905–85 Source/Notes: SOURCE Authors’ tabulations based on census data. NOTES “Whites” refers to non-Hispanic whites.
Exhibit 2
Exhibit 2
Survival Curves For White Women With Less Than A High School Education Compared To White Female College Graduates, 1990 And 2010 Source/Notes: SOURCE Authors’ tabulations based on National Vital Statistics System Multiple Cause-of-Death data and census data. NOTES LTHS is less than high school. CG is college graduate. “Whites” refers to non-Hispanic whites.
Exhibit 3
Exhibit 3
Survival Curves For White Men With Less Than A High School Education Compared To White Male College Graduates, 1990 And 2010 Source/Notes: SOURCE Authors’ tabulations based on National Vital Statistics System Multiple Cause-of-Death data and census data. NOTES LTHS is less than high school. CG is college graduate. “Whites” refers to non-Hispanic whites.
Exhibit 4
Exhibit 4
Survival Curves For White Women By Quartile Rank In Educational Attainment, 1990 And 2010 Source/Notes: SOURCE Authors’ tabulations based on National Vital Statistics System Multiple Cause-of-Death data and census data. NOTES “Whites” refers to non-Hispanic whites.
Exhibit 5
Exhibit 5
Survival Curves For White Men By Quartile Rank In Educational Attainment, 1990 And 2010 Source/Notes: SOURCE Authors’ tabulations based on National Vital Statistics System Multiple Cause-of-Death data and census data. NOTES “Whites” refers to non-Hispanic whites.
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Comment in

  • Declining US Life Expectancy, 1990-2010.
    Montez JK, Sasson I, Hayward MD. Montez JK, et al. Health Aff (Millwood). 2016 Mar;35(3):550. doi: 10.1377/hlthaff.2016.0132. Health Aff (Millwood). 2016. PMID: 26953312 No abstract available.
  • US Life Expectancy: The Authors Reply.
    Bound J, Geronimus AT, Rodriguez JM, Waidmann TA. Bound J, et al. Health Aff (Millwood). 2016 Mar;35(3):550. doi: 10.1377/hlthaff.2016.0133. Health Aff (Millwood). 2016. PMID: 26953313 No abstract available.

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