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. 2021 Dec:80:102540.
doi: 10.1016/j.jhealeco.2021.102540. Epub 2021 Oct 1.

Forecasting mortality inequalities in the U.S. based on trends in midlife health

Péter Hudomiet  1 , Michael D Hurd  2 , Susann Rohwedder  3
Affiliations

Forecasting mortality inequalities in the U.S. based on trends in midlife health

Péter Hudomiet et al. J Health Econ. 2021 Dec.

Abstract

Recent literature has documented a widening gap in mortality between older individuals of high versus low socioeconomic status (SES) in the U.S. This paper investigates whether this trend will continue. We analyze the health status of successive cohorts of 54-60-year-old U.S. individuals born between 1934 and 1959 and use a rich set of health indicators to forecast life expectancies. The detailed health measures come from the longitudinal Health and Retirement Study. We find that many health indicators have worsened recently. For example, rates of obesity, diabetes, and self-reported levels of pain sharply increased between 1992 and 2016. Directly relevant for mortality, recent cohorts report lower subjective survival probabilities. Using Social Security wealth as an SES indicator, we find strong evidence for increasing health inequalities. We predict overall life expectancy to increase further; but the increase will be concentrated among higher SES individuals and mortality inequality will continue to increase.

Keywords: Differential survival; Health inequality; Social security wealth; Socioeconomic status.

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Conflict of interest statement

Declaration of Competing Interest none

Figures

Figure 1.
Figure 1.. Subjective survival probability to age 75 by gender, cohort, and Social Security wealth
Notes: HRS, 1992-2016, Age 54-60. Social Security wealth quintiles are cohort-specific quintiles of household Social Security wealth. The dotted curves show averages in six birth-cohort bins in the lowest and highest Social Security wealth quintiles. The solid and dashed curves show a linear fit on the raw data in all five quintiles. Weighted statistics. The sample sizes of the male cohorts from oldest to youngest were 2153, 1563, 819, 1030, 1381, and 1757. The corresponding numbers for the female cohorts were 2408, 1882, 1252, 1403, 1687, and 2212.
Figure 2.
Figure 2.. Class 2 obesity by gender, cohort, and Social Security wealth
Notes: Class 2 obesity is defined as having a BMI of 35 or more.
Figure 3.
Figure 3.
Fraction currently smoking by gender, cohort, and Social Security wealth
Figure 4.
Figure 4.. Health index by gender, cohort, and Social Security wealth
Notes: The health index is a predicted probability of survival from age 55 to 85 as a function of various health measures. Model estimated on the 1934-38 cohort.
Figure 5.
Figure 5.
Median age at death conditional on survival to age 55 by gender, cohort, and Social Security wealth
See this image and copyright information in PMC

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