Continuity and Change in the Geography of US Longevity

Magali Barbieri, Institut National d'Études Démographiques (INED)
Florian Bonnet , Ecole normale supérieure de Paris-Saclay
Celeste Winant, University of California, Berkeley

The paper focuses on inter-state differences in longevity in the United States from 1959 to 2016, using data from the United States Mortality DataBase and the National Center for Health Statistics to better understand the historical context of the recent increase in geographic inequalities. After describing trends in survival across states and changes in the magnitude of the gap between the two extremes of the distribution in terms of life expectancy at birth, the study focuses on the results of a cluster analysis in which states are grouped according to both their level of life expectancy at birth and their year-to-year changes in life expectancy over two consecutive time periods (1959-1984 and 1984-2016). Inter-cluster variations in mortality patterns are examined and differences in life expectancy at birth between each cluster and the US as a whole are decomposed by age groups and by causes of death. While geographic variations in mortality have declined over the 1959-1984 period, they have been increasing since 1984 due to the deterioration of the situation in the worse-off half of US states, with the remarkable exception of the District of Columbia (D.C.). Preliminary findings further indicate that the statistical clustering corresponds to a certain extent to a geographic clustering, with states in the most unfavorable grouping (aside from D.C.) located in the southeastern US. The results also show that all age groups and all broad causes of death have contributed to the relative deterioration of the mortality situation in these states.

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 Presented in Session P2. Poster Session Ageing, Health and Mortality