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Education Differentials in Mortality by Cause of Death: United States, 1960
Abstract
Analysis of educational differentials in mortality by cause of death was made possible by matching some 340,000 death certificates, of a total of 535,000 deaths which occurred in the United States during the months May-August, 1960, to the 1960 Census records. Since only about 80 percent of the deaths could be matched to census schedules, provision was made for the control of bias by obtaining census-type information for the unmatched deaths.
A strong inverse relation of mortality to level of education obtained among the white population of the United States in 1960 for both males and females, with consistent declines in mortality as years of schooling increased. Specific causes of death were, in the main, also inversely related to education, the most important exceptions being found in the positive relationship between death by reason of prostatic cancer for males and death by reason of mammary cancer for females.
Measurement was obtained of “excess deaths” by cause, that is, the proportion of deaths which would have been saved if the mortality of the three less-educated groups had been equal to that of the best-educated. For males aged 25 years and over, “excess mortality” from all causes of death constituted 9.4 percent of all deaths in 1960 and for females 29.3 percent of all deaths. Excess deaths among males exceeded 40 percent of all deaths from accidents, stomach cancer, and tuberculosis. Excess deaths among females exceeded 40 percent of all deaths caused by stomach cancer, diabetes mellitus, hypertensive disease, and arteriosclerotic and degenerative heart disease.
The study points to the important contribution that socioeconomic epidemiology, as contrasted with bio-medical epidemiology, can make toward the reduction of mortality. Additional papers will flow from this study.
... In Sweden, for example, the emergence of a class gradient in mortality can be traced back to the 1950s (Bengtsson, Dribe, and Helgertz 2020). In the United States, a marked socioeconomic gradient in mortality had already existed in the 1960s and has since widened considerably (Hayward, Hummer, and Sasson 2015;Kitagawa and Hauser 1968;Meara, Richards, and Cutler 2008). ...
Research on mortality inequalities has proliferated in demography in recent decades, documenting disparities between nations and within them across multiple social dimensions. Yet, this literature remains largely descriptive and atheoretical. In this paper , I identify three open questions in need of theoretical development. First, I identify a general shift from gender (and race) based mortality inequalities to class-based inequalities across low-mortality countries. I argue that this shift may be better understood by focusing on the structural determinants of population health, in addition to explanations grounded in individual behavior and risk factors. Second, a growing body of literature has called for moving beyond group differences in life expectancy and adopting the concept of lifespan inequality. However, the drivers of lifespan inequality are not well understood. I argue that a comprehensive framework is needed for clarifying the interplay of nature, nurture, and chance in shaping variability in individual lifespans. Third, I draw attention to the causal role that mortality inequalities may play in driving social change. I argue that differential exposure to death in one's network of social relations may give rise to different modes of thinking, feeling , and acting, and in turn lead to group differences in preferences, actions, and outcomes.
... The first examples were provided across occupations for England, US and France before the XX century [24]. The work of [25], which matches census data of 1960 with death certificates of 1960, is seminal in documenting mortality heterogeneity for all US by education. For Italy, see the seminal work of [26] which shows mortality profiles by gender over 1790 − 1966. ...
This work analyses the mortality differential between the total and the employed population for the Italian region of Liguria in 2015–2019. Values for life expectancy at ages [65, 74) are used to quantify the transfer mechanism implicitly triggered when, in the case of persistent longevity heterogeneity, a country-wide longevity factor is adopted in calculating pension annuities. Results confirm that a lower mortality force characterises the employed population of Liguria compared to the total population. In terms of implicit tax/subsidy rates, Liguria total population is almost unaffected, being taxed by an average of 0.05% of the fair value for pension. Instead, Liguria employed population is subsidised by 6.24%. Longevity heterogeneity directly impacts on public finances, if not compensated within the same cohort by socio-economic groups living shorter. Some corrective policies are discussed.
... Findings from the late nineteenth and early twentieth centuries are more mixed [15,17,[25][26][27][28]. The FCT emphasizes the importance of cause-specific mortality [22], but the evidence remains inconclusive [29][30][31][32][33][34][35][36][37][38][39][40][41][42][43][44][45][46]. ...
Higher socioeconomic status (SES) is associated with lower mortality, and this correlation has been confirmed using different indicators across several geographical settings. Nevertheless, the timing of the emergence of the SES gradient remains unclear. We used individual-level longitudinal data for a regional population in southern Sweden covering the period between 1813 and 2014, and we applied a cause-specific proportional hazard model. We estimated SES differences in all-cause, nonpreventable, preventable, and cause-specific adult mortality in four subperiods (1813–1921, 1922–1967, 1968–1989, 1990–2014) by gender adjusting for birth year, place of residence, marital status, and migration status. The SES gradient in mortality present today for both genders emerged only around 1970, and with few exceptions, it emerged at approximately the same time for all causes of death. It emerged earlier for women than for men, particularly in infectious diseases. In the nineteenth and early twentieth centuries, we found a positive association between SES and mortality from circulatory diseases for men. SES has not always been a fundamental cause of mortality; it only emerged as such in the second half of the twentieth century. We argue that habits and behaviors embedded in the different social strata played a major role in the emergence of the SES gradient.
... In particular, the connection between income and mortality was investigated in Chetty et al. (2016), Cristia (2009) , Jemal, Ward, Anderson, Murray, and Thun (2008), and Hahn et al. (1995), whereas income and rural versus urban mortality outcomes were investigated in Gong, Phillips, Hudson, Curti, and Philips (2019). A connection between education and mortality was made by Montez et al. (2019), Bound, Geronimus, Rodriguez, and Waidmann (2015), Rostron, Arias, and Boies (2010), Hadden and Rockswold (2008), and Kitagawa and Hauser (1968). The connection between race and mortality was investigated in Murray et al. (2006) and Cunningham et al. (2017), whereas Olshansky et al. (2012) investigated the effects of both education and race on mortality. ...
This work provides an investigation of the presence of spatial variability in the determinants of mortality rates. Specifically, by using the age‐adjusted mortality rates of the counties of the contiguous United States, this research applies a multiscale geographically weighted regression (MGWR) approach to examine the spatial variations in the relationships between mortality rates and a diverse group of associated determinants. The results demonstrate that the MGWR approach produces a differentiable account of the global, regional, and local effects acting on mortality rates across the United States. Thus, this work lays the groundwork for the consideration of spatial varying effects on mortality rates, which operate at different spatial scales.
... Educational attainment has long been used as a predictive variable (see, e.g., Kitagawa and Hauser, 1968). As a measure of social status, it has recently received considerable attention in the study of the relationship between social groups and LE (for a recent example, see Olshansky et al., 2012). ...
We introduce a new modelling framework to explain socio-economic differences in mortality in terms of an affluence index that combines information on individual wealth and income. The model is illustrated using data on older Danish males over the period 1985–2012 reported in the Statistics Denmark national register database. The model fits the historical mortality data well, captures their key features, generates smoothed death rates that allow us to work with a larger number of sub-groups than has previously been considered feasible, and has plausible projection properties.
... Educational attainment has long been used as a predictive variable (see, for example, Kitagawa and Hauser, 1968). As a measure of social status, it has recently received considerable attention in the study of the relationship between social groups and life expectancy (for a recent example, see Olshansky et al., 2012). ...
We introduce a new modelling framework to explain socioeconomic differences in mortality in terms of an affluence index that combines information on individual wealth and income. The model is illustrated using data on older Danish males over the period 1985-2012 reported in the Statistics Denmark national register database. The model fits the historical mortality data well, captures their key features, generates smoothed death rates that allow us to work with a larger number of subgroups than has previously been considered feasible, and has plausible projection properties.
... Algumas técnicas utilizadas nesse estudo para mensurar impactos da discriminação demandam, em razão da teoria que as motiva, que se insira apenas atributos individuais como fatores explicativos da probabilidade de pertencer ao grupo dos ricos (Fairlie, 1999;Cotton, 1998;Kitagawa & Hauser, 1968;Oaxaca & Ransom, 1994;Yun, 2009). Sendo assim, o controle estatístico pela segmentação geográfica, especialmente importante para os padrões observados de desigualdade racial, será implementado através da restrição da aplicação desses modelos às zonas urbanas da Região Sudeste. ...
Resumo Este artigo estuda a participação das mulheres negras no grupo dos ricos no Brasil. São definidos como ricos aqueles que integram o conjunto de 1% com maiores rendimentos advindos do trabalho principal. Através de modelos logísticos, estima-se em que medida a escolaridade, incluindo a segmentação por áreas de formação superior, contribui para as desvantagens desse grupo de mulheres quanto à participação entre os ricos. Estima-se também a contribuição relativa da remuneração discriminatória dos níveis educacionais. O estudo aborda também como a condição racial afeta a condição de status das mulheres negras ricas, sendo o conceito de status operacionalizado a partir das dinâmicas conjugais. O que se observa é que mulheres negras ricas, além de tenderem a não contar com um cônjuge, experimentam maiores probabilidades de estarem unidas a cônjuges não ricos, em comparação com as mulheres brancas. Isso indica que a condição racial deprecia suas possibilidades de conversão da afluência econômica em status social. A análise da dinâmica matrimonial é realizada com base em modelos logísticos multinominais. Os dados são provenientes do Censo Demográfico de 2010.
... Unfortunately, I do not observe a person's life expectancy in the CPS data, so I cannot control for life expectancy directly. However, Kitagawa and Hauser (1968) find that there is a strong inverse relationship between educational attainment and mortality among white males. More recently, Christenson and Johnson (1995) confirmed this result using actual data from death certificates after education was added to the U.S. death certificate. ...
... The equation I use is the following: directly. However, Kitagawa and Hauser (1968) find that there is a strong inverse relationship between educational attainment and mortality among white males. Further, Hurd and McGarry (1995) find that not only do low-educated individuals die younger, they also expect to die younger (Table 5). ...
... In the US and elsewhere, there exists a strong correlation between education and adult health outcomes. In respect to mortality, an early seminal study by Kitagawa and Hauser (1968) matched 1960 death certificates to the 1960 Census and found that an individual's mortality risk declined with his/her educational attainment. Since then, many others have confirmed this pattern and have examined the education gradient in mortality along many dimensions -over time (Pappas et al, 1993), over the life cycle (Beckett, 2000; Lynch, 2003) and across the sexes (McDonough et al, 1999; Christenson and Johnson, 1995) and races (Williams and Collins, 1995). ...
... However, the rise in relative inequality was considerably steeper in New Zealand. In the United States, differences in CVD mortality by education were evident among women but less so for men in 1960 (81), but since that time relative differentials have increased (117). Differences in IHD and stroke across racial and ethnic groups in the United States also emerged during the period of CVD declines, but the picture shows considerable heterogeneity by specific causes of CVD-related death. ...
This article reviews the historical declines in cardiovascular mortality and provides an overview of the contribution of social and economic factors to disease change. We document the magnitude of declines in cardiovascular diseases and the major role of changes in conventional risk factors, and we review the contributions of social determinants to changes in disease rates. We conclude by arguing that understanding patterns and trends of social inequalities in cardiovascular disease and its risk factors requires consideration of the specific intersections of health and social exposures acting across the life course in different settings, in both time and place.
... Alternatively, the association could be a proxy indicator of household wealth. The relationship between parental educational level and nutritional status could be related to health knowledge, but it has been suggested that educational level is an indirect measure of socioeconomic status (18). Educational level remained significantly associated with nutritional status after allowing for a range of socioeconomic variables, and we suggest that education per se has an important influence on nutrition. ...
An anthropometric survey of children aged 0-59 months in north-west Uganda in February-March 1987 indicated a high prevalence of stunting but little wasting. Use of unprotected water supplies in the dry season, prolonged breast-feeding, and age negatively affected nutrition; in contrast, parental education level improved nutrition. Mortality during the 12 months following the survey was higher among those who had low weight-for-age and weight-for-height, but children who had low height-for-age did not have higher mortality. Weight-for-age was the most sensitive predictor of mortality at specificities > 88%, while at lower specificity levels weight-for-height was the most sensitive. Children whose fathers' work was associated with the distillation of alcohol had a higher risk of mortality than other children. The lowest mortality was among children whose fathers were businessmen or who grew tobacco.
... Rather surprisingly, acute respiratory infections were not a particularly common cause of death. Kitagawa & Hauser (1968) found education to be an indirect measure of socioeconomic status. Hobcraft, McDonald & Rutstein (1984), analysing data from the World Fertility Survey, found a correlation between parents' education, father's occupation, place of residence and child mortality. ...
Anthropometric and sociodemographic variables were taken from 4320 children in a baseline survey carried out in March-April 1988 in the district of Mbarara, south-west Uganda. After 12 months a follow-up survey assessed the mortality of the children during the preceding year. Lack of ownership of cattle, recent arrival in the village, using candles for lighting, being of birth order higher than 5 and having a father with less than 8 years of schooling were significantly associated with child mortality. The addition of mid-upper arm circumference significantly improved the logistic model of socioeconomic variables and mortality and did not diminish the predictive power of socioeconomic variables in relation to increased mortality. This suggests that nutritional status and specific socioeconomic factors are both, independently, important predictors of child mortality.
... Yeracaris and Kim (1978) found a negative relationship between an index of socioeconomic status and mortality rates from heart disease, malignant neoplasms, and all other causes of death. Altenderfer (1947) found a negative relationship between levels of income and mortality; Kitagawa and Hauser (1968) found negative relationships between education and mortality. Other researchers who have examined the connection between socioeconomic status and levels of mortality generally agree that a negative relationship exists (e.g., Antonovsky 1967;Benjamin 1965;Vallin 1980). ...
Epidemiological transition theory suggests that two population existing under disparate socioeconomic conditions would have different life expectancies as the result of cause-of-death differences. The effect of racial socioeconomic differentials on the total racial life expectancy differential are examined as they act through specific cause-of-death differentials. Results suggest that residential isolation of blacks has a strong effect on the total life expectancy differential as it acts through the racial homicide differential. The racial unemployment difference also has a strong effect on the total differential as it acts through the racial heart disease differential. Implications of the findings for reducing life expectancy differentials are discussed.
... Thus, the variables used in the study might not have been those of choice had this study not been constrained by time and circumstances to data already in existence. For example, the number of years of schooling has been reported to be associated with mortality (Grossman 1975;Kitagawa and Hauser 1968). However, because of variations across states and over time in Australia during the Vietnam conflict, the highest class attended at school was standardised according to equivalents of the New South Wales Intermediate and Leaving Certificates (junior and senior high school examinations usually occuring after three and five years of secondary schooling, respectively), according to army practice. ...
Risk factors for mortality from motor vehicle accidents (MVAs) were examined in all Australian former National Service conscripts of the Vietnam conflict era, by comparing all those who had died from MVAs since the end of their basic training up until 1982 with a random sample of survivors, using data available from service records. Decedents were in their third and fourth decades. Risk of mortality was higher for men with lower scores on the army intelligence test, with poorer education, with lower preenlistment occupational status, with a history of juvenile offenses before army enlistment, and who went absent without leave (AWOL) during National Service. These factors were modelled using logistic regression, which showed that intelligence plus either lower levels of education or a history of offenses before army service were the most important of these factors in predicting mortality in MVAs.
There are marked differences in life expectancy between regions of England, between countries in the UK, and between the UK and other wealthy countries. In England, there are large differences in mortality rates between less and more educated adults, and between less and more deprived places. Austerity measures enacted after the financial crisis of 2008 not only harmed many people directly and unequally, through reductions in public services, but may also have played a role in the anaemic reduction in mortality rates observed for adults after 2010. Prescriptions on policy to improve the health of those left behind will need to wait for more and better data. It is not possible to understand the upstream mechanisms responsible for health outcomes using geographic indices of multiple deprivation. The most promising approach to improving population health is to continue to focus on the health and well-being of children.
We provide new evidence on the causal effect of higher education on mortality. Our empirical strategy exploits the reduction in college openings introduced by the Pinochet regime after the 1973 coup in Chile, which led to a sharp downward kink in college enrollment among those cohorts reaching college age in the following years. Using administrative data from the vital statistics, we document an upward kink in the age-specific yearly mortality rate of individuals in the affected cohorts. We estimate a negative effect of college on mortality between ages 34-74, which is larger for men, but also sizable for women. Individuals in the affected cohorts experience worse labor market outcomes, are more likely to be enrolled in the public health system, and report lower consumption of health services. This suggests that economic disadvantage and limited access to care play an important mediating role in the link between higher education and mortality.
Israel, like other high-income countries, exhibits substantial and rising class disparities in health and mortality. Individuals with high levels of education and income benefit on average from better physical and cognitive health, as well as lower mortality rates. Yet in spite of the importance of socioeconomic disparities for health inequality, this area of research received little attention in Israeli sociological research. As a result, key sociological insights are absent from public and academic discussions on health inequalities and how to reduce them. In this article we first review the causal mechanisms for explaining class-based disparities in health and mortality, emphasizing three theoretical frameworks: health lifestyle theory, the life course approach to health disparities, and the chronic stress paradigm. Second, we provide an empirical review of class-based inequalities in health and mortality in Israel. Lastly, we propose new directions for research on health inequalities in Israel, pointing to underutilized data sources and highlighting patterns and trends unique to Israeli society.
In this paper, I examine progress in the field of mortality over the past 25 years. I argue that we have been most successful in taking advantage of an increasingly data-rich environment to improve aggregate mortality models and test pre-existing theories. Less progress has been made in relating our estimates of mortality risk at the individual level to broader mortality patterns at the population level while appropriately accounting for contextual differences and compositional change. Overall, I find that the field of mortality continues to be highly visible in demographic journals, including Population Studies. However much of what is published today in field journals could just as easily appear in neighbouring disciplinary journals, as disciplinary boundaries are shrinking.
The present study aims in general to identify the impact of Modernization, with its indictors, and its health culture on Epidemiologic Transition (age at deaths, The main Cause of death, Rate of morbidity, The pattern of prevalent diseases). In order to achieve the above- mentioned aims, and test hypotheses of the present study, the researcher depends on a social survey of Heads of families, in the village of Al Zawya Al Khadra, South of Al Fashn city in Bine- Suief governorate. The survey included (748) Heads depending on them to getting information about all socio-economic and demographic characteristics related to each family member.
Moreover, the researcher relies on a comparative approach; through the analysis of the three pattern of Modernization (Lowest, Middle, and Highest), and three pattern of Health culture of modernization (Traditional, Transformational, and modern) and their all impact positively or negatively on indictors of Epidemiologic transition. Furthermore, the researcher, depends on a number of techniques of data collection such as questionnaire, in-depth interviews, direct observation and analysis of documents and records.
Finally main the results of the study can be summarized as follows: (1)The indicators of modernization (education and occupation) are positive associated with Two indicators of Epidemiologic transition (age at deaths, transformation in Causes of death to non-communicable diseases as basic Cause of death, non-communicable diseases as The pattern of prevalent diseases). In addition to, they have inversely associated with Rate of morbidity. (2) The Modernization as composite index is positive associated with Two indicators of Epidemiologic transition (age at deaths, transformation in Causes of death to non-communicable diseases as basic Cause of death. And has an inversely associated with Rate of morbidity ,and is not associated with The pattern of prevalent diseases.
(3) An important finding of the study that all indicators of modernization have are positive associated with Healthy culture. The study also confirmed that the level of health culture is positive associated with age at deaths, transformation in Causes of death to non-communicable diseases as basic Cause of death. And has an inversely associated with Rate of morbidity, and is not associated with The pattern of prevalent diseases.
O negro no mundo dos ricos é produto de pesquisa de doutorado realizada na Universidade de Brasília, com apoio do CNPq, e na University of Illinois at Urbana Champaign, com apoio da Capes. O livro utiliza os dados do último Censo Demográfico brasileiro para identificar padrões na desigualdade de renda entre negros e brancos no Brasil, dando ênfase ao grupo dos 1% mais ricos da população. Com isso, o trabalho pretende lançar novas luzes sobre o estudo da desigualdade racial de renda no Brasil, que tem dado enfoque a diferenças na média dos rendimentos ou na composição racial das faixas mais pobres da população. A intenção das análises é identificar, a partir de uma série de exercícios estatísticos, o papel desempenhado, de um lado, por processos de discriminação racial e, do outro, pelas desigualdades educacionais entre negros e brancos, inclusive em termos de área de formação superior, na determinação das desigualdades observadas na composição do grupo dos ricos. Destacando as interações entre condição racial e condição de gênero, o livro traz também um diagnóstico sobre as situações enfrentadas, especificamente, pelas mulheres negras.
Does education change people’s lives in a way that delays mortality? Or is education primarily a proxy for unobserved endowments that promote longevity? Most scholars conclude that the former is true, but recent evidence based on Danish twin data calls this conclusion into question. Unfortunately, these potentially field-changing findings—that obtaining additional schooling has no independent effect on survival net of other hard-to-observe characteristics—have not yet been subject to replication outside Scandinavia. In this article, we produce the first U.S.-based estimates of the effects of education on mortality using a representative panel of male twin pairs drawn from linked complete-count census and death records. For comparison purposes, and to shed additional light on the roles that neighborhood, family, and genetic factors play in confounding associations between education and mortality, we also produce parallel estimates of the education-mortality relationship using data on (1) unrelated males who lived in different neighborhoods during childhood, (2) unrelated males who shared the same neighborhood growing up, and (3) non-twin siblings who shared the same family environment but whose genetic endowments vary to a greater degree. We find robust associations between education and mortality across all four samples, although estimates are modestly attenuated among twins and non-twin siblings. These findings—coupled with several robustness checks and sensitivity analyses—support a causal interpretation of the association between education and mortality for cohorts of boys born in the United States in the first part of the twentieth century.
Vom anthropologischen Ausgangspunkt her müssen wir das Kranksein an die Primärerfahrungen des Menschen anbinden, aus denen seine Befindensweisen resultieren. Das gestörte Befinden weicht als mißliches Leib-Erleben oder Miß-Befinden von der Normalität des Leibes ab, über die nur der Betroffene selber Angaben machen kann, wenn er sich unwohl bzw. krank fühlt. Einige grundsätzliche Befindensweisen des Menschen werden seit altersher durch ein Fehlen (modus deficiens), Nicht-mehr-können, Zuwenig/Zuviel oder ‘Anderssein’, jedenfalls als Entgleisung eines gleichgewichtigen Lebensverlaufs gekennzeichnet und durch einen medizinischen Befund, das subjektive Befinden und durch Auffälligkeiten sozialen Handelns definiert.
Studies of differentials in mortality usually have been bivariate and without benefit of a theoretical structure. In this study, mortality is approached through a multivariate framework and conceptualized as an indicator of inequality resulting from differential life chances and styles, which, in turn, reflect general stratification processes. An ecological factor, residency, and a social factor, racial composition, are used to investigate four questions: Do metropolitan counties have lower death rates than nonmetropolitan counties? Does the difference between White and non-White county mortality still favor White counties, and will a racial differential favoring White-designated counties exist when residency status is held constant and when areal social class characteristics are held constant?
All counties of the 12-state North Central Region (N = 1056) provide the data. T-test, covariance, and multiple classification analyses are used to investigate the questions. Metropolitan and White counties (with age controlled) displayed lower crude death rates. The latter two questions were answered strongly in the affirmative, indicating, not only that significant residency and racial differences in county mortality exist, but also that, even when controlled for residency status and areal social class, the racial differential persists. Conclusions support the use and conceptualization of mortality as an indicator of inequality. Discussion centers around the persistent racial differential and draws tentatively upon a “theory of insecurity” or “minority group status” hypothesis for explanation.
This study investigated the association between moderate lead poisoning in early childhood with performance on a comprehensive set of end-of-grade examinations at the elementary school level in two urban school districts.
Children born between 1996 and 2000 who resided in Milwaukee or Racine, WI, with a record of a blood lead test before the age of 3 years were considered for the analysis. Children were defined as exposed (blood lead level ≥10 and <20 μg/dL) or not exposed (BLL < 5 μg/dL). Parents of eligible children were mailed surveys to consent to participation and elicit information on potential confounders. On consent, children were matched to educational records for fourth grade Wisconsin Knowledge and Concepts Examinations. Seemingly unrelated regression was used to evaluate the relation between scaled scores on all sections of the examination (math, reading, language arts, science, and social studies) with exposure status, controlling for demographics, social status indicators, health indicators, and district-based poverty indicators.
A total of 1133 families responded to the survey and consented to have educational records released; 43% of children were considered exposed. After controlling for demographic and socioeconomic covariates, lead exposure was associated with significantly lower scores in all sections of the Wisconsin Knowledge and Concepts Examinations (range: science, β = -5.21, P = .01; reading, β = -8.91, P = .003). Children who were black, had a parent with less than a high-school education, and were classified by parents as having less than excellent health had significantly lower performance on all examination components.
Children with moderate lead poisoning in early childhood performed significantly lower on all components of elementary school end-of-grade examinations compared with unexposed children. Household level social status and childhood health indicators partially explain decreased examination scores.
The major purpose of this paper is to examine one part of the ratio variable correlation problem, correlated denominators, using path models of young, middle-age, and older-age mortality, each with 11 sociodemographic and cause-of-death independent variables. The models are calculated using a traditional ratio approach and a residual variable approach for a sample of counties. The methodological discussion focuses on differences in coefficients for the two approaches in terms of significance, magnitude, and hypothesis support. It is concluded that the residual approach is worth pursuing as a viable statistical solution to the correlated denominators component of the ratio variable correlation problem.
Researchers have explored the considerable negative effect of an individual’s or his spouse’s poor health on their wealth accumulation. Health selection may also operate across generations, affecting the wealth of children whose parents suffer from poor health. We develop an intergenerational model of health selection in wealth using life course theory to understand whether parents’ non-fatal serious health events affect inter vivos financial transfers to children. First, we estimate the relationship between parents’ serious health events in adulthood and wealth accumulation, showing that data from the Wisconsin Longitudinal Study reproduce results from research using U.S. national panel studies and supporting the generalizability of our intergenerational health selection results. Second, we find strong evidence of intergenerational health selection. Individuals with less initial wealth and who experience a serious health event are about 34% more likely to transfer money to their children and transfer 60% more money to their children when they do.
Using data from the linked National Health Interview Survey National Death Index (NHIS-NDI), a new and unique data set, we examine the interaction of age and self-rated health as a predictor of overall and cause-specific mortality. Proponents of wear and tear theories argue that as the body ages, it begins to degenerate, leaving the aged in poor health and vulnerable to their ultimate mortality. We find that although the majority of the elderly rate their health as good or better, low levels of education and income contribute to poor perceived health, and the effect of age on mortality varies by level of perceived health. While the oldest old who report the poorest health experience greater risks of mortality, elders who report good health experience much lower risks. As a larger share of our population survives into old age, it is important to emphasize preventive health care policy, as well as strong economic and health care safety nets, not only to promote health but also to lengthen life.
Understanding how childhood and adolescent health may affect schooling is important for understanding the socioeconomic ramifications of poor early-life health as well as the relations between schooling and adult health. Using three waves of U.S. longitudinal data with extensive covariate information on a national sample of 2368 American children aged 5-14 at baseline, we used regression methods to investigate how patterns of general health status over a 10-year period relate to completed years of schooling at the end of follow-up. As a sensitivity analysis, we used sibling fixed effects models to help control for differences stemming from familial or community factors shared between siblings. The effect of health on years of completed schooling appeared to accumulate over time, and was more evident among children who were older at baseline. Among participants aged 5-7, 8-10, and 11-14 at baseline, average differences in years of completed schooling between participants with poor health in all 3 waves and those with good health in all 3 waves were 0.02 ([95% confidence interval] -0.31, 0.35), -0.50 (-0.88, -0.12), and -1.28 (-1.78, -0.78), respectively. Point estimates from fixed effects models were very similar. Our results document the emergence and compounding over time of health-related disparities in schooling at young ages, suggesting a vicious cycle between poor health and educational outcomes. Future research better characterizing how early-life health affects educational progress will ultimately be necessary for developing effective interventions to reduce educational and health disparities.
There is a strong, positive and well-documented correlation between education and health outcomes. There is much less evidence on the extent to which this correlation reflects the causal effect of education on health - the parameter of interest for policy. In this paper we attempt to overcome the difficulties associated with estimating the causal effect of education on health. Our approach exploits two changes to British compulsory schooling laws that generated sharp differences in educational attainment among individuals born just months apart. Using regression discontinuity methods, we confirm that the cohorts just affected by these changes completed significantly more education than slightly older cohorts subject to the old laws. However, we find little evidence that this additional education improved health outcomes or changed health behaviors. We argue that it is hard to attribute these findings to the content of the additional education or the wider circumstances that the affected cohorts faced (e.g., universal health insurance). As such, our results suggest caution as to the likely health returns to educational interventions focused on increasing educational attainment among those at risk of dropping out of high school, a target of recent health policy efforts.Institutional subscribers to the NBER working paper series, and residents of developing countries may download this paper without additional charge at www.nber.org.
The system of nuptiality probabilities for never married males and females, the “marriage regime,” is viewed as a population
transformation, which operates on a population thereby changing the composition. The marriage regime has many properties common
to other population transformations, but embodies a constraint such that, in general, the marriage regime cannot be strictly
stable over time. The approach is applied to study the “marriage squeeze,” the alteration in marriage patterns that results
from an imbalance in the “marriage market” or numbers of never married males and females at the usual marriage ages. Using
data on age at first marriage for the 1960 American white population, nuptiality probabilities by single year of age and sex
are estimated for the years 1915–58. Annual estimates also are made of the relative number of eligible mates (never married
of the usual marriage ages) for never married persons of a given age and sex. No close correspondence is found between annual
fluctuations in the marriage market and in the nuptiality probability, possibly because of the crudeness of the estimates.
Alternatively, response to the imbalance may take another form such as marriage postponement or a redefinition of eligibility.
This book of readings focuses on two questions: how do demographic variables influence social systems; and how do social variables influence demographic systems? It is the intersection between these two systems that defines the field of social demography and the point of view of this book. Part 1 presents a new approach to relating social and demographic phenomena using a systems approach. Part 2 offers a series of theoretical articles concerned with the relationship between various social factors and demographic structure and process. Part 3 deals with the reciprocal relations between demographic factors and major institutional systems, such as the family, religion, government, health, education, welfare, and the economy. Part 4 relates demographic changes to changes in social aggregate systems, including racial and ethnic groups, and value and belief systems. Part 5 examines the demographic transition in relation to the social and economic development of societies. The book is not intended as a beginning text in population, and assumes some knowledge of both demography and sociology. Believing that significant demography is necessarily interdisciplinary, the authors have sought to clarify at least one area of interdisciplinary relationship. (Author/JLB)
Theories employed to explain regularities in social behavior often contain reference (explicit or implicit) to the presence of nonlinear and/or nonadditive (i.e., multiplicative) relationships among germane variables. While such nonadditive features are theoretically important, the inclusion of quadratic or multiplicative terms in structural equations to model such features can cause significant methodological problems. This paper estimates a set of equations and formally examines how the inclusion of quadratic terms and multiplicative interaction terms contribute to the level of collinearity or ill-conditioning of the input data matrix and the precision of the parameter estimates. Subsequently we examine how effects of explanatory variables in nonadditive models can be measured and tested for statistical significance. The results indicate that collinearity may not be as big a problem for linear structural social science models as is often believed. Further, although collinearity is increased by adding quadratic and/or multiplicative terms, the effects of the collinearity tend to be localized and entail only variables with a common base. The findings suggest the substantive insight gained from including theoretically appropriate nonlinear and nonadditive terms outweigh the methodological problems they create.
Abstract Model patterns of the cause structure of mortality at different levels were established for males and females, based on data for 165 national populations. These patterns suggest that the cause of death most responsible for mortality variation is influenza/bronchitis, followed by 'other infectious and parasitic diseases', respiratory tuberculosis, and diarrhoeal disease. Together, these causes typically account for about 60 per cent of the change in level of mortality from all causes combined. Their respective contributions have not depended in an important way on the initial level of mortality. These results - especially tbe importance of the respiratory and diarrhoeal diseases - imply that past accounts may have over-emphasized the role in mortality decline of specific and well-defined infectious diseases and their corresponding methods of control. There is strong statistical support for the suggestion that most of the remainder of mortality variation should be ascribed to changes in cardio-vascular diseases, but that methods of cause-of-death assignment in high-mortality populations have often obscured the importance of these diseases. When death rates from 'other and unknown' causes are held constant, changes in cardio-vascular disease account for about one-quarter of the decline in mortality from 'all causes'.Although the causal factors are poorly established, corroborative results have been demonstrated cross-sectionally in the United States. The composition of the group of populations most deviant from the structural norms is apparently dominated by differentials in the mode of assigning deaths to cardio-vascular disease. However, when broad groups of regions or periods are distinguished, more subtle differences emerge. Controlling mortality level for all causes combined, diarrhoeal diseases are significantly higher in non-Western populations and southern/eastern Europe than in overseas Europe or northern/western Europe. These differences are probably related to standards of nutrition and personal hygiene, but may also reflect climatic factors. Much higher cardio-vascular mortality in overseas European populations than in non-Western populations at similar overall levels probably reflects variation in habits of life. Regional differences in death rates from violence, maternal mortality, respiratory tuberculosis and influenza/pneumonia/bronchitis are briefly noted and commented upon. Cause-of-death structures at a particular level of mortality display some important changes over time. Respiratory tuberculosis and 'other infectious and parasitic diseases' have tended to contribute less and less to a certain level of mortality. They have in part been 'replaced' by diarrhoeal disease, specifically in non-Western populations. These developments reflect an accelerating rate of medical and public health progress against the specific infectious diseases, and a disappointing rate of progress against diarrhoeal disease. Western and non-western populations have shared to approximately the same extent in the accelerating progress against infectious diseases, and developments during the post-war period are more appropriately viewed as an extension of prior trends rather than as radical departures therefrom. For males, cardio-vascular disease and cancer have significantly increased their contribution to a particular level of mortality, while no such tendency is apparent for females. These developments may be related to changes in personal behaviour and in environmental influences whose differential impact on the sexes has been demonstrated in epidemiological studies. Although we have avoided an explicit treatment of age by having recourse at the outset to standardization, certain of the results are apparently reflected in studies of age patterns of mortality. The joint occurrence in non-Western populations and Southern/Eastern populations of exceptionally high death rates from diarrhoeal disease may explain why the 'South' age-pattern, with it high death rates between ages one and five, is often the most accurate referent for use in Latin America and Asia. The fact that the list of populations with the least deviation cause structure is almost exclusively confined to members of the 'West' group of Coale and Demeny may account for the lack of persistent deviation in this group's age patterns. Finally, tbe increasing importance of cardio-vascular disease and neoplasms in cause-of-death structures for males but not females is probably associated with the changing age patterns of male mortality noted by Coale and Demeny.
Abstract Empirical expressions derived by Coale and Demeny accurately characterized the relationships among death rates of different age groups for each sex during an extended period of time in Western nations. However, the relationships have changed in recent years, as the mortality of older persons has increasingly exceeded the level expected on the basis of these expressions. The recent disruption is relatively small for females and may be due to very rapid declines in maternal mortality. Among males, the change has been quite pronounced, and it is suggested that increases in cigarette consumption are largely responsible.
The long-standing inverse relationship between education and mortality strengthened substantially at the end of the 20th century. This paper examines the reasons for this increase. We show that behavioral risk factors are not of primary importance. Smoking declined more for the better educated, but not enough to explain the trend. Obesity rose at similar rates across education groups, and control of blood pressure and cholesterol increased fairly uniformly as well. Rather, our results show that the mortality returns to risk factors, and conditional on risk factors, the return to education, have grown over time.
The purpose of this study is to translate research findings on pathological effects of unemployment and other forms of economic distress into a form that would be useful for national economic policy decisions. Economic indices considered by themselves are questionable because such data permit no inferences as to quantitive social implications. In the present report, we have brought together several of the scientific findings on the impact of economic distress in a policy relevant framework which would ultimately permit quantitive estimates of that impact on social pathology. Some success has been achieved in formulating models to explain how the various sources of national economic distress may be associated with pathology.
Overall, it is evident that significant relationships exist between economic policy and measures of national well-being. This study indicates that actions which influence national economic activity-especially the unemployment rate-have a substantial bearing on physical health, mental health, and criminal aggression. To the extent, therefore, that economic policy has acted to influence economic activity, it has always been related to the nation's social health. It would appear that on a day-today basis, nearly all political and deliberate economic policy decisions which affect the national, regional, and local economic situations also are associated with many aspects of the nation's well-being. Indeed, significant amelioration of many of our basic social problems may depend, in part, on national economic policy considerations.
To determine whether Mexican Americans have an increased incidence of non-insulin-dependent (type II) diabetes mellitus relative to non-Hispanic whites. Currently, no study has reported on the incidence of this disorder in Mexican Americans.
We determined the 8-yr incidence of type II diabetes in 617 Mexican Americans and 306 non-Hispanic whites who participated in the San Antonio Heart Study, a population-based study of diabetes and cardiovascular disease. Forty Mexican Americans (6.5%) and 6 non-Hispanic whites (2%) developed type II diabetes, as defined by World Health Organization criteria. The age-adjusted ethnic odds ratio (OR; Mexican Americans/non-Hispanic whites) for diabetes incidence was 8.13 (95% confidence interval [C1] 1.10-59.9) in men and 3.62 (95% CI 1.37-9.55) in women. We adjusted for age, sex, ethnicity, body mass index, and level of educational attainment with multiple logistic regression analyses.
Mexican Americans continued to show a statistically significant increase in diabetes incidence (OR 2.72, 95% CI 1.02-7.28). Obesity and age were also positively related to diabetes incidence in this analysis (P less than 0.001). In addition, subjects with at least some college education had a lower incidence of diabetes than those with less than a high school education (OR 0.51, 95% CI 0.26-0.99).
The incidence of type II diabetes in Mexican Americans is greater than in non-Hispanic whites, a difference that is not explained by ethnic differences in obesity, age, or level of educational attainment.
Risk factors for mortality from all causes in Australian former National Service conscripts of the Vietnam conflict era were determined by comparing decedents with a random sample of survivors using data available from service records. Three-quarters of the deaths were due to external causes. A log-linear regression model was used to evaluate variables in four classes: education and cognitive abilities, employment, conduct while in service, and physical and mental health. Risk of mortality was higher for men with lower scores on the army intelligence test. Age left school and highest class reached were not as important to survival as participation in post-secondary education, which was associated with a lower risk of early death. Risk of death also increased with a conduct history of being Absent Without Leave or being charged for offences involving alcohol or motor vehicles. Employment instability between school and military service also was associated weakly with a higher risk of death, as was duration of hospitalisation during service. Given survival to the end of National Service, service in Vietnam per se did not figure in the regression model as an important determinant of subsequent mortality.
Recent investigations of the relation of mortality to weight have involved more than 4 million insured persons in a study by insurance companies and over 1 million men and women in a study by the American Cancer Society. These studies present a large volume of information on the effects of underweight and overweight on death rates of healthy middle-class Americans, free of the confounding effects of low socioeconomic status and associated health impairments. However, only the American Cancer Society's study separates findings by smoking status. These investigations indicate that the lowest mortality occurs among persons somewhat underweight and that mortality rises steadily as weight increases. The study of insured persons shows that among underweight persons mortality is relatively high initially but declines with time, whereas among overweight persons mortality is low initially but increases to distinctly higher levels after about 15 years.
Evaluation of health care is equated with the intent to continuously improve rather than to control its quality. Quality is seen as being affected by and therefore embracing 1) patient's health status and attitudes on entry to care, 2) suitability of the delivery machinery (structure), 3) application of care (process), and 4) outcomes of application to care. It is suggested that analysis in depth at two points of this paradigm, the entry to care and the outcomes of care, are the most likely to reveal the basis of failures. These may largely reside with the patient, the health care delivery structure, or the inability of the patient and care deliverer to perform together appropriately. These suggest the kind of interventions most likely to provide good results in the future. Such interventions or changes are very likely to call for significant changes in many social institutions, including that of the health care delivery machinery. Focusing on process is seen as contributing to professional education but less likely to result in meaningful changes because it works on the assumption that what the professional in a given illness cycle offers is the main factor in achieving better quality care.
This is the third of a series of reports which compare 604 deaths from stroke in U.S. veterans between 1 July 1967 and 30 June 1968 in Georgia with 560 stroke deaths over the same period in the states of Colorado, Idaho, Montana, Utah and Wyoming; 1210 and 1644 deaths selected from among all other causes are used for controls.An entry of hypertension was found in a higher proportion of certificates of cases than controls in both geographic areas, and these proportions were at least twice as high in Georgia as in the West. In Georgia the association between stroke and hypertension was greatest in men less than 50 yr of age.About 80 per cent of the men dying in Georgia had been born there or in other Southern Atlantic states. Only about 30 per cent of the decedents in the West had been born in the part of the country where they died, and 30 per cent had migrated to the mountains from the West Central plains. In both Georgia and the West there was an excess of stroke deaths among farmers and farm laborers compensated in both areas by an excess of deaths in the controls among craftsmen, foremen and machine operators. In both racial groups and in both areas the men dying of stroke were evidently poorer than the controls. There was an excess of widowed men among stroke cases in both areas.
The relationship between deaths during 1959-61 from nine leading causes and socioeconomic status was examined in the city of Hartford, Conn. Socioeconomic status was determined according to social rank areas, and mortality was measured by expected deaths and excess deaths. The measure of expected deaths shows how deaths from each cause in each of four social rank areas differ from those that would have occurred if age-specific death rates by cause for the total city had prevailed. The comparative measure of excess deaths approximates the assumption that age-specific death rates for each cause of death in the highest social rank area would be applied to the age composition of the three lower socioeconomic areas. The major difference between the measurements of observed and expected deaths and excess deaths is that the measure of excess deaths yielded slightly larger relative differences in mortality among the four social rank areas by cause of death. A more important observation, however, is that, with minor exceptions, both measures of mortality demonstrated a clear inverse association between socioeconomic status and mortality from all nine causes. The extent of the association was strongest for infectious and parasitic diseases, respiratory and digestive diseases, diabetes, and accidents. An inverse relationship between mortality from heart diseases, cancer, and genitourinary diseases was also ascertained, but the strength of the association was less apparent. Excess deaths (deaths which can be prevented) result mainly from chronic diseases, especially from heart disease. Therefore, in order to reduce the overall level of mortality of the lower socioeconomic group to a level closer to that of the higher socioeconomic groups, early diagnosis and better treatment should be provided for persons at lower socioeconomic levels.
The significance for stroke and correlates of transient ischemic attacks (TIA) were studied prospectively in a population of 2,772 persons aged 65 to 74. The prevalence of TIA at the beginning of the study was 63 per 1,000. TIA prevalence was substantially higher among blacks and women than among whites and men. Only 13% of those with TIA were free from any other major evidence of cardiovascular disease. White men, black men and black women with TIA had higher observed incidence rates of stroke than those without TIA; white women were a notable exception to this trend. There was a positive association between frequency of TIA and risk of stroke. Those with TIA and hypertension experienced higher stroke incidence rates than normotensive persons with TIA.
The Comparability of Reports on Occupation from Vital Records and the 1950 Census,”Vital Statistics-Special ReportsOccupational and Social Class Differences in Mortality,” inTrends and Differentials in Mortality
- See
- Example
- L David
- Elizabeth Kaplan
- P K Parkhurst
- Whelpton
The Comparability of Reports on Occupation from Vital Records and the 1950 CensusOccupational and Social Class Differences in Mortality,” inTrends and Differentials in MortalityMortality by Occupation and Industry Among Men 20-64 Years of Age: United States
- See
- David L Example
- Elizabeth Kaplan
- P K Parkhurst
- M Iwao
- Lillian Moriyama
- Lillian Guralnick
- Guralnick
Methods Used in a Current Study of Social and Economic Differentials in Mortality
- Evelyn M Kitagawa
- Philip M Hauser
Design of Surveys Linked to the Death Record
- Monroe G Sirken
- James W Pifer
- Morton L Brown
Completeness of Coverage of the Nonwhite Population in the 1960 Census and Current Estimates, and Some Implications “ (Paper presented to the Conference on Social Statistics and the City
- See Jacob
- S Siegel
The Comparability of Reports on Occupation from Vital Records and the 1950 CensusOccupational and Social Class Differences in Mortality
- David L See
- Elizabeth Kaplan
- P K Parkhurst
- M Whelpton Iwao
- Lillian Moriyama
- Guralnick
The Comparability of Reports on Occupation from Vital Records and the 1950 Census
- David L See
- Elizabeth Kaplan
- P K Parkhurst
- Whelpton
Mortality by Occupation and Industry Among Men 20-64 Years of Age: United States
- M Iwao
- Lillian Moriyama
- Guralnick