Trends in Health and Mortality Inequalities in the United States

Recent literature has documented a widening gap in mortality in the United States between
individuals with high socioeconomic status (SES) and low SES. An important question is
whether this trend will continue. In this paper we document trends and inequalities in the health
status at ages 54 to 60 of individuals born between 1934 and 1959. We do so by using detailed
subjective and objective measures of health in the Health and Retirement Study to examine
contributors to mortality inequality and to forecast life expectancy. We found that the health of
individuals 54 to 60 years old has generally declined in recent years. In particular, we found
large increases in obesity rates, notable increases in diabetes and reported levels of pain, and
lower self-reported health and subjective survival probabilities. We also found strong evidence
for increasing health inequalities, as the health of individuals in these cohorts with high SES
remained largely stable while that for individuals with low SES declined. When we forecast life
expectancies using these predictor variables, as well as gender- and SES-specific time trends,
we predict overall life expectancy to increase further. However, the increase is concentrated
among high SES individuals, suggesting growing mortality inequality. Results are similar among
men and women.