Last year there was much discussion here and elsewhere about a paper by Anne Case and Angus Deaton, who noticed that death rates for non-Hispanic white Americans aged 45-54 had been roughly flat since 1999, even while the death rates for this age category had been declining steadily in other countries and among nonwhite Americans.
Here’s the quick summary of what was happening in the U.S. for non-Hispanic white Americans aged 45-54:
Different things are happening in different regions—in particular, things have been getting worse for women in the south and midwest, whereas the death rate of men in this age group have been declining during the past few years—but overall there has been little change since 1999. In contrast, other countries and U.S. nonwhites have seen large declines in death rates, something like 20%.
The above graph (from this paper with Jonathan Auerbach) is not quite what Case and Deaton showed. They didn’t break things down by sex or region, and they didn’t age adjust, which was a mistake because during the 1999-2013 period, the baby boom moved through the 45-54 age group, so that this group increased in average age, leading to an increase in raw death rates simply because the people in this age category are older. (The instantaneous probability of dying increases at a rate of about 8% per year; that is, each year in this age range your chance of dying during the next year is multiplied by approximately a factor of 1.08; thus, when looking at relatively small changes of death rate you really have to be careful about age composition.)
Anyway, that’s all been hashed out a million times and now we understand it.
Today I want to talk about something different: trends in death rate by education. Much of the discussion in the news media has centered on the idea that the trend is particularly bad for lower-educated whites. But, as I wrote in my first post on the topic:
I’m not quite sure how to interpret Case and Deaton’s comparisons across education categories (no college; some college; college degree), partly because I’m not clear on why they used this particular binning but also because the composition of the categories have changed during the period under study. The group of 45-54-year-olds in 1999 with no college degree is different from the corresponding group in 2013, so it’s not exactly clear to me what is learned by comparing these groups. I’m not saying the comparison is meaningless, just that the interpretation is not so clear.
I was just raising a question, but it turns out that some people have studied it, and there’s a paper from 2015 in the journal Health Affairs.
Here it is: Measuring Recent Apparent Declines In Longevity: The Role Of Increasing Educational Attainment, by John Bound, Arline Geronimus, Javier Rodriguez, and Timothy Waidmann, who write:
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.
Yes, this was the question I raised earlier, and Bound et al. back it up with a graph, which I reproduced at the top of this post. (John Bullock argues in a comment that the above graph is wrong because high school completion rates aren’t so high, but this does not affect the general point made by Bound et al.)
Then they take the next step:
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.
That makes sense. By using relative rank, they’re making an apples-to-apples comparison. And here’s what they find:
Estimating trends in mortality for the bottom quartile, we found little evidence that survival probabilities declined dramatically.
Interesting! They conclude:
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.