The Increasing Disparity in Mortality between Socioeconomic Groups in the United States, 1960 and 1986
- 7 July 1993
- journal article
- research article
- Published by Massachusetts Medical Society in New England Journal of Medicine
- Vol. 329 (2), 103-109
- https://doi.org/10.1056/nejm199307083290207
Abstract
Background There is an inverse relation between socioeconomic status and mortality. Over the past several decades death rates in the United States have declined, but it is unclear whether all socioeconomic groups have benefited equally. Methods Using records from the 1986 National Mortality Followback Survey (n = 13,491) and the 1986 National Health Interview Survey (n = 30,725), we replicated the analysis by Kitagawa and Hauser of differential mortality in 1960. We calculated direct standardized mortality rates and indirect standardized mortality ratios for persons 25 to 64 years of age according to race, sex, income, and family status. Results The inverse relation between mortality and socioeconomic status persisted in 1986 and was stronger than in 1960. The disparity in mortality rates according to income and education increased for men and women, whites and blacks, and family members and unrelated persons. Over the 26-year period, the inequalities according to educational level increased for whites and blacks by over 20 percent in women and by over 100 percent in men. In whites, absolute death rates declined in persons of all educational levels, but the reduction was greater for men and women with more education than for those with less. Conclusions Despite an overall decline in death rates in the United States since 1960, poor and poorly educated people still die at higher rates than those with higher incomes or better educations, and this disparity increased between 1960 and 1986.Keywords
This publication has 24 references indexed in Scilit:
- Health inequalities among British civil servants: the Whitehall II studyThe Lancet, 1991
- On the measurement of inequalities in healthSocial Science & Medicine, 1991
- Health and social inequities in Finland and elsewhereSocial Science & Medicine, 1990
- Race or class versus race and class: mortality differentials in the United StatesThe Lancet, 1990
- Socioeconomic Differentials in Health: A Review and RedirectionSocial Psychology Quarterly, 1990
- NATIONAL TRENDS IN EDUCATIONAL DIFFERENTIALS IN MORTALITYAmerican Journal of Epidemiology, 1989
- Social Class Inequality in Mortality From 1921 to 1972 in England and WalesPopulation Studies, 1985
- ADEQUACY OF SURVEY DATA COLLECTED FROM SUBSTITUTE RESPONDENTSAmerican Journal of Epidemiology, 1977
- SOCIAL CLASS, SUSCEPTIBILITY AND SICKNESSAmerican Journal of Epidemiology, 1976
- Differential Mortality in the United StatesPublished by Harvard University Press ,1973