Understanding Geographic Disparities in Mortality

Jason Fletcher, University of Wisconsin-Madison, visited Iowa on Friday, May 6 and gave a seminar on his paper, “Understanding Geographic Disparities in Mortality” .

Fletcher is a Professor of Public Affairs at Wisconsin with appointments in Sociology, Applied Economics, and Population Health Sciences.  His research covers a wide array of topics including health economics, the economics of education, social networks, and genetics.  He is the Director of the Center for Demography of Health and Aging at Wisconsin and the Director of the Wisconsin RDC.

Abstract
A rich literature shows that early life conditions shape later life outcomes, including health and migration events. However, analyses of geographic disparities in mortality outcomes focus almost exclusively on contemporaneously measured geographic place (e.g., state of residence at death), thereby potentially conflating the role of early life conditions and migration patterns. We address this gap by constructing life expectancies by state of birth and comparing them to life expectancies by state of residence. We use the newly available Mortality Disparities in American Communities (MDAC) dataset, which links respondents in the 2008 ACS to official death records, to show that there are important differences in the two life expectancy measures. We find that regional inequality in life expectancy is higher based on life expectancies by state of birth. This implies that interstate migration mitigates the baseline geographical inequality in mortality outcomes. Finally, we find that cross-state differences in the relative mortality outcomes of in-migrants compared to stayers play a key role in explaining the discrepancies between the two life expectancy measures.