Trends in Health and Mortality Inequalities in the United States

Published: 2019


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.

Key Findings

    • Our analysis of Health and Retirement Study data found increasing levels of inequality in health and life expectancy. We assessed the health status of successive cohorts born between 1934 and 1959 when respondents were 54 to 60 years old.
    • We measured socioeconomic status (SES) by both projected Social Security wealth and educational attainment. We found, particularly for those of lower SES, increases in obesity, diabetes, and reported levels of pain; a decline in self-reported health; and a decrease in subjective survival probabilities.
    • As a result, while we predict overall life expectancy to increase, the increase will be concentrated among those of higher SES, leading to greater mortality inequality.


Hudomiet, Péter, Michael D. Hurd, and Susann Rohwedder. 2019. “Trends in Health and Mortality Inequalities in the United States.” Ann Arbor, MI. University of Michigan Retirement and Disability Research Center (MRDRC) Working Paper; MRDRC WP 2019-401.