23 Apr Strong Decrease in Mortality Among Young People Bodes Well For Future

Posted at 21:16h in Author Interviews, Global Health, Pediatrics by

MedicalResearch.com Interview with:

Janet Currie Henry Putnam Professor of Economics and Policy Affairs Chair, Department of Economics Director, Center for Health and Wellbeing Princeton University Princeton NJ 08544

Janet Currie

Janet Currie
Henry Putnam Professor of Economics and Policy Affairs
Chair, Department of Economics
Director, Center for Health and Wellbeing
Princeton University
Princeton NJ 08544

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Many recent studies point to increasing inequality in mortality in the United States over the past 20 years. These studies often use mortality rates in middle and old age. This is the first study to examine mortality trends for younger ages.  We find that for infants, children and young adults below age 20, however, there have been strong mortality improvements that were most pronounced in poorer counties, implying a strong decrease in mortality inequality. There is a great deal of evidence from past studies that healthier children grow up to be healthier adults.  These current young people will form the future adult U.S. population, so this research suggests that inequality in middle and old-age mortality may have peaked and is likely to decline as these cohorts become older.

MedicalResearch.com: What should clinicians and patients take away from your report?

Response: One reason for the decline in mortality inequality among young people is the tremendous expansion of public health insurance for poor pregnant women and children that has taken place since the late 1980s.  In addition to expansions of the Medicaid program, the creation of the SCHIP program covered many additional children in middle income families.  Our results suggest that these programs have been tremendously successful in improving health outcomes for poor children.  Hence, these results underline the importance of maintaining health insurance programs for low income families in future, and the importance of access to medical care more generally for maintaining health and reducing inequalities in mortality.

MedicalResearch.com: What recommendations do you have for future research as a result of this study?

Response: There are many unresolved questions.

  • One is which causes of death have shown the greatest declines?
  • A second is whether these reductions in mortality will continue into the future. 
  • Third, how do these patterns of mortality reduction compare with those in other countries with different health care systems such as Canada, the U.K., Germany, or France? 

MedicalResearch.com: Is there anything else you would like to add?

Response: Increases in mortality among some segments of the population have gotten inordinate attention in the media.  At the same time, a more positive story is being completely ignored.  For example, a recent front page story in the New York Times highlighted that suicides increased from 10.5 to 13 per 100,000 between 1999 and 2014.  By way of comparison, we show that the 3-year mortality rate for male newborns in poor counties decreased from 1,828 to 979 per 100,000! And for 15-19 year-olds (an age with very low mortality) the male mortality rate in poor areas declined from 583 to 310 per 100,000.  The New York Times also highlighted an increase from 0.6 to 1.5 suicides per 100,000 for girls 10-14. At the same time the overall annual death rate for girls of that age decreased from 19 to 13 per 100,000 between 2000 and 2010.   While not meaning to minimize the devastating impact of suicide, the relentless focus on the negative aspects of the mortality story is really causing an overall success story to be overlooked.  This distortion of the true picture could have serious consequences if it convinces voters that public policies to reduce mortality are ineffective.

MedicalResearch.com: Thank you for your contribution to the MedicalResearch.com community.

Citation:

Janet Currie, Hannes Schwandt. Inequality in Mortality Between Rich and Poor U.S. Counties Decreased Among the Young While Increasing for Older Adults, 1990-2010. Science, April 2016 DOI:10.1126/science.aaf1437

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Last Updated on April 23, 2016 by Marie Benz MD FAAD

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