In 1905, children of physicians had the same likelihood of dying as
children of farmers or managers. By 1924, however, the mortality
of physicians’ children was about two-thirds lower than that of
farmers’ children. The reason: Quicker assimilation of improved
personal health care practices among parents with more education.
United States at the beginning of the 1900s. In 1905, children of physicians had the same likelihood of dying as
children of farmers or managers. By 1924, however, the
mortality of physicians’ children was about two-thirds
lower than that of farmers’ children. An important reason for the faster improvement in mortality rates for
professionals’ children was the quicker assimilation of
improved personal health care practices among parents
with more education.
It’s important to recognize that educational differences in survival at older ages are the result of earlier
mortality differentials that removed those individuals
with less advantageous characteristics—such as the poor
and those with less education—from the population.
Mortality selection is thus an important force acting on
the structure of the population. This is particularly relevant for health behaviors as they reflect a lifetime of
stresses and damage to the body.
Both our results and those from other sources show
that mortality differentials by socioeconomic status
are likely to remain—and may be growing. Our results,
however, have some limitations. We don’t have time-varying information on activity limitation over the
period of study. We thus assumed that people remain
in the same status reported at the baseline. In this regard, the differences in life expectancy reported here
represent the case in which the prevalence of activity
limitation remained constant between 1990–1991 and
2006. As mentioned before, there’s conflicting evidence
as to whether mobility limitations are increasing or
declining. To the extent that there remain educational
differences in mortality, it’s likely that these differences
may be exacerbated by health status.
JENNIFER AILSHIRE is a postdoctoral fellow at
the Andrus gerontology Center at the university of
Southern California. Her research focuses on the social
determinants of health and health disparities in the
united States. She holds a ph.D. in sociology from the
university of Michigan.
This article is solely the opinion of its authors. It does not express
the official policy of the American Academy of Actuaries; nor does
it necessarily reflect the opinions of the Academy’s individual
officers, members, or staff.
Beckett, M., “Converging Health Inequalities in Later Life-An
Artifact of Mortality Selection?” Journal of Health and Social
Behavior 41( 1):106-119, 2000.
Bell, F.C., and M. L. Miller, 2005. “Life Tables for the United States
Social Security Area, 1900-2100,” Social Security Administration,
Office of the Chief Actuary. 2005.
Crimmins, E.C., “Socioeconomic Differentials in Mortality and Health
at Older Ages,” Genus 61( 1):163-176, 2005.
Crimmins, E.M., and H. Beltrán-Sánchez, “Mortality and Morbidity
Trends: Is There Compression of Morbidity?” The Journals of
Gerontology Series B: Psychological Sciences and Social Sciences
66B( 1):75-86, 2011.
Crimmins, E.M., and Y. Saito, “Trends in Healthy Life Expectancy
in the United States, 1970-1990: Gender, Racial, and Educational
Differences,” Social Science & Medicine 52( 11):1629-1641, 2001.
Kawachi, I., and B. P. Kennedy, “Income Inequality and Health:
Pathways and Mechanisms,” Health Services Research 34( 1):
Manton, K.G., “Recent Declines in Chronic Disability in the Elderly
U. S. Population: Risk Factors and Future Dynamics,” Annual Review
of Public Health 29( 1):91-113, 2008.
Marmot, M.G., S. Stansfeld, C. Patel, F. North, J. Head, I. White,
E. Brunner, A. Feeney, and G. D. Smith, “Health Inequalities
among British Civil Servants: The Whitehall II Study.” The Lancet
Montez, J. K., R. Hummer, M. Hayward, H. Woo, and R. Rogers,
“Trends in the Educational Gradient of U.S. Adult Mortality From
1986 Through 2006 by Race, Gender, and Age Group.” Research on
Aging 33( 2):145-171, 2011.
Preston, S.H., American Longevity: Past, Present, and Future.
Syracuse, N. Y.: Maxwell School of Citizenship and Public Affairs,
Center for Policy Research, 1996.
Seeman, T. E., S. S. Merkin, E. M. Crimmins, and A. S. Karlamangla,
“Disability Trends Among Older Americans: National Health and
Nutrition Examination Surveys, 1988-1994 and 1999-2004.” American
Journal of Public Health 100( 1):100-107, 2010.
This article is adapted from a presentation given at
the SOA 2011 Living to 100 and Beyond international
Symposium, which was held Jan. 5-7, 2011 in Orlando,
Fla. ( http://livingto100.soa.org).