Abstract
This study examined the association between unemployment and life expectancy in the United States during 1990–2010. Census-based unemployment rates were linked to US county-level mortality data. Life expectancies were calculated by age, sex, race, and unemployment level during 1990–2010. Differences in life expectancy were decomposed by age and cause of death. Life expectancy was consistently lower in areas with higher unemployment rates. In 2006–2010, those in areas with high unemployment rates (≥9%) had a life expectancy of 76.9 years, compared with 80.7 years for those in areas with low unemployment rates (<3%). The association between unemployment and life expectancy was stronger for men than for women. Life expectancy ranged from 69.9 years among black men in high unemployment areas to 90.0 years among Asian/Pacific Islander women in low unemployment areas. Disparities persisted over time. In 1990–1992, life expectancy was 4.7 years shorter in high unemployment than in low unemployment areas. In 2006–2010, the life expectancy difference between the lowest and highest unemployment areas decreased to 3.8 years. Heart disease, cancer, homicide, unintentional injuries, diabetes, HIV/AIDS, and liver cirrhosis contributed most to the lower life expectancy in high unemployment areas. High unemployment areas recorded larger gains in life expectancy than low unemployment areas, contributing to the narrowing gap during 1990–2010.
Highlights
Life expectancy is one of the most widely used indicators of health status and a key measure of human development [1, 2]
Since employment status of decedents is not reported in the national mortality database and direct computation of life expectancy by unemployment level is not possible, the 1990 and 2000 census-based unemployment data were linked to the age-sex-race-countyspecific mortality statistics during 1990–1998 and 1999–2010, respectively, to derive life expectancy estimates [4, 12, 20,21,22]
Cardiovascular diseases, all cancers, diabetes, HIV/AIDS and other infectious diseases, pneumonia/influenza, and kidney diseases accounted for a larger proportion of the life expectancy gap in women, while homicide, unintentional injuries, liver cirrhosis, COPD, and lung cancer accounted for a greater percentage of the life expectancy gap in men
Summary
Life expectancy is one of the most widely used indicators of health status and a key measure of human development [1, 2]. Life expectancy estimates are routinely available for sex and broad racial/ethnic groups in the United States [3,4,5]. Estimation of US life expectancy according to unemployment levels has received less attention, the analysis of trends in life expectancy among areas or populations with high unemployment rates [7]. Substantial disparities in life expectancy have been reported among sex, racial/ethnic, and socioeconomic groups in the USA, it is important to know the magnitude and causes of life expectancy disparities among populations with different unemployment rates for formulating comprehensive public policies to tackle the problem of growing health and socioeconomic inequalities in the country [6]
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