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Rising Mortality Among Non-Hispanic Whites Is Only Among Women

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I have been meaning to post a followup to the posts Paul wrote about the Case and Deaton study finding increasing mortality among whites ages 45-54.

Andrew Gelman and Jonathan Auerbach adjusted the data by age (the original dataset aggregated people in ten year age bins, which could create a bias if the members of, say the cohort from 45-54 were getting older) and stratified the data from sex, and found that the increasing mortality rate only exists among white women, mostly in the South:

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It’s a good time to revisit this article, mostly for the research it reports on, which, confusingly, Case and Deaton don’t cite.  Kindig and Chen also find that increasing mortality rates are specific to women, especially in the South:

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The article also reports on this paper that investigates some possible upstream causes of increasing mortality among white women without high school diplomas:

 [T]he researchers discovered something else that was driving women like her to early graves: whether the women had a job mattered, and it mattered more than income or other signs of financial stability, like homeownership. In fact, smoking and employment were the only two factors of any significance.

At first, Montez and her co-author suspected that women who are already unhealthy are less able to work and so are already more likely to die. When they investigated that hypothesis, however, it didn’t hold up. Jobs themselves contributed something to health. But what? It could be, the authors suggested, that work connects women to friends and other social networks they otherwise wouldn’t have. Even more squishy sounding, Montez wrote that jobs might give women a “sense of purpose.”

Better-educated women are the most likely to work and to achieve parity with men: Seventy–two percent are in the workforce, compared with 81 percent of their male counter-parts. Women without high-school diplomas are the least likely to work. Only about a third are in the workforce, compared to about half of their male counterparts. If they do find work, women are more likely than men to have minimum-wage jobs. They account for most workers in the largest low-paying occupations—child-care providers, housecleaners, food servers. Even if they do have minimum-wage jobs, this group of women is more likely to leave the labor force to take care of young children because child care is prohibitively expensive.

Speculation about the causes of this effect is necessarily different when you realize it’s specific to women.  There’s a lot of risk in inferring causation, but it makes sense to me that being forced into very isolating caretaking work would be both psychologically and physically risky.  It is probably more isolating in rural areas, where the distance between homes is larger.  I’d also be interested in the forms of movement involved in childcare and eldercare, as contrasted with more male-dominated low-wage jobs, although any explanation for this effect needs to explain why it’s specific to white women, and that suggests a cause rooted in a difference between rural white women’s social position and that of black women and Hispanic women.

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