Economic Opportunity, Health Behaviors, and Mortality in the United States

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Abstract

Objectives

We assessed whether economic opportunity was independently associated with health behaviors and outcomes in the United States.

Methods

Using newly available, cross-sectional, county-level data from the Equality of Opportunity Project Database and vital statistics, we estimated associations between all-cause mortality rates (averaged over 2000-2012) and economic opportunity, adjusting for socioeconomic, demographic, and health system covariates. Our measure of economic opportunity was the county-average rank in the national income distribution attained by individuals born to families in the bottom income quartile. Secondary outcomes included rates of age- and race-specific mortality, smoking, obesity, hypertension, and diabetes.

Results

An increase in economic opportunity from the lowest to the highest quintile was associated with a 16.7% decrease in mortality. The magnitudes of association were largest for working-age adults and African Americans. Greater economic opportunity was also associated with health behaviors and risk factors.

Conclusions

Economic opportunity is a robust, independent predictor of health. Future work should investigate underlying causal links and mechanisms.

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