Emerging political and demographic divides: State politics, welfare generosity, and adult mortality in U.S. states 1977–2017

Andrew Fenelon, Christopher Witko

Research output: Contribution to journalArticlepeer-review

6 Scopus citations

Abstract

Geographic disparities in adult mortality within the US have grown over the past several decades, but the reasons for these trends remain unclear. In this article, we examine trends in adult mortality (ages 55+) across US states from 1977 to 2017, paying close attention to the shifting geographic pattern of high- and low-mortality states. We find that states in the South tended to fall behind the rest of the country in the 1970s and 1980s, while states in the Great Plains and Mountain West tended to fall behind in the 1990s, 2000s, and 2010s. In contrast, states on the East and West Coasts have tended to see considerable improvement in mortality. We consider the role of state-level per-capita spending on public welfare programs in the mortality experience of states between 1977 and 2017. We use fixed effects models to show that greater state welfare generosity predicts greater yearly reductions in mortality. State shifts toward more generous welfare spending regimes may contribute to significant geographic divergences in adult mortality in the United States.

Original languageEnglish (US)
Article number102644
JournalHealth and Place
Volume71
DOIs
StatePublished - Sep 2021
Externally publishedYes

Bibliographical note

Funding Information:
The authors acknowledge institutional support from the Population Research Institute at Penn State ( P2C-HD041025 ). The authors are grateful to the Population Health Working Group at Penn State and the Network on Life Course Health Dynamics and Disparities supported by the National Institute on Aging.

Publisher Copyright:
© 2021 Elsevier Ltd

Keywords

  • Geographic divergence
  • Mortality
  • State liberalism
  • State policy
  • United States

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