Mortality Inequality: The Good News from a County-Level Approach.

L ife expectancy for the US population has shown a strong increase since 1990. The rise in life expectancy at birth holds for both men and women, as shown in Figure 1. This development has not been driven solely by improvements in life expectancy at older ages. Mortality rates for those under one year of age, for the age group 1–4, and for every five-year age group above that level, declined for both males and females between 1990 and 2010. Particularly pronounced improvements in mortality occurred at younger ages, which tend to be age groups in which deaths occur predominantly among the poor. However, this overall decline in mortality rates has been accompanied by prominent recent studies highlighting that the gains have not been distributed equally (for example, Cutler, Lange, Meara, Richards-Shubik, and Ruhm 2011; Chetty et al. 2015; National Academies of Science, Engineering, and Medicine (NAS) 2015; Case and Deaton 2015). Indeed, several studies argue that when measured across educational groups and/or geographic areas, mortality gaps are not only widening, but that for some US groups, overall life expectancy is even falling (Olshansky et al. 2012; Wang, Schumacher, Levitz, Mokdad, and Murray 2013; Murray et al. 2006). It seems to have become widely accepted that inequality in life expectancy is increasing. Given that the number of years that one can expect to live is such an