Assessment of Linked Associations in Predictors of Life Expectancy Inequality | Health Care Economics, Insurance, Payment | JAMA Network
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Research Letter
April 2018

Assessment of Linked Associations in Predictors of Life Expectancy Inequality

Author Affiliations
  • 1Department of Emergency Medicine, University of Arizona College of Medicine–Phoenix, Maricopa Integrated Health System, Phoenix
JAMA Intern Med. 2018;178(4):563-564. doi:10.1001/jamainternmed.2017.7893

Human health has improved dramatically over the last couple centuries.1 Yet, disparities remain, and recent work2 suggests that these disparities are widening for life expectancy. These disparities are owing to a combination of socioeconomic and race/ethnicity factors, behavioral and metabolic risk factors, and health care factors. However, multivariable analyses that include all these risk factors suggest that the variations in life expectancy are largely explained by behavioral and metabolic risk factors, with socioeconomic and race/ethnicity factors no longer being statistically significant.2 This is an interesting finding, especially given how much we hear about rising income inequality.3 Indeed, in bivariate analysis, income is the strongest predictor of life expectancy.2 Given these somewhat incongruous results, I sought to compare the rise of income inequality, as well as racial inequality, over the same time frame as the rise in life expectancy inequality.

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