Trends in Area- and Individual-Level Socioeconomic Inequalities in U.S. All-Cause and Cancer Mortality, 1970-2000

Gopal K. Singh, Maternal & Child Health Bureau, HRSA & NIH

Despite impressive reductions in overall U.S. mortality and subsequent increases in life expectancy during the latter half of the twentieth century, substantial disparities in mortality among various socioeconomic groups continue to exist, and in many instances, such disparities appear to be widening. Using national mortality data and the National Longitudinal Mortality Study, this paper analyzes trends in all-cause mortality across the life course by both area- and individual level socioeconomic factors (e.g., education, income, poverty, and area deprivation) from 1970 to 2000, showing a widening of the social gradient in male and female mortality over time for each age cohort. The paper also analyzes the dynamic nature of social disparities in mortality for all cancers combined and for such major cancers as lung, colon/rectum, prostate, breast, and cervix; and discusses policy implications of these disparities for cancer prevention and control and for overall health improvement in the United States.