Shorter Lives in Stingier States: Social Policy Shortcomings Help Explain the US Mortality Disadvantage

Beckfield, J.; Bambra, C.

doi:10.1016/j.socscimed.2016.10.017

Shorter Lives in Stingier States: Social Policy Shortcomings Help Explain the US Mortality Disadvantage

Beckfield, J.; Bambra, C.

Authors

J. Beckfield

C. Bambra

Abstract

The United States has a mortality disadvantage relative to its political and economic peer group of other “rich democracies”. Recently it has been suggested that there could be a role for social policy in explaining this disadvantage. In this paper, we test this ‘social policy’ hypothesis by presenting a time trend analysis from 1970 to 2011 of the association between welfare state generosity (for unemployment insurance, sickness benefits, and pensions) and life expectancy, for the US and 17 other high-income countries. Fixed-effects estimation with autocorrelation-corrected standard errors (robust to unmeasured between-country differences and serial autocorrelation of repeated measures) found strong associations between welfare generosity and life expectancy. A unit increase in overall welfare generosity yields a 0.17 year increase in life expectancy at birth (p < 0.001), and a 0.07 year increase in life expectancy at age 65 (p < 0.001). The strongest effects of the welfare state are in the domain of pension benefits (b = 0.439 for life expectancy at birth, p < 0.001; b = 0.199 for life expectancy at age 65, p < 0.001). Models that lag the measures of social policy by ten years produce similar results, suggesting that the results are not driven by endogeneity bias. There is evidence that the US mortality disadvantage is, in part, a welfare-state disadvantage. We estimate that life expectancy in the US would be approximately 3.77 years longer, if it had just the average social policy generosity of the other 17 OECD nations.

Citation

Beckfield, J., & Bambra, C. (2016). Shorter Lives in Stingier States: Social Policy Shortcomings Help Explain the US Mortality Disadvantage. Social Science & Medicine, 171, 30-38. https://doi.org/10.1016/j.socscimed.2016.10.017

Journal Article Type	Article
Acceptance Date	Oct 17, 2016
Online Publication Date	Oct 18, 2016
Publication Date	Dec 1, 2016
Deposit Date	Apr 25, 2016
Publicly Available Date	Nov 1, 2016
Journal	Social science and medicine
Print ISSN	0277-9536
Publisher	Elsevier
Peer Reviewed	Peer Reviewed
Volume	171
Pages	30-38
DOI	https://doi.org/10.1016/j.socscimed.2016.10.017

Files

Accepted Journal Article (749 Kb)
PDF

Publisher Licence URL
http://creativecommons.org/licenses/by/4.0/

Copyright Statement
This article is available under the terms of the Creative Commons Attribution License (CC BY).
You may copy and distribute the article, create extracts, abstracts and new works from the article, alter and revise the article, text or data mine the article and otherwise reuse the article commercially (including reuse and/or resale of the article) without permission from Elsevier. You must give appropriate credit to the original work, together with a link to the formal publication through the relevant DOI and a link to the Creative Commons user license above. You must indicate if any changes are made but not in any way that suggests the licensor endorses you or your use of the work.