Social Mobility

Economic Opportunity, Health Behaviors, and Mortality in the United States

Abstract

Objectives

We assessed whether economic opportunity was independently associated with health behaviors and outcomes in the United States.

Methods

Using newly available, cross-sectional, county-level data from the Equality of Opportunity Project Database and vital statistics, we estimated associations between all-cause mortality rates (averaged over 2000-2012) and economic opportunity, adjusting for socioeconomic, demographic, and health system covariates. Our measure of eco- nomic opportunity was the county-average rank in the national income distribution attained by individuals born to families in the bottom income quartile. Secondary out- comes included rates of age- and race-specific mortality, smoking, obesity, hypertension, and diabetes.

Results

An increase in economic opportunity from the lowest to the highest quintile was associated with a 16.7% decrease in mortality. The magnitudes of association were largest for working-age adults and African Americans. Greater economic opportunity was also associated with health behaviors and risk factors.

Conclusions

Economic opportunity is a robust, independent predictor of health. Future work should investigate underlying causal links and mechanisms.