סמינר מחלקתי-Institutional Policy Changes and the Growing Inequality in US Health and Mortality

תקציר ההרצאה: 

How has inequality in U.S. adult health and mortality changed in recent decades? Are all socioeconomic groups improving or are some groups being left behind? This talk showcases the trend in the vast improvements in life expectancy experienced by socioeconomic advantaged persons, which is being offset by declines or stagnating mortality for disadvantaged persons. Traditionally, studies aimed at explaining disparities in U.S. adult health have focused on individual-level mechanisms rather than the contextual conditions that allow the disparities to exist and expand. Here, a conceptual framework is developed, pointing to the importance of societal technological and institutional changes – many of which are profound and fast-moving - for individuals’ ability to marshal personal resources to garner health advantages. The importance of several large-scale changes in public policy are highlighted that have exacerbated inequality in health and mortality and concentrated the inequality differentially across US states. New empirical results showcase that states are affecting inequality largely by implementing policies that are placing persons with low SES at greater risk; persons with high SES are largely inoculated from these policies. This evidence is consistent with the argument that states are becoming critical institutional actors in developing and maintaining policies that foster vastly different exposures and resources for individuals’ health and well-being. The pace and magnitude of the changes in inequality in health point to the importance of understanding how policy changes are colliding with people’s individual resources to alter health risk exposure. This understanding is crucial both for individuals and policymaks