Geographic divergence in adult mortality in the United States

Life Expectancy at birth for women in the United States rose to nearly 78 years in 2007. While this is a new milestone for low mortality among Americans, the United States lags significantly behind its counterparts in Europe, partially reflecting a history of heavy smoking among Americans. However, health and mortality experience in the United States is far from homogeneous. The same factors that are responsible for the shortfall of American life expectancy may also be manifested in geographic inequalities in mortality within the United States. The current geographic pattern in adult mortality in the US is a relatively recent phenomenon, the result of increasing divergence in mortality experience between the southern states and the rest of the United States over past several decades. The goal of this paper is to examine the contribution of cigarette smoking to the increasing mortality gap between the southern states and the rest of the US since 1965. Data come from US vital statistics and the impact of smoking is estimated using indirect methods. Preliminary results indicate that the divergence in all-cause mortality occurs concomitantly with divergence in mortality attributable to cigarette smoking.