Mortality patterns in the United States since 1960: Essays on migrant mortality, the impact of Medicare, and demographic consequences of cause -specific mortality change

Greg Lee Drevenstedt, University of Pennsylvania


The three essays which comprise this dissertation examine particular features of mortality patterns in the United States since 1960, with special reference to differences by race and sex. The first essay investigates mortality by region of birth and migration status using data from the National Longitudinal Mortality Study. Contrary to previous studies based on vital statistics data, this research does not find excess mortality among southern-born blacks relative to blacks born elsewhere, but does find higher mortality among southern-born whites. Differences in sociodemographic characteristics between migrants and non-migrants are examined. Educational attainment appears to be the most important factor affecting mortality differentials between U.S.-born migrants and non-migrants. In contrast, foreign-born migrants maintain a substantial mortality advantage over natives despite having less education. The second essay investigates the impact of the Medicare program on mortality at older ages. When Medicare was introduced on July 1, 1966 health care coverage among older adults increased from around 50 percent to over 95 percent. Many experts suggest that access to high-quality medical care through Medicare has helped older Americans live longer, healthier, and more independent lives. This study uses a relational model of mortality at older ages to simulate conditions that might have prevailed if Medicare had not been introduced. The results suggest that for females, but not for males, a substantial portion of the increase in longevity at older ages since 1966 may be associated with enrollment in Medicare. The third study uses counterfactual population projections to examine the demographic consequences of cause-specific mortality change since 1960 by race and sex. Deaths between 1960 and 2000 are assigned to 28 exhaustive, mutually exclusive cause groups. Cumulative population gains or losses resulting from changes in mortality are derived by way of difference between race-sex-specific populations projected under observed mortality conditions and populations projected while holding mortality constant for each cause. The absolute and proportionate impact of cause-specific mortality change on the 2000 population is compared for whites and blacks by sex.

Subject Area

Demographics|Public health|Minority & ethnic groups|Sociology|African Americans|Welfare

Recommended Citation

Drevenstedt, Greg Lee, "Mortality patterns in the United States since 1960: Essays on migrant mortality, the impact of Medicare, and demographic consequences of cause -specific mortality change" (2001). Dissertations available from ProQuest. AAI3003622.