Deregulation, Devolution, and State Preemption Laws' Impact on US Mortality Trends

摘要

Open any introductory demography textbook and you will find the core explanations for the historical decline in mortality: industrialization, improved standard of living, better nutrition, andpublichealth infrastructure. In other words, macrolevel explanations. These core explanations are widely accepted, even if their relative importance remains a matter of debate.Fast forward to recent trends in mortality—trends that are less favorable, even worrisome. Since the early 1980s, declines in mortality in the United States have not kept pace with those in other high-income countries.1 Moreover, some parts of the United States and certain population subgroups, such as low-educated adults, have reportedly experienced increases in mortality.2 According to the US National Center for Health Statistics, between 2014 and 2015, life expectancy at birth for the nation as a whole declined by 0.1 year.3 Although that decline may ultimately prove to be a minorhiccup, it is a troubling indicator of the nation’s current health.