Changes in the Age Distribution of Mortality Over the 20th Century

David Cutler, Ellen Meara

NBER Working Paper No. 8556
Issued in October 2001
NBER Program(s):Economics of Aging, Children, Health Care

Mortality has declined continuously in the United States over the course of the 20th century, and at relatively constant rates. But the constancy of mortality reductions masks significant heterogeneity by age, cause, and source. Using historical data on death by age and cause, this paper describes the characteristics of mortality decline over the 20th century. Early in the 20th century, mortality declines resulted from public health and economic measures that improved peoples' ability to withstand disease. Because nutrition and public health were more important for the young than the old, mortality reductions were concentrated at younger ages. By mid-century, medical care became more significant and other factors less so. Penicillin and sulfa drugs brought the first mortality reductions at older ages, which were coupled with continuing improvements in health at younger ages. The pattern of mortality reduction was relatively equal by age. In the latter part of the 20th century, death became increasingly medicalized. Cardiovascular disease mortality was prevented in significant part through medical intervention. Most of the additional years added to life in the last few decades of the 20th century were at older ages.

download in pdf format
   (183 K)

email paper

A non-technical summary of this paper is available in the March 2002 NBER Digest.  You can sign up to receive the NBER Digest by email.

Machine-readable bibliographic record - MARC, RIS, BibTeX

Document Object Identifier (DOI): 10.3386/w8556

Published: Wise, David (ed.) Perspectives on the Economics of Aging. Chicago: University of Chicago Press, 2003.

Users who downloaded this paper also downloaded* these:
Cutler, Deaton, and Lleras-Muney w11963 The Determinants of Mortality
Cutler and Miller w10511 The Role of Public Health Improvements in Health Advances: The 20th Century United States
Preston Causes and Consequences of Mortality Declines in Less Developed Countries during the Twentieth Century
Jayachandran, Lleras-Muney, and Smith w15089 Modern Medicine and the 20th Century Decline in Mortality: Evidence on the Impact of Sulfa Drugs
Cutler and Meara Changes in the Age Distribution of Mortality over the Twentieth Century
NBER Videos

National Bureau of Economic Research, 1050 Massachusetts Ave., Cambridge, MA 02138; 617-868-3900; email:

Contact Us