A New Database to Measure the Association Between Income and Mortality Across the United States and as Foundation to Enhance Health for All Americans

Disparities in health and life expectancy by income are a central challenge for the United States. The highest income American men live nearly 15 years longer on average than the lowest-income American men; the corresponding gap for women is 10 years. The COVID-19 pandemic has amplified these disparities by income, race, and other dimensions. Unfortunately, we currently lack information on how mortality rates due to COVID-19 vary with individual income, because available U.S. population mortality data lacks information on income. The absence of this information has hindered our ability to monitor the impacts of COVID-19 and develop policies to mitigate its impacts, particularly on disadvantaged and underserved populations, going forward. This project will resolve these challenges by constructing a new public database of mortality rates incorporating socioeconomic and demographic variables and covering the entire U.S. population. Using these data, researchers will be able to analyze the sources of disparate impacts of COVID-19 on mortality across subgroups, with the aim of understanding how to reduce health inequality in the pandemic and beyond.

The project has three specific aims.
Aim 1 of this project is to release a new public database of mortality rates by age, income,race/ethnicity, gender and county, and provide recurring annual updates to this database. This database will be constructed by linking from tax returns, the decennial Census, and Social Security death records.
Aim 2 will characterize the short-term effects of the COVID-19 pandemic on mortality rates by race and income in 2020-21. This analysis will measure the quantity of excess deaths and disparities in their distribution caused by the pandemic, and identify economic and health mechanisms generating those disparities.
Aim 3 will measure the long-term effects of post-pandemic changes in health, health behaviors, labor income, tax and transfer policies, and behaviors on racial and socioeconomic inequality in mortality. This broader set of analyses will use the substantial disruptions generated by the pandemic to examine how and why disparities are growing or shrinking over time. Taken together, this project will contribute to research and policy work by providing critical new data on the relationship between socioeconomic status and health, thereby providing a tool to monitor progress in mitigating the impacts of the COVID-19 pandemic in underserved communities.