The plight of poorly-educated US women: Trickle down isn’t happening

I have a post on The Incidental Economist documenting the decades-long and continuing decline in life expectancy among poorly-educated white women in the US. The figure below (from J. Olshansky and colleagues) shows the sharp decline in life expectancy among white women who have not completed high school. Please read that post. Then I want to say something here about why this matters.

It matters first, and obviously, because lives matter and a decline in life expectancy is merely a statistic describing loss of life.

It also matters because a decline in life expectancy among poorly-educated US women bears on the legitimacy of the American social order. A commonly heard justification of US social inequality is that it is a necessary consequence of a rapidly growing economy that benefits all participants. Moreover, this growth is a good and possibly the best way to benefit poor Americans.

Therefore, if you believe that benefiting the poor should have priority in our social policy, then you can argue that despite its extraordinary inequality the US social order is nevertheless a legitimate social order. A Rawlsian might argue that the US fulfills the second condition of the second principle of justice:

Second Principle: Social and economic inequalities are to satisfy two conditions:

They are to be attached to offices and positions open to all under conditions of fair equality of opportunity;

They are to be to the greatest benefit of the least-advantaged members of society (the difference principle).

But when a large demographic group loses life expectancy despite decades of economic growth, the premise of the argument is wrong and these legitimizations cannot get off the ground. Arguments about whether ‘trickle down’ economics can justify US inequality are moot if well-being doesn’t trickle down.

About Bill Gardner

A health care researcher and a child and quantitative psychologist by training. I am an American living in Canada and am Professor of Paediatrics, Obstetrics & Gynaecology, and Community Health & Epidemiology at Dalhousie University; and Professor of Pediatrics, Psychology, and Psychiatry at The Ohio State University. I also blog at The Incidental Economist ( and you can follow me @Bill_Gardner on Twitter.
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9 Responses to The plight of poorly-educated US women: Trickle down isn’t happening

  1. Pingback: Mortality among poorly-educated women | The Incidental Economist

  2. ken thompson says:

    bill, good point.. it might make some difference if we knew something about the geography of this loss in life expectancy. it may be that some sections and sectors of the national economy and the ensuing social order are in trouble and the least able to stay afloat are going down, dragging the average down. if there are some geographic centers to the what is happening, this doesnt change to moral argument you are making, but it might suggest what elements of the economy and social structure are most problematic..

  3. Bill Gardner says:

    Ken, good to hear from you. Check the link to my The Incidental Economist post in the first sentence of this post. I present a couple of maps showing changes in female life expectancy and it is concentrated, mostly in the rural south. That post has links to the original studies in Health Affairs.

  4. MichaelWStory says:

    Is it not also plausible that some of this effect can be explained by changes to the constitution of the group, without any need for individual women to face lower life expectancy? Given the rise in women’s levels of education, improvements in educational sorting and the established link between IQ and life expectancy could it be that the pool of women who in previous years would have achieved 12 or fewer years of education is being more efficiently fished for those with better prospects, leaving behind a rump of more troubled individuals?

    • Brian S says:

      I was thinking the same thing. However, life expectancy is nearly the same in 2008 for 12 years education as in 1990 for less than 12 years. So even if you equalize the size of the two <12 yrs. groups (1990 and 2008) by adding in women from the 2008 12 yrs. group, there's still going to be a pretty big decline.

      • MichaelWStory says:

        But that depends on the size of the groups being similar, and even then the high school/no college group will be losing members up the education ladder too- white women are particularly more likely to be in the 13-15 bracket in 2008 than they were in 1990. What we need to figure this out is more numbers- centiles of life expectancy for a start

      • Brian S says:

        Well it definitely depends on the size of the groups, but I’m not motivated enough to track down all of the statistics and produce a real estimate. If we were looking at the bottom 10% in 1990, then we want to look at the bottom 10% in 2008, and that group doesn’t include anyone from the college groups. I’m not looking at the change over time in the high school / no college group, just observing that their life expectancy in 2008 was very close to the no diploma group in 1990.

        Basically what I’m saying is that if the 2008 no diploma group was only 70% of the size of the 1990 group, then you have 70% that declined by five years, and 30% that at best stayed the same, so the decline is still at least 3.5 years. Unless the high school dropout rate has declined to near zero, the conclusion that the least educated women lost life expectancy stands, it just might not be a full five years if you go by relative attainment instead of absolute.

      • MichaelWStory says:

        Or, each group has lost it’s healthiest members to the next group up- that could account for the average change in the groups without any need for a change in life expectancy for any individual.

        You wrote:”If the 2008 no diploma group was only 70% of the size of the 1990 group, then you have 70% that declined by five years, and 30% that at best stayed the same, so the decline is still at least 3.5 years. ”

        In your example, that 70% may not have experienced and change in life expectancy, it could have been the departure of the healthiest 30% that lowered the group average. Why didn’t that raise the average of the HS graduate group? Because they in turn could have lost their healthiest members to the ‘some college’ group and so on.

  5. Bill Gardner says:

    Michael, that is a plausible hypothesis. Montez (see the link in the post on The Incidental Hypothesis) considers it and is skeptical, but I don’t think we have a definitive answer. Even if what is going on is partially explained by changes in the composition of the cohort of poorly educated women, I think my points about justice still stand.

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