Volume 31 - Article 2 | Pages 27–70  

Factors responsible for mortality variation in the United States: A latent variable analysis

By Christopher Tencza, Andrew C. Stokes, Samuel Preston


Background: Factors including smoking, drinking, substance abuse, obesity, and health care have all been shown to affect health and longevity. The relative importance of each of these factors is disputed in the literature, and has been assessed through a number of methods.

Objective: This paper uses a novel approach to identify factors responsible for interstate mortality variation. It identifies factors through their imprint on mortality patterns and can therefore identify factors that are difficult or impossible to measure directly, such as sensitive health behaviors.

Methods: The analysis calculates age-standardized death rates by cause of death from 2000-2009 for white men and women separately. Only premature deaths between ages 20-64 are included. Latent variables responsible for mortality variation are then identified through a factor analysis conducted on a death-rate-by-state matrix. These unobserved latent variables are inferred from observed mortality data and interpreted based on their correlations with individual causes of death.

Results: Smoking and obesity, substance abuse, and rural/urban residence are the three factors that make the largest contributions to state-level mortality variation among males. The same factors are at work for women but are less vividly revealed. The identification of factors is supported by a review of epidemiologic studies and strengthened by correlations with observable behavioral variables. Results are not sensitive to the choice of factor-analytic method used.

Conclusions: The majority of interstate variation in mortality among white working-age adults in the United States is associated with a combination of smoking and obesity, substance abuse and rural/urban residence.

Author's Affiliation

Other articles by the same author/authors in Demographic Research

An integrated approach to cause-of-death analysis: cause-deleted life tables and decompositions of life expectancy
Volume 19 - Article 35

Cohort fertility patterns and breast cancer mortality among U.S. women, 1948-2003
Volume 18 - Article 9

Comparative mortality levels among selected species of captive animals
Volume 15 - Article 14

Most recent similar articles in Demographic Research

Measuring short-term mobility patterns in North America using Facebook advertising data, with an application to adjusting COVID-19 mortality rates
Volume 50 - Article 10    | Keywords: COVID-19, data collection, Facebook, mortality, North America, short-term mobility

Immigrant mortality advantage in the United States during the first year of the COVID-19 pandemic
Volume 50 - Article 7    | Keywords: COVID-19, immigrants, mortality

Early life exposure to cigarette smoking and adult and old-age male mortality: Evidence from linked US full-count census and mortality data
Volume 49 - Article 25    | Keywords: linked census and mortality data, linked census data, smoking, United States of America

Frailty at death: An examination of multiple causes of death in four low mortality countries in 2017
Volume 49 - Article 2    | Keywords: aging, causes of mortality, mortality, multiple causes of death

Ethnic and regional inequalities in Russian military fatalities in Ukraine: Preliminary findings from crowdsourced data
Volume 48 - Article 31    | Keywords: armed conflict, fatality, military, mortality, Russia, Ukraine, war