Subnational Inequalities in Mortality: Developments and applications in decomposition methods

Abstract

Mortality inequalities have become a public health priority within society as countries are experiencing increasing disparities, as shown by gradients of life expectancy and life span variation between different subpopulations stratified by socioeconomic status. Life expectancy and life span variation measure the average length of life and the variability in age-at-death distribution for the subpopulation, respectively. These inequalities should be a public health priority since "[Mortality inequality] ...is the most fundamental of all inequalities; every other type of inequality is conditional upon being alive." (van Raalte et al. 2018). A large body of literature has been dedicated to exploring, investigating, and evaluating mortality inequalities at the national level. However, explorations on the heterogeneous mortality levels of the subpopulations under the national "umbrella", i.e. the mortality at the national level, are needed. More importantly, these different mortality experiences among subpopulations aggregate towards the mortality trend we observe at the national level. The national-level mortality is merely a manifestation of different mortality schedules belonging to different subpopulations at the subnational level. The exploration of the subnational-national link of mortality would guide approaches that improve life expectancies and life span variations for more disadvantaged populations and for future improvements to mortality at the national level. This dissertation aims to explore and quantify the relationship between the mortality changes at the national level and the mortality experiences of its subpopulations. The research questions include how do mortality rates of subpopulations influence mortality at the national level? And how sensitive is mortality at the national level to mortality changes at the subnational level? In order to answer these research questions, this dissertation proposes novel decomposition methods and applications in mathematical demography. The theoretical contribution of this dissertation is to further the understanding of the mathematical link between micro and macro levels of mortality, which is not sufficiently addressed in the current demographic literature. Show more