The Cardiovascular Revolution in the United States. A Geographic Analysis

Magali Barbieri, Institut National d'Études Démographiques (INED) and University of California, Berkeley
Nadine Ouellette, Institut National d'Études Démographiques (INED)
Mila Andreeva, City University of New York (CUNY)
Celeste Winant, University of California, Berkeley

The range of life expectancy at birth across the states of the United States is as wide as the range across all high-income countries. We examine whether current geographic differentials reflect state-wide variations in past mortality trends. We are specifically interested in the period when infectious diseases have been replaced by cardiovascular diseases and cancer as the leading causes of death. The analysis is based on a massive effort to reconstruct cause-specific and age-standardized death rates as well as life tables by sex for every calendar year from 1959 through 2004 in each of the 50 U.S. states and D.C. It demonstrates that the change in survival trends that started at the end of the 1960s was not only sudden, unexpected and ominous but that it was also generalized and driven everywhere by a major decline in cardiovascular mortality. Implications for theories of mortality change are discussed.