The Contribution of Drug Overdose to Educational Gradients in Life Expectancy in the United States, 1992-2011

Demography. 2017 Jun;54(3):1175-1202. doi: 10.1007/s13524-017-0565-3.


Since the mid-1990s, the United States has witnessed a dramatic rise in drug overdose mortality. Educational gradients in life expectancy widened over the same period, and drug overdose likely plays a role in this widening, particularly for non-Hispanic whites. The contemporary drug epidemic is distinctive in terms of its scope, the nature of the substances involved, and its geographic patterning, which influence how it impacts different education groups. I use vital statistics and National Health Interview Survey data to examine the contribution of drug overdose to educational gradients in life expectancy from 1992-2011. I find that over this period, years of life lost due to drug overdose increased for all education groups and for both males and females. The contribution of drug overdose to educational gradients in life expectancy has increased over time and is greater for non-Hispanic whites than for the population as a whole. Drug overdose accounts for a sizable proportion of the increases in educational gradients in life expectancy, particularly at the prime adult ages (ages 30-60), where it accounts for 25 % to 100 % of the widening in educational gradients between 1992 and 2011. Drug overdose mortality has increased more rapidly for females than for males, leading to a gender convergence. These findings shed light on the processes driving recent changes in educational gradients in life expectancy and suggest that effective measures to address the drug overdose epidemic should take into account its differential burden across education groups.

Keywords: Drug overdose; Educational gradients; Life expectancy.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Drug Overdose / epidemiology*
  • Educational Status*
  • Female
  • Health Surveys
  • Humans
  • Life Expectancy / ethnology*
  • Male
  • Middle Aged
  • Sex Distribution
  • United States / epidemiology
  • Whites / statistics & numerical data*