Edward Conard

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New York City Is a Lot Safer Than Small-Town America

Justin Fox Bloomberg
Date Posted:
June 27, 2022
Is Database:
Database

New York City is safer than nonmetro, small metros, medium metros, central and fringe counties most of the country in terms of deaths from external causes per 100K population.

New York City, despite perceptions of high crime, is statistically safer than many rural and small-town areas in the US when considering deaths from external causes per 100k population. From 2017 to 2019, NYC's homicide rate was lower than suburban counties in large metro areas and only slightly higher in 2020. Transportation-related fatalities in NYC are significantly lower, with New Yorkers being about a third as likely to die in transportation accidents compared to the national average. When combining homicide and transportation risks, NYC emerges as a safer environment compared to rural America, where the risk of death from external causes is three times higher. This counterintuitive finding highlights the complex dynamics of urban versus rural safety, influenced by factors such as infrastructure and emergency services availability.

New York — which is where I happen to live — isn’t just safe relative to other big cities. The data in the above chart are from the Federal Bureau of Investigation and local police departments, but the Centers for Disease Control and Prevention also keep track of homicides as reported on death certificates, and one can sort them by, among other things, whether they befell residents of a county that contains all or part of the biggest city in a large (population of one million or more) metropolitan area, a fringe (suburban) county in such a metropolitan area, or elsewhere. Suburban counties in large metro areas have tended to have the lowest homicide rates, but New York City’s was even lower from 2017 to 2019 and was only slightly higher in 2020, the most recent year for which the CDC has full data. Some causes of death other than homicide seem pretty relevant to assessing safety. Your risk of getting killed on the subway or in a subway station is much higher in New York City than in a place with no subway, for example,but if you add up all risks related to getting to work or school or wherever else it is you need to go, it’s a different story. New Yorkers are only about as third as likely to die in transportation accidents of any kind as Americans are overall. Put homicide and transportation risks together, and New York starts looking like a refuge from the American carnage.All these accountings leave out the September 2001 terrorist attacks. The most dangerous areas are a more hardscrabble lot, although led by an affluent coastal metro (Baltimore-Columbia) where the main city has an awful violent crime problem. The city of Baltimore’s homicide rate was a staggering 58.5 per 100,000 residents in 2021, twice that of Chicago and more than 10 times New York City’s.

Justin Fox, "New York City Is a Lot Safer Than Small-Town America,"Bloomberg, June 7, 2022, https://www.bloomberg.com/opinion/articles/2022-06-07/is-new-york-city-more-dangerous-than-rural-america

New York City Is a Lot Safer Than Small-Town America

Since the summer of 2020 the United States has been experiencing a deadly wave of violence, and New York City has not been immune. The number of homicides in the city shot up 47% in 2020, and rose another 4% last year. While the tally is down 9% so far this year there have been some shocking murders, not to mention a mass shooting on the subway that miraculously didn’t take any lives.

Regular consumers of the news would thus be forgiven for believing that the Big Apple has become a terribly dangerous place. And yes, it is markedly more dangerous than it was before the pandemic. I’m not here to dismiss concerns about rising crime in the city. But a little context is in order. And by “a little context,” I mean a lot of charts.

The historical context, which a fair number of people are aware of, is that New York’s pandemic murder wave followed a long decline, with the city’s homicide rate in 2021 still less than a fifth what it was in 1990. The geographical context, which seems to be less widely understood, is that while homicide rates fell sharply all over the the US in the 1990s, that decline slowed in the 2000s and reversed starting in 2015. In Philadelphia the homicide rate is now worse than it was in the early 1990s, and in Chicago it’s close. Which means there’s a growing gap between New York City and most of the rest of urban America.

New York City Is a Lot Safer Than Small-Town America: Extended Excerpt Image 1


New York — which is where I happen to live — isn’t just safe relative to other big cities. The data in the above chart are from the Federal Bureau of Investigation and local police departments, but the Centers for Disease Control and Prevention also keep track of homicides as reported on death certificates, and one can sort them by, among other things, whether they befell residents of a county that contains all or part of the biggest city in a large (population of one million or more) metropolitan area, a fringe (suburban) county in such a metropolitan area, or elsewhere. Suburban counties in large metro areas have tended to have the lowest homicide rates, but New York City’s was even lower from 2017 to 2019 and was only slightly higher in 2020, the most recent year for which the CDC has full data.

New York City Is a Lot Safer Than Small-Town America: Extended Excerpt Image 2


The CDC’s Wide-ranging Online Data for Epidemiologic Research, aka Wonder, databases, with which I have become way too familiar since the beginning of the pandemic, also contain statistics on every other cause of death listed in ICD-10, the 10th edition of the World Health Organization’s International Classification of Diseases.

Some causes of death other than homicide seem pretty relevant to assessing safety. Your risk of getting killed on the subway or in a subway station is much higher in New York City than in a place with no subway, for example, but if you add up all risks related to getting to work or school or wherever else it is you need to go, it’s a different story. New Yorkers are only about as third as likely to die in transportation accidents of any kind as Americans are overall. Put homicide and transportation risks together, and New York starts looking like a refuge from the American carnage.

New York City Is a Lot Safer Than Small-Town America: Extended Excerpt Image 3


All these accountings leave out the September 2001 terrorist attacks. If included, those would push New York’s combined homicide and transport mortality rate for 2001 to 32. Remarkably, though, that’s still only slightly higher than the rate that year for rural and small town America — that is, in counties not part of metropolitan areas (which contained 86% of the US population in 2021). 1 Rural life, in particular driving long distances on two-lane roads far from emergency services, can be a high-risk activity.

There are other accidental threats listed in ICD-10 that seem less salient in the city than in the country, and in some cases, the suburbs. To name a few: “contact with powered lawnmower,” “drowning and submersion while in swimming pool,” “contact with venomous snakes and lizards,” “victim of volcanic eruption.” So I ran the numbers again for mortality from all external causes.

New York City Is a Lot Safer Than Small-Town America: Extended Excerpt Image 4


The mortality-rate gap between New York City and the rest of the country is even bigger in this chart than in the last one. But the trend has been headed in the wrong direction in New York and everywhere else for a while, mainly because of the opioid epidemic.

The explosion of drug-overdose deaths in the US over the past decade is one of the most depressing trends one encounters in CDC Wonder, but it does take us somewhat afield from what people usually have in mind when they consider whether a place is safe or dangerous. Same goes for suicides, which have also risen but not as sharply. Then there are external causes such as falls and surgical complications that are usually fatal only for the very old. If included in the calculations, they tend to make retirement communities look terribly dangerous, which doesn’t seem right.

Here’s what mortality from external causes looks like if one excludes (1) accidental poisoning (how drug overdoses are classified), (2) intentional self-harm, (3) falls, (4) complications of medical and surgical care and (5) sequelae of external causes of morbidity and mortality (after-effects, that is, which are also fatal mostly for the elderly).

New York City Is a Lot Safer Than Small-Town America: Extended Excerpt Image 5


The overall lesson seems to be that the more urban your surroundings, the less danger you face. High homicide rates in some cities mean that the central counties in large metropolitan areas are on the whole slightly more dangerous than the suburban counties, but that’s the only exception. The risk of death from truly external causes, as defined here, is three times higher in rural and small-town America than in the country’s largest city.

This is so opposite from conventional wisdom that it’s worth teasing out why. One obvious explanation is that murder scares people a lot more than accidents do, and homicide risk is in fact highest in urban counties — just not in New York City. Another is that, as a colleague put it to me, you may be less likely to be victim of a crime in New York City, but you’re more likely to witness one. In dense urban environments you simply see a lot more of what’s going on, for good and ill. It’s also possible that the issue is not so much urban versus rural as it is who lives where. An affluent rural or exurban county where lots of people can work from home might be lower risk than a poorer urban one where most can’t. Rural counties in Appalachia or the Deep South might have very different profiles from those in New England or the Plains states.

A look at 2020 selected-external-causes mortality by state offers some support for the latter interpretation. The Northeast is the safest part of the country, but some heavily rural states (Mississippi, Arkansas) are a lot more dangerous than others (Vermont, Iowa).

New York City Is a Lot Safer Than Small-Town America: Extended Excerpt Image 6


County-by-county statistics from the CDC provide added perspective, albeit with data limitations that I’ll get to in a moment.

New York City Is a Lot Safer Than Small-Town America: Extended Excerpt Image 7


The very safest places in America by this reckoning are very affluent suburbs. Loudoun County, Virginia, has the country’s highest median household income, at $147,111 according to the Census Bureau’s American Community Survey 2016-2020 estimates. All the other suburban counties here but Hampshire County, Massachusetts (which is less a suburb than an assortment of college towns), have median incomes above $100,000. Still, there are also three New York City boroughs in the top 15, all with median incomes below $90,000 but above the national median of $64,994. Brooklyn and the Bronx, where incomes are below the national median, come in a respectable 48th and 127th place in the county mortality rankings. Living in the country’s biggest city does seem to have its advantages, even for the non-wealthy.

But let’s not forget those data limitations. While CDC Wonder knows everything about mortality in the US, for privacy reasons it only shares what it knows if there are 10 or more deaths to report, and because of reliability concerns it only calculates mortality rates if there are 20 or more deaths. For the collection of external causes I selected, Wonder churned out 2020 death totals for 1,711 of the nation’s 3,143 counties and county equivalents (parishes in Louisiana, census areas in Alaska, independent cities in Virginia and some other states) and mortality rates for 997. It provided enough data to calculate the mortality rates for all 1,711, but I chose not to for the charts here. If I had, three more Northern Virginia cities and counties would have entered the top 10 along with Story County, Iowa, and La Crosse County, Wisconsin.

If I selected a wider array of external causes, or combined data from several years, more counties with smaller populations would enter the mix. Still, pretty much any version of the most-dangerous-counties list would be at least as heavy on rural counties as this.

New York City Is a Lot Safer Than Small-Town America: Extended Excerpt Image 8


There are a couple of other data issues worth mentioning. One is that all the mortality statistics except those in the very first chart are reported by the residence of the victims, not where the accident or homicide occurred. The CDC does offer some data on deaths by place of occurrence, but not with wildly different results, at least not for New York City, where 462 residents died of homicide in 2020 and 469 homicides occurred. If one were to use the latter number, there’s the question of what population to use in calculating mortality rates. New York City welcomes hundreds of thousands of commuters and tourists every day. Should they be counted in its population totals?

Also, because complete 2020 Census results have yet to be released, the CDC is still using outdated 2020 population estimates based on the 2010 census. For New York City, this estimate is 550,977 lower than the number from the 2020 census, and the CDC estimates for most of the 2010s are probably too low as well. To give a sense of the impact, the city’s CDC-calculated homicide rate of 5.4 per 100,000 in 2020 would drop to 5.1 using the census population. I decided to stick with the CDC’s numbers nonetheless because (1) the city likely lost several hundred thousand residents in the months following the April 1 census record date, and (2) redoing all the 2020 mortality-rate calculations using census data would have introduced a lot of opportunities for error. But keep in mind that all the mortality rates for New York City in recent years in the CDC-derived charts are probably slight overestimates.

Finally, it would be nice to see this data by metropolitan area, wouldn’t it? CDC Wonder’s most up-to-date deaths databases does not provide statistics by metro area. It is possible to download them by counties, then sort those into metropolitan areas, but with 2020 deaths data from my list of external causes available for only a little over half of US counties, that doesn’t really work. By combining deaths from the five most recent available years I was able to get a more complete county list, and fill in the blanks with a little extra effort. Here, then, are the safest metropolitan areas in the US from 2016 through 2020, by my admittedly somewhat idiosyncratic definition.

New York City Is a Lot Safer Than Small-Town America: Extended Excerpt Image 9


It’s a mix of affluent coastal metropolises (the Worcester and Nashua metro areas are both part of Greater Boston), college towns, the Twin Cities and … the “Malibu of the Midwest” (Sheboygan). All nice places!

The most dangerous areas are a more hardscrabble lot, although led by an affluent coastal metro (Baltimore-Columbia) where the main city has an awful violent crime problem. The city of Baltimore’s homicide rate was a staggering 58.5 per 100,000 residents in 2021, twice that of Chicago and more than 10 times New York City’s.

New York City Is a Lot Safer Than Small-Town America: Extended Excerpt Image 10


Even the safest areas in the US remain killing fields compared with most of Western Europe. In Paris, the city described in 2016 by presidential candidate Donald Trump as “so, so, so out of control, so dangerous,” the homicide rate in recent years has been well below one death per 100,000 residents, and traffic deaths below three per 100,000, meaning that Parisians face a combined risk from those two sources about one-third that of New Yorkers. So there’s lots of room for improvement in New York City. There’s just even more room for improvement almost everywhere else in the US.

Data sources for charts

Safest of the Six Largest U.S. Cities: The main data sources here are the FBI’s Crime Data Explorer and Census Bureau annual population estimates that I got from the Data Commons Place Explorer (for pre-2010 numbers) and the Census Bureau (for 2010-2021). I could not find city population estimates for 1985-1989 so I calculated my own by just assuming the cities grew (or shrank) at a uniform pace between the 1980 and 1990 censuses. The FBI hasn’t released 2021 crime data yet so I got that year’s numbers either directly from police departments or from news reports based on police department data. Also, for some reason the FBI’s post-2014 homicide numbers for Philadelphia are different from (and lower than) those on the Philadelphia Police Department website, so I went with the latter.

Murder in the Cities, Suburbs and Country: This is downloaded straight from CDC Wonder’s Underlying Causes of Death database, but there are two different ways to get homicide totals from that. One is to look under “Injury Intent and Mechanism” and select “homicide” as the injury intent, the other is to look through the ICD-10 codes used to classify all causes of death and select “assault” under “External causes of morbidity and mortality.” The former includes deaths from terrorist attacks and the latter does not, because they are classified under a separate ICD-10 category of “Codes for special purposes.” When this piece was first published, the chart showed homicide deaths with the September 2001 terrorist attacks subtracted out (for consistency with the FBI data and because otherwise New York’s high 2001 rate would make the chart very hard to read); subsequently I realized it would be simpler and more consistent with the other charts to use the assault numbers, which are almost but not quite identical. Here they are by county urbanization status (I combined the two categories of nonmetro counties for the charts) and for New York City. Once you click through, you’ll have to agree to a couple of data use restrictions, then wait as CDC Wonder generates the data.

Car Crashes Change the Picture: This adds together assault plus transportation accident deaths as reported under “External causes of morbidity and mortality.” Here they are by county urbanization, and for New York City.

Safer in the Big City: This is all “External causes of morbidity and mortality,” by county urbanization, and for New York City.

Still Safer in the Big City: This is external causes minus the categories discussed in the text and the chart footnotes, by county urbanization and for New York City.

Safe States and Dangerous Ones: Selected external causes by state for 2020.

The Safest Counties in America, Sort Of, and The Most Dangerous Counties in America, Sort Of: Selected external causes by county for 2020.

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Previous articleJune 27, 2022Co-Working in Close Proximity: Knowledge Spillovers and Social InteractionsStartups within 20 meters of each other in a US tech co-working hub experienced significant knowledge spillovers, with proximity effect diminishing rapidly beyond 20 meters.Next articleJune 27, 2022The post-COVID stock listing boomThe post-COVID stock listing boom saw a 28% increase in publicly listed US firms from Aug 2020 to Dec 2021, driven by SPACs & traditional IPOs.
Showing 70 database articles primarily about Poverty/Crime

An Extra Point for Attendance: The Impact of High School Varsity Athletics on Absenteeism

AI Summary. High school varsity sports participation reduces student absenteeism by ~20%, with absence rates falling further during active seasons, indicating the relationship is at least partly causal rather than purely a result of selection.

Nat Malkus and Sam Hollon American Enterprise Institute
Date Posted:
April 16, 2026
Is Database:
Database

The absentee rate of Indiana high school students, ~23% of whom played a varsity sport, was ~20% lower for those who participated in varsity athletics than for non-athletes. The effect was stronger when an athlete’s particular sport was in season.

Does participation in high school sports significantly reduce student absenteeism?

Core argument: Varsity athletes’ absence rates drop 1.37 pts below non-athletes’, a ~20% reduction that drives improved school engagement year-round.

We find that varsity sports participation is strongly associated with better student attendance, and we argue it is plausible that varsity sports participation causes better attendance. When we control for a number of factors that we know matter for both sports participation and attendance, we continue to find that varsity athletes are absent less often than their peers across the entire year. Across the school year, athletes’ absence rate was 1.37 points lower than non-athletes’. That’s a reduction of almost 20%. The broad pattern shown in Table 1 is that students from more advantaged groups were more likely to participate in varsity sports and less likely to be absent from school. It’s thus no surprise that, in the raw data, there is an association between playing varsity sports and having good attendance (Figure 3). But is that because students who attend school more reliably are more likely to play sports or because playing sports leads to better attendance? One way to tease out the answer is to compare varsity athletes' attendance during their sports seasons with their attendance the rest of the year. Not only do varsity athletes have lower annual absence rates—especially unexcused absences—than non-athletes, but [Figure 3 and Figure 4] show that their absence rates fall further when their sport is in season, [which suggests at least some causal effect].

Takeaways by Macro Roundup® AI

  1. Varsity athletes’ absence rates drop 1.37 pts below non-athletes’, a ~20% reduction that drives improved school engagement year-round.
  2. In-season absence rates fall further for varsity athletes, suggesting sports participation directly leads to more reliable attendance patterns.
  3. Athletes from advantaged backgrounds show stronger attendance gains, indicating varsity sports participation compounds existing socioeconomic advantages in school engagement.

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  • The Benefits of Scholastic Athletics — Heckman et al, using two longitudinal data sets with a rich set of controls, find that participation in varsity athletics raises rates of high school and…
  • Long COVID for Public Schools: Chronic Absenteeism Before and After the Pandemic — 28% of American public school students missed at least 10% of the school year in 2022 up from 15% before the pandemic. The change was most pronounced in…
  • The Latest Chronic Absenteeism Numbers — The number of students missing 10% or more of the school year doubled from 15% in 2019 to 28% in 2022 and 26% in 2023. Early reports for 2024 show signs of…
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Sports Betting Across Borders: Spatial Spillovers, Credit Distress, and Fiscal Externalities

Jacob Goss and Daniel Mangrum Federal Reserve Bank of New York
Date Posted:
March 27, 2026
Is Database:
Database

After the legalization of sports betting in 2018, delinquency rates on a wide range of consumer debts rose, increasing .31pp as of 2025. The delinquency rate for the ~3% of the population that were new gamblers increased by ~10pp driven by those under 40.

Exploiting the staggered roll-out of state-level legalization following the 2018 Murphy v. NCAA decision, we use an extended two-way fixed effects (ETWFE) framework that separately estimates direct treatment effects and cross-border spillover effects. Our first-stage estimates establish that legalization dramatically increases betting activity: average quarterly spending per person rises by roughly $46 from a pre-treatment mean of $2.50, and the share of the population with any sportsbook spending in a quarter increases by 3.1 percentage points. The effects on average spending grow continually over time with no clear evidence of saturation, suggesting the market for mobile sports betting continues to mature years after legalization. At the same time, substantial betting activity occurs in counties where sports betting is not legal but which lie near a legal state, with spillover effects on total spending roughly 14% of the direct effect for counties within 15 miles of a legal state, declining monotonically with distance and approaching zero by 60 miles. These spillovers have real consequences for consumer financial health. Three years after legalization, median credit scores are one point lower and overall delinquency rates increase by 0.31 percentage points following legalization. [Under-40 auto loan delinquency increases by half a percentage point and credit card delinquency by one percentage point, driving the overall increase in delinquency.] Since only about 3.1% of the population takes up betting after legalization, these intent-to-treat estimates would imply that those who are induced to bet due to legalization experience delinquency increases of 10 percentage points.

Related Articles:

  • The Case for Prohibiting Vice — Lehman makes the case for restricting sports gambling, marijuana, and pornography. The costs of vice and its regulation are not limited to individual harm…
  • Americans Increasingly See Legal Sports Betting As A Bad Thing For Society and Sports — 43% of American adults say widespread betting on sports is “a bad thing for society,” up from 34% in 2022. 47% of men under 30 say legal sports…
  • From Sports to AI, America Is Awash in Speculative Fever. Washington Is Egging It On — Citing the AI-related equity boom, crypto and the rise of sports betting, Greg Ip argues that “speculation has become woven into today’s political…
  • Poverty/Crime
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New York City Government Services: Services for the Unsheltered

Thomas DiNapoli New York State Comptroller
Date Posted:
March 16, 2026
Is Database:
Database

In 2025 New York City spent $81,705 per “street” homeless person, up 262% from 2019 whose numbers increased 26% during that period. This does not include spending on “sheltered” homeless, who are ~97% of the homeless population.

New York City’s unsheltered population increased from 3,588 in FY 2019 to 4,504 in FY 2025 — a 26% increase from pre-pandemic levels. In that time, spending on services for this population has more than tripled, growing from $102 million in FY 2019 to nearly $368 million in FY 2025 (a 262% increase). Its share of spending has also increased, from just under 5% to nearly 9% of total Department of Homeless Services (DHS) spending.

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  • The Clock Now Ticks on Zohran Mamdani — Reihan Salam argues that NYC’s incoming mayor will take office with “the clock on his program already five minutes to midnight,” citing the erosion of the tax…
  • Supply and The Mam — At ~15%, NYC has the highest combined city-state personal tax rate in the US, and the top marginal corporate income tax rate at 17.4%. The city also has the…
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Poverty and Dependency in the United States, 1939–2023

Richard Burkhauser and Kevin Corinth National Bureau of Economic Research
Date Posted:
February 3, 2026
Is Database:
Database

Btw 1939 and 1963, the % of Americans below LBJ’s absolute poverty line (3× the cost of a minimal meal plan), fell from 48.5 to 19.5, driven by rising market income. Post-1964, most (for non-blacks, all) drops were the result of transfers, not earnings.

The major innovation of this paper is to extend a comprehensive and consistent measure of poverty back to 1939, exploiting a quarter century of data before the War on Poverty began. From 1939-1963, absolute poverty fell from 48.5% to 19.5%, a 29 percentage point reduction. This pre-war progress provides important context for previously documented success in reducing poverty afterwards, since it occurred before the major expansion of safety net programs like SNAP, Medicaid, and refundable tax credits. During that 1939–1963 period, it was the growth of market income rather than government transfers net of taxes that reduced poverty rates. In fact, poverty fell no faster in the 24 years after the War on Poverty was declared than in the 24 years before, even when applying the same initial poverty rate to both periods. Our results do not imply that poverty would have necessarily continued to fall at the same rate after 1963 in the absence of the War on Poverty. A pre versus post comparison is conflated by contemporaneous macroeconomic and social changes, such as slower economic growth in the post-1963 period. Conversely, any claim that the War on Poverty was necessary for poverty to decline should be accompanied by an attempt to understand why it had already been falling in the quarter century before it was declared.

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  • Evaluating the Success of the War on Poverty since 1963 Using an Absolute Full-Income Poverty Measure — The US won the War on Poverty on LBJ’s terms, cutting the absolute full-income poverty rate from 19.5% in 1963 to 1.6% in 2019. During these years the share of…
  • The Great “Transfer”-mation — Transfer payments made up 18% of all US personal income in 2022, up from 8% in 1970. Social Security/Medicare made up 56% of the increase from 1970 to 2022…
  • Government Benefit Programs Already Do A Lot To Help Low Income Families — A 2-adult, 3-child US family with $20,000 of market income receives at least $61,000 in annual benefits and has $79,000 of disposable income. That same family…
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  • Fiscal Policy
    • Government Spending
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The Biggest Fraud in Welfare

Phil Gramm and John Early Wall Street Journal
Date Posted:
December 18, 2025
Is Database:
Database

Counting non-cash benefits as income would reduce the 19.8mm US households defined as poor by 90%. If the $1.4T in annual Federal poverty spending, including non-cash benefits, were distributed in cash to those households, each would receive $70,000.

Counting non-cash benefits as income would reduce the 19.8mm US households defined as poor by 90%. If the $1.4T in annual...
The government’s failure to count its largess as recipients’ income allows welfare households to blow past the income level above which a working family no longer qualifies for government help. Take a single parent with two school-age children who earns $11,000 annually from part-time work. The government considers this household in poverty because its income is below $25,273. But this family would qualify for benefits worth $53,128. It would receive Treasury checks of $3,400 in refundable child tax credits and $4,400 in refundable earned-income tax credits. The family would also receive Food Stamp debit cards worth $9,216 a year, $9,476 in housing subsidies, $877 of government payments for utility bills, $16,033 to fund Medicaid, $3,102 in free meals at school and $6,624 in Temporary Assistance for Needy Families. All this puts the family’s income at $64,128, or 254% of the poverty level. A hardworking family earning anything like $64,128 in salary wouldn’t be eligible for any of these welfare benefits in four-fifths of the states. Meanwhile, the welfare family would be eligible for another 90 small federal benefits and sundry state and local welfare programs.

Related Articles:

  • Stranded by the Safety Net: How to Fix the Benefit Cliff Problem — A non-working, non-disabled mother of two in North Carolina can collect $50k in benefits. Due to benefit phase-outs, she would have to earn $70k in market…
  • Mitigating Benefits Cliffs for Low-Income Families: District of Columbia Career Mobility Action Plan as a Case Study — A single parent with one child in Washington DC, earning $11K, receives $68K of government benefits net of taxes for a total after-tax income of $79K. A…
  • Welfare Is What’s Eating the Budget — Phil Gramm notes that after transfers and taxes “the average household in the bottom, second, and middle quintiles all have roughly the same incomes—despite…
  • Poverty/Crime
  • Fiscal Policy
    • Government Spending
  • Workforce

Explaining the Widening Divides in US Midlife Mortality: Is There a Smoking Gun?

Christopher Foote, Ellen Meara, Jonathan Skinner, and Luke Stewart National Bureau of Economic Research
Date Posted:
December 17, 2025
Is Database:
Database
Is Important:
Important

The college/non-college life expectancy gap widened from 2.6–6.3 years btw 1992 and 2019, while county mortality inequality jumped 30% to the detriment of rural areas. Smoking by state predicts ~300 extra deaths per 100k for non-college grads, 0 for grads.

The education-mortality gradient has increased sharply in the last three decades, with the life expectancy gap btw people with and without a college degree widening from 2.6 years in 1992 to 6.3 years in 2019. During the same period, mortality inequality across counties rose 30%, accompanied by an increasing rural health penalty. Using county- and state-level data from the 1992–2019 period, we demonstrate that these three trends arose due to a fundamental shift in the geographic patterns of mortality among college and non-college populations. First, we find a sharp decline in both mortality rates and geographic inequality for college graduates. Second, the reverse was true for people without a college degree; spatial inequality became amplified. Third, we find that rates of smoking play a key role in explaining all three empirical puzzles, with secondary roles attributed to income, other health behaviors, and state policies. [An objection is that] the non-college smoking rate declined by somewhat more than the college rate from 1992 to 2019. [The resolution is that] college populations gave up smoking decades before non-college populations did. [The key] college/non-college comparison [is] among 55–64 year-olds, the age group for which the smoking mortality penalty is greatest.

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