# Economic distress and growing educational disparities in life expectancy: Weathering, high effort coping, and despair

> **NIH NIH R01** · UNIVERSITY OF MICHIGAN AT ANN ARBOR · 2022 · $375,691

## Abstract

PROJECT SUMMARY: Researchers have used a variety of data sources and methodologies to independently
document two disturbing trends: a halt to universal gains in life expectancy (LE) across US subpopulations,
and a subsequent rise in educational inequality in LE since 1990—both of which take us further from achieving
the high-priority national public health objective of population health equity. The timing of growing LE inequities
suggests that the stagnating or deteriorating economic prospects of moderate income households in light of
jobs lost to globalization and automation play an important role. Yet, this hypothesis has yet to be rigorously
empirically tested. The impact of globalization and automation has varied geographically. We propose to
leverage this geographic variation to study the cumulative effect of persistent and structural economic distress
on mortality and growing educational inequities in LE. Another important question concerns the mechanisms
through which LE disparities linked to exogenous economic trends have grown. Over time, which specific
causes of death increased among the less educated or decreased among the more educated, or both? How
might this vary by race, gender, age-group or locale? Beyond the accounting mechanics, we will also consider
how different causes of death follow different biopsychosocial trajectories over the life course, conceptually
guided by the weathering hypothesis. Weathering theorizes that cumulative and stress-mediated wear and
tear on cellular integrity leads to accelerated biological aging, the dysregulation of important body systems by
midlife, and the early onset of chronic diseases of aging, health-induced disability, and excess death, with their
associated personal, familial, and societal tolls and increased health care costs. Growing inequity in LE is
hypothesized to reflect the weathering effects of deepening and prolonged structural inequity and the
cumulative physiological effects of the persistent high-effort coping such inequity entails over the life course.
Our empirical approach is designed to test propositions predicted by the weathering hypothesis and also to test
the strength of common competing hypotheses that have been forwarded to explain increased educational
inequity in LE between 1990 and 2015. These competing hypotheses include focusing on the roles of smoking,
obesity, medical care, and also on “deaths of despair,” such as opioid deaths and suicide. Placing specific
causes of death that may have risen among the educationally disadvantaged in perspective with other causes
of death that may have also increased, and considering them within a biologically plausible theoretical
framework, is critical to the evaluation of the social, economic, public health, and health services policies that
are likely to promote or impede health equity nationally and subnationally going forward.

## Key facts

- **NIH application ID:** 10433969
- **Project number:** 5R01AG059743-05
- **Recipient organization:** UNIVERSITY OF MICHIGAN AT ANN ARBOR
- **Principal Investigator:** Arline T Geronimus
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $375,691
- **Award type:** 5
- **Project period:** 2018-08-15 → 2025-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10433969

## Citation

> US National Institutes of Health, RePORTER application 10433969, Economic distress and growing educational disparities in life expectancy: Weathering, high effort coping, and despair (5R01AG059743-05). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10433969. Licensed CC0.

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