From Lifespan Inequality to Lifespan Inequity

Magdalena Muszynska-Spielauer , Institute of Applied Statistics, Johannes Kepler University Linz
Yukiko Asada, Department of Bioethics, National Institutes of Health Clinical Center
Alyson A. Van Raalte, Max Planck Institute for Demographic Research (MPIDR)
Isaac Sasson, Tel Aviv University

This article introduces a comprehensive framework for defining and quantifying lifespan inequity, grounded in the capability approach. Lifespan inequity is defined as inequality resulting from lifespan deprivation due to premature mortality. We introduce the concept of the Minimally Adequate Length of Life as the threshold distinguishing premature from full-length lives and propose to quantify it as the modal age at death. We propose to quantify lifespan inequity with standard measures of poverty, which allow us to assess unfair inequalities in the length of life by considering the proportion of the life-table population who die prematurely (incidence), the extent of their lifespan deprivation (depth), and the distribution of the deprivation among those who die prematurely (distribution). As an empirical demonstration, we study premature mortality and lifespan inequity in the United States compared to other high-income countries in 1933-2019. Our results reveal that the high levels of premature mortality and lifespan inequity in the United States are not recent developments but have been persistent challenges spanning several decades. Furthermore, moving from lifespan inequality to inequity, we show this trend is ethically problematic according to the capability approach. We demonstrate that the proposed framework effectively defines, quantifies, and informs policymaking for lifespan inequity.

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 Presented in Session 48. Life Table Methods and Decompositions in Mortality Research