America’s Mid-Life Mortality Gap

Mortality rates fell sharply for college-educated Americans in recent decades but not for other Americans. Mortality trends also differ sharply between rural and urban areas of the United States and across US counties. Steve asks Jonathan Skinner about these puzzling and troubling trends, and how to explain them. According to Jonathan’s recent research, “Deaths of despair,” “the China shock," obesity, and income inequality don’t explain the trends. Instead, the explanation turns on differences in smoking trends and the consequences for mortality. 

Recorded on March 19, 2026.