Social
Stratification and accumulation? Explaining changing mortality inequities between business owners and non-owners in the US (1984-2022) Jerzy Eisenberg-Guyot* Jerzy Eisenberg-Guyot Eisenberg-Guyot Eisenberg-Guyot Eisenberg-Guyot Eisenberg-Guyot NYU Grossman School of Medicine
Background: Consolidating power among business owners, reflected in plunging labor-union density and growing precarious employment, may be fueling mortality inequities across social classes. However, the issue remains understudied. Thus, we quantified and explained temporal changes in mortality inequities between business owners (“owners”) and non-owners in the US.
Methods: Our sample included respondents ages 18-66 in the 1984, 1989, 1994, and 1999-2013 Panel Study of Income Dynamics waves with mortality follow-up through 2022. Owners were those who themselves or whose family units owned a business or had a financial interest in a business in the prior year. Using parametric g-computation, we estimated how inequities between owners and non-owners in 10-year age-adjusted mortality risks changed from 1984-2013. Next, we analyzed whether any changes in the inequities across years could be attributed to shifting gendered, racialized, and socioeconomic stratification. Finally, we analyzed whether growing income and wealth disparities between owners and non-owners exacerbated inequities across years.
Results: Our sample included 23,859 respondents and 115,161 observations. In 1984, non-owners had 1.34-times (95% CI: 1.07, 1.70) greater 10-year age-adjusted mortality risks than owners; the 2013 figure was 2.20 (95% CI: 1.72, 2.96) (Figure 1), for a ratio of risk ratios (RRR) across years of 1.64 (95% CI: 1.13, 2.38). After social-stratification-adjustment, within-year inequities lessened; however, increases across years attenuated only somewhat (RRR for 2013 vs 1984: 1.46 [95% CI: 1.01, 2.04]). Finally, we estimated increases in the inequities across years would not have meaningfully lessened if income and wealth distributions had remained at 1984 levels.
Conclusions: We estimated growing mortality inequities between owners and non-owners in the US, which cannot be fully explained by shifting social stratification and individual-level income and wealth distributions.
