Adult Mortality and the Wealth Gradient in Low- and Middle-Income Countries

Julia Callaway , Interdisciplinary Centre on Population Dynamics (CPop), University of Southern Denmark
Carl Riumallo Herl, Erasmus Centre for Health Economics Rotterdam
Rebecca Mann, Jeb E. Brooks School of Public Policy, Cornell University
Angela Chang, Danish Centre for Health Economics, University of Southern Denmark

Socioeconomic inequalities in mortality are a major source of inequality that disrupts domestic and international stability. While 80% of the world's adult population lives in low- and middle-income countries (LMICs), knowledge about socioeconomic inequalities in adult mortality in these settings remains limited due to lack of high-quality data linking mortality and socioeconomic status (SES), and few methodologies applicable under such constraints. This study estimates age-specific adult mortality rates by SES in LMICs using kinship methods applied to publicly available data. We analyzed sibling mortality from 98 Demographic and Health Surveys (DHS) across 47 countries (2000-2024) and parent mortality from national censuses via IPUMS International. We estimated adult mortality rates by wealth quintile using indirect estimation methods, calculating age-standardized and age-specific mortality rates stratified by geographic region, country income classification, and sex. For South Africa, we combined DHS and IPUMS data to create complete a mortality profile for ages 15-84. Results show Southern Africa had the highest adult mortality and widest inequalities, particularly among women. Statistically significant mortality gaps between richest and poorest groups existed across Middle Africa, Western Africa, Southern Asia, East Asia & Pacific, Latin America & the Caribbean, and among women in Northern Africa. Upper-middle-income countries had lower adult mortality across all age groups compared to low- and low-middle-income countries. Future work will develop wealth indices for all IPUMS countries with parental mortality data from 2000 onwards, analyze regional and temporal trends, and combine datasets to present comprehensive adult mortality inequalities across LMICs.

See extended abstract

 Presented in Session 38. Flash Session Social Inequalities in Mortality