Development of a Typology of Economic Place for Explaining County-Level Health Factors and Outcomes

Social and economic factors are understood to shape health outcomes. Yet, there has been little rigorous work to identify and model the specific constellation of economic factors that lead to different health factors and outcomes.  One reason for this has been the relative scarcity of consistent, high-quality county-level data on local economic conditions and trends.  Our project will overcome these previous data limitations and achieve two key goals.

The first is to broaden the lens on the types of economic variables that shape health factors and outcomes. While commonly-used measures like unemployment are vital, they themselves are outcomes of broader dynamics shaped by things like industry employment trends, occupational structures, wage policies of major industries and employers, and industry history and legacy. To our knowledge, these factors remain understudied in the context of understanding health factors and outcomes.  

The second goal is to operationalize the idea of "economic opportunity" within the context of health factors and outcomes. Case and Deaton's research and writings offer hypotheses about the (various) linkages between economic despair and health outcomes. However, there is still a need for rigorous, broad-based examination and testing of characteristics of economic opportunity and specific impacts by sex and racial/ethnic groupings that shape health factors and outcomes.

We will achieve these goals by creating a typology of economic place that groups each of the 3,142 US counties and county equivalents according to a broad set of economic and opportunity characteristics. Variables to be explored in the development of the typology include (partial list): county position on the rural-urban continuum and other measures of urbanity/rurality; short-, medium-, and long-term employment and population change; wage structures, especially trends in living wage outcomes in key economic industries and clusters; the prevalence of middle-wage job opportunities; opportunities for occupational and career advancement; the proportion of living- and middle-wage jobs held by racial and ethnic minorities and women; the prevalence of gendered and racialized employment and wage outcomes; opportunities for workers without four-year degrees; the prevalence of new economy and growing industries in the local employment base; and measures of overall wage and wealth inequality.