A county-by-county survey of U.S. life expectancy reports a 20-year gap between the lows and the highs – a gap that correlates with socioeconomic factors, race and ethnicity, and the availability of health care as well as preventable risk factors such as obesity and smoking.
The study, conducted by researchers at the University of Washington’s Institute for Health Metrics and Evaluation and published in JAMA Internal Medicine, suggests that the gap is widening.
“This is way worse than any of us had assumed,” UW professor Ali Mokdad, who leads U.S. county health research at the institute, told The Guardian.
A cluster of counties in Colorado showed the highest life expectancy in 2014, with Summit County topping the list (86.8 years). South Dakota’s Oglala Lakota County reported the lowest average (66.8 years), a figure comparable to life expectancies in Sudan and Iraq.
The good news is that nearly all counties registered gains in life expectancy between 1980 and 2014. The bad news is that the high-vs.-low gap has widened over those 34 years, and that 13 counties registered declines in expected lifespans.
The low-lifespan counties were concentrated in Kentucky, West Virginia, Alabama and several states along the Mississippi River.
In a news release, lead author Laura Dwyer-Lindgren said “looking at life expectancy on a national level masks the massive differences that exist at the local level, especially in a country as diverse as the United States.”
She and her colleagues found that preventable risk factors explained 74 percent of the variation in longevity. Socioeconomic factors were independently related to 60 percent of the inequality, and access to health care explained 27 percent. (The figures add up to more than 100 percent because multiple factors can be involved in mortality.)
Mokdad said the survey demonstrates “an urgent imperative, that policy changes at all levels are gravely needed to reduce inequity in the health of Americans.”
“Federal, state, and local health departments need to invest in programs that work and engage their communities in disease prevention and health promotion,” he said.
You can check the figures for your own county on this interactive map. For what it’s worth, the 2014 average for life expectancy in Washington state’s King County is 81.4 years, which is a couple of years above the average for Washington state (80 years) and the nation as a whole (79.1 years).
Earlier studies have gotten even more granular about disparities in longevity. Last year, an analysis of mortality data found that within King County, residents of West Bellevue recorded the highest average life expectancy (86.2 years), while the lowest figure (76.6 years) came from South Auburn.
In addition to Dwyer-Lindgren and Mokdad, the authors of “Inequalities in Life Expectancy Among US Counties, 1980 to 2014” include Amelia Bertozzi-Villa, Rebecca Stubbs, Chloe Morozoff and Christopher Murray from UW; and Johan Mackenbach and Frank van Lenthe of the Department of Public Health, Erasmus University Medical Center in the Netherlands.
