Life Expectancy Trends Reveal Growing Geographic Disparities

The Institute for Health Metrics and Evaluation (IHME) offered insight into lifespan trends throughout the United States over the past several decades. The study, published in JAMA Internal Medicine, reported calculated life expectancies by county from 1980 to 2014.¹

The results demonstrated a growing gap between the highest and lowest life expectancies between counties since 1980.

Counties with the largest decreases in life expectancy from 1980 to 2014 include:

• Owsley County, Kentucky (-3%)
• Lee County, Kentucky (-2%)
• Leslie County, Kentucky (-1.9%)
• Breathitt County, Kentucky (-1.4%)
• Clay County, Kentucky (-1.3%)
• Powell County, Kentucky (-1.1%)
• Estill County, Kentucky (-1%)
• Perry County, Kentucky (-0.8%)
• Kiowa County, Oklahoma (-0.7%)
• Perry County, Alabama (-0.6%)

Counties with the largest increases life expectancy from 1980 to 2014 include:

• Aleutians East Borough, Aleutians West Census Area, Alaska (+18.3%)
• North Slope Borough, Alaska (+17.9%)
• New York County, New York (+15.2%)
• Sumter County, Florida (+13.8%)
• San Francisco County, California (+13.5%)
• Kings County, New York (+13.2%)
• Kodiak Island Borough, Alaska (+12.8%)
• Northwest Arctic Borough, Alaska (+12.8%)
• District of Columbia (+12.8%)
• Loudoun County, Virginia (+12.4%)

Risk factors of obesity, lack of exercise, smoking, hypertension, and diabetes explained 74% of the variation in life expectancies. Socioeconomic factors, such as a combination of poverty, income, education, unemployment, and race, were independently related to 60% of the inequality. Access to and quality of health care accounted for 27%.

Oglala Lakota County, South Dakota, had the lowest overall life expectancy in the country in 2014 at 66.8 years. The researchers noted that this was comparable to other countries, such as Sudan, India, and Iraq.

The researchers used data from the National Center for Health Statistics (NCHS) to calculate life expectancy for every US county by looking at de-identified death certificates, as well as obtaining population counts from the US Census Bureau, NCHS, and the Human Mortality Database.

The researchers concluded that policies and programs that target socioeconomic factors and behavioral and metabolic risk factors could help narrow the increasing gap in life expectancy and improve overall health.

Reference

• Dwyer-Lindgren L, Bertozzi-Villa A, Stubbs RW, et al. Inequalities in life expectancy among US counties, 1980 to 2014 temporal trends and key drivers. JAMA Intern Med. May 8, 2017. doi:10.1001/jamainternmed.2017.0918