Econintersect: With all the discussion about the increase in income inequality in the U.S. over the past several decades, another growing inequality has been building. A study published Wednesday 10 July 2013 by Haidong Wang, Austin E. Schumacher, Carly E. Levitz, Ali H. Mokdad and Christopher J.L. Murray in Population Health Metrics, 10 July 2013, documents the growing disparity of life expectancy across the U.S. Over 25 years (1985-2010) life expectancy has depended upon county of residence at the time of death. The range of variation over U.S. counties increased over the 25 years.
A number of graphs and tables are included in the paper and some are reproduced here. The discussion from the paper for the first graph includes:
Figure 1 shows trends in US life expectancy as well as the mean life expectancy across counties and the highest and lowest life expectancy in each year. For males in Figure 1, the highest life expectancy has steadily increased from 75.5 in 1985 to 81.7 in 2010, 0.25 years per calendar year. The lowest life expectancy remains below 65 throughout the entire 25-year period.
National, mean of county, and range of life expectancy, males, 1985–2010.
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Discussion for the next graph includes:
For females, as seen in Figure 2, the highest life expectancy has increased 0.16 years per calendar year, from 81.1 to 85.0. The lowest life expectancy for females has remained relatively constant around 73 over the entire 25-year period. By 2010, the highest county specific male life expectancy was greater than the female national life expectancy. The increasing difference in both Figures 1 and 2 between national life expectancy and the arithmetic mean of county-level life expectancy estimates indicates higher heterogeneity in life expectancy across counties. Moreover, it shows that an increasing number of counties have life expectancy at birth that are below the national values.
National, mean of county, and range of life expectancy, females 1985–2010.
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Econintersect believes that the lower line for mean of county values indicates that the average population for lower counties is less than for higher counties. Implication is that living in cities and populous suburbs is healthier than living in the country, at least as far as life expectancy is concerned. Of course a variety of other health factors are likely involved, such as income level, diet, obesity, etc.
The following graph shows that the disparity between counties has increased from 1985 to 2010, by approximately 50% for males and about 35% for females.
Range in life expectancy, males and females, 1985–2010.
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The following two tables show the best and worst counties.
Top 20 and bottom 20 counties in terms of life expectancy, males, 2010.
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Top 20 and bottom 20 counties in terms of life expectancy, females, 2010.
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According to the life expectancy list from the World Health Organization (WHO) presented in Wikipedia, the U.S. is tied for 33rd place with four other countries. The authors of the paper give the rank for the U.S. in 2010 as 40th. Either way the U.S. is far from the top of the world ranking overall. However, the life expectancy in the very top U.S. counties is higher than Japan or Switzerland, the two countries tied for first.
At the other extreme, if you are a man in McDowell County, West Virginia, your life expectancy is somewhere about 140th on the list, ranking you below the men in such countries as Cambodia, Namibia, Pakistan and Botswana.
For the second worst U.S. county (Bolimar, Mississippi) the rank in the world would be about 138th. The lowest 17 counties are below the mean life expectancy for all 198 countries on the WHO list.
U.S. women fair better. The worst county for women (Perry, Kentucky) would rank in the 60s on the country list. All 20 of the worst counties rank well above the mean life expectancy for women (70.14 years) on the global list.
People in some U.S. counties do have the best health care in the world. Others might just as well live in the third world.
Sources:
- Left behind: widening disparities for males and females in US county life expectancy, 1985–2010 (Haidong Wang, Austin E Schumacher, Carly E Levitz, Ali H Mokdad and Christopher JL Murray, Population Health Metrics, 10 July 2013)
- List of countries by life expectancy (Wikipedia)
