U.S. life expectancy can vary by as much as 20 years among the counties — between 60 and 80 years old, according to a study published Monday in the Journal of the American Medical Association.
Babies born in 10 counties — eight of them in Kentucky — are expected to have a shorter life expectancy than their parents, according to the study “Inequalities in Life Expectancy among U.S. Counties, 1980 to 2014.”
Researchers at the Institute for Health Metrics and Evaluation (IHME) at the University of Washington found that three key factors affected overall life expectancy: behavioral and metabolic risk such as obesity, smoking, hypertension and diabetes; socio-economic factors, including income, education levels and unemployment rates; and availability to health care, such as insurance, quality of service and access to doctors.
The data included death records compiled by the National Center for Health Statistics and population counts from the U.S. Census Bureau and the Human Mortality Database.
The researchers note that while life expectancy from birth increased overall in the U.S. — from 73.8 years old in 1980 to 79.1 years old in 2014 — disparities in social factors accounted for at least a 20.1-year difference at the county level.
“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,” said lead author Laura Dwyer-Lindgren, a researcher at IHME. “Risk factors like obesity, lack of exercise, high blood pressure and smoking explain a large portion of the variation in life spans, but so do socioeconomic factors like race, education and income.”
In Owsley County, Kentucky, life expectancy from birth dropped by 2.2 years, from 72.4 in 1980 to 70.2 in 2014. In that county, the poverty rate was 42.4 percent, and the median household income less than $25,000, according to 2015 census data.
The county with the lowest life expectancy in the U.S. — 66.8 years old — was Oglala Lakota County, South Dakota. The No. 1 cause of death for the population — which is 90 percent Native American — is cancer, followed by accidents, chronic liver disease, heart disease and diabetes, according to 2015 census data.
Oglala Lakota County’s life expectancy is even less than that of some developing nations. The authors noted that life expectancy from birth is 67.2 years old in Sudan, 66.9 in India and 67.7 in Iraq.
Additionally, counties in the lower half of Mississippi, eastern Kentucky and southwestern West Virginia had lower life expectancy compared to the rest of the country.
More affluent counties, such those as in central Colorado, life expectancy was between 83 and 86 years old.
Alaska, California and states along the East Coast also had high life expectancy, with the age at death increasing by as much as 12 years and 18 percent over the past 34 years.
The researchers also noted that the number of deaths based on age groups differed, with all counties recording a drop in the risk of dying before age 5. However, 11.5 percent of counties saw an increased risk of deaths in adults between 25 and 45.
A study published earlier this year showed that mortality rates were increasing among white, middle- and working-class Americans. The researchers, Anne Case and Angus Deaton, found that “deaths of despair” — related to drug overdose, suicide, obesity and alcohol abuse — and economic inequality increased for white males, despite mortality rates decreasing for other racial groups.
“The magnitude of these disparities demands action all the more urgently because inequalities will only increase further if recent trends are allowed to continue uncontested,” the authors wrote in their conclusion.
The researchers also compared the amount of money spent on health care and life expectancy between the U.S. and other Western nations. In 2014, the U.S. spent $9,237 per person for health care and boasted a life expectancy of 79.1 years. But Australia spent $4,032 and had a life expectancy of 82.3 years, and Japan spent $3,816 and enjoyed a life expectancy of 83.1 years.
Dr. Ali Mokdad, a co-author on the study, said in a phone interview with The Washington Times that while the U.S. has invested and built a respected medical and treatment system, letting preventive services fall to the wayside has led to disparate life expectancy across the country.
“We’re not getting the return on investment because we’re spending more money and our health outcomes are behind other countries,” Dr. Mokdad said. “We’re not doing it right, that’s what the debate has to be.”
It’s preventive services that West Virginia Health Department officials are hoping will turn around their low life expectancy.
The top health problems facing West Virginia are: tobacco, complications from obesity, substance abuse and drugs, Dr. Rahul Gupta, the state health officer of West Virginia, told The Washington Times.
“Prevention has to be at the heart and core of every effort we do,” he said and added that education campaigns about smoking have helped decrease the number of expectant mothers who smoke and the prevalence of smoking among the youth.
“Eating right, physical activity, vaccination, reducing obesity, tobacco, drug abuse, it’s the preventative aspects that we need in public health that we need to focus in order to achieve the gains we need to see in the next decade,” Dr. Gupta said.
