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Nationwide in 2014, the average life expectancy was about 79.1
years, up 5.3 years from 1980, the study found. For men, life
expectancy climbed from 70 years to 76.7 years, while for women it
increased from 77.5 years to 81.5 years.
But the study also highlighted stark disparities: a baby born in
Oglala Lakota County, South Dakota, can expect to live just 66.8
years, while a child born in Summit County, Colorado, can expect to
live 86.8 years, on average.
“For both of these geographies, the drastically different life
expectancies are likely the result of a combination of risk factors,
socioeconomics and access and quality of health care in those
areas,” said senior study author Dr. Christopher Murray, director of
the Institute for Health Metrics and Evaluation at the University of
Washington in Seattle.
“We found that risk factors - obesity, lack of exercise, smoking,
hypertension, and diabetes - explained 74 percent of the variation
in longevity in the U.S.,” Murray said by email. “Socioeconomic
factors - a combination of poverty, income, education, unemployment
and race - were independently related to 60 percent of the
inequality, and access to and quality of health care explained 27
percent.”
To examine changes in life expectancy over time, researchers looked
at death certificates from each county in the country.
Several counties in South and North Dakota, typically with Native
American reservations, had the lowest life expectancy, the study
found. Counties along the lower half of the Mississippi and in
eastern Kentucky and southwestern West Virginia also had very low
life expectancy compared with the rest of the country.
In contrast, counties in central Colorado had the highest life
expectancy.
Some of the biggest gains in life expectancy during the study were
seen in counties in central Colorado, Alaska and in metropolitan
areas around San Francisco and New York.
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But there was little, if any, improvement in life expectancy in some
southern counties in states stretching from Oklahoma to West
Virginia. Many counties where life expectancy dropped the most are
in Kentucky.
One limitation of the study is that there might be errors in county
death records, the authors note. Researchers also lacked data to
explore how much the findings might be explained by migration of
certain types of people to certain communities.
“The bottom line is that our life expectancy is increasingly being
shaped by where we live within the U.S.,” said Jennifer Karas Montez,
a sociology researcher at Syracuse University in New York who wasn’t
involved in the study.
“Lifestyle behaviors are not causes, they are symptoms,” Montez said
by email. “They are symptoms of the environment and the social and
economic deprivation that many parts of the country now endure
thanks to decades of policy decisions.”
SOURCE: http://bit.ly/2qKzJLD JAMA Internal Medicine, online May 8,
2017.
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