A report states that life expectancy is higher among Americans living in the rural Northern Plains. (AP Graphics)
Posted on 09/11/2006 7:46:12 PM PDT by NormsRevenge
WASHINGTON - Where you live, combined with race and income, plays a huge role in the nation's health disparities, differences so stark that a report issued Monday contends it's as if there are eight separate Americas instead of one.
Asian-American women living in Bergen County, N.J., lead the nation in longevity, typically reaching their 91st birthdays. Worst off are American Indian men in swaths of South Dakota, who die around age 58 — three decades sooner.
Millions of the worst-off Americans have life expectancies typical of developing countries, concluded Dr. Christopher Murray of the Harvard School of Public Health.
Asian-American women can expect to live 13 years longer than low-income black women in the rural South, for example. That's like comparing women in wealthy Japan to those in poverty-ridden Nicaragua.
Compare those longest-living women to inner-city black men, and the life-expectancy gap is 21 years. That's similar to the life-expectancy gap between Iceland and Uzbekistan.
Health disparities are widely considered an issue of minorities and the poor being unable to find or afford good medical care. Murray's county-by-county comparison of life expectancy shows the problem is far more complex, and that geography plays a crucial role.
"Although we share in the U.S. a reasonably common culture ... there's still a lot of variation in how people live their lives," explained Murray, who reported initial results of his government-funded study in the online science journal PLoS Medicine.
Consider: The longest-living whites weren't the relatively wealthy, which Murray calls "Middle America." They're edged out by low-income residents of the rural Northern Plains states, where the men tend to reach age 76 and the women 82.
Yet low-income whites in Appalachia and the Mississippi Valley die four years sooner than their Northern neighbors.
He cites American Indians as another example. Those who don't live on or near reservations in the West have life expectancies similar to whites'.
"If it's your family involved, these are not small differences in lifespan," Murray said. "Yet that sense of alarm isn't there in the public."
"If I were living in parts of the country with those sorts of life expectancies, I would want ... to be asking my local officials or state officials or my congressman, 'Why is this?'"
This more precise measure of health disparities will allow federal officials to better target efforts to battle inequalities, said Dr. Wayne Giles of the Centers for Disease Control and Prevention, which helped fund Murray's work.
The CDC has some county-targeted programs — like one that has cut in half diabetes-caused amputations among black men in Charleston, S.C., since 1999, largely by encouraging physical activity — and the new study argues for more, he said.
"It's not just telling people to be active or not to smoke," Giles said. "We need to create the environment which assists people in achieving a healthy lifestyle."
The study also highlights that the complicated tapestry of local and cultural customs may be more important than income in driving health disparities, said Richard Suzman of the National Institute on Aging, which co-funded the research.
"It's not just low income," Suzman said. "It's what people eat, it's how they behave, or simply what's available in supermarkets."
Murray analyzed mortality data between 1982 and 2001 by county, race, gender and income. He found some distinct groupings that he named the "eight Americas:"
_Asian-Americans, average per capita income of $21,566, have a life expectancy of 84.9 years.
_Northland low-income rural whites, $17,758, 79 years.
_Middle America (mostly white), $24,640, 77.9 years.
_Low income whites in Appalachia, Mississippi Valley, $16,390, 75 years.
_Western American Indians, $10,029, 72.7 years.
_Black Middle America, $15,412, 72.9 years.
_Southern low-income rural blacks, $10,463, 71.2 years.
_High-risk urban blacks, $14,800, 71.1 years.
Longevity disparities were most pronounced in young and middle-aged adults. A 15-year-old urban black man was 3.8 times as likely to die before the age of 60 as an Asian-American, for example.
That's key, Murray said, because this age group is left out of many government health programs that focus largely on children and the elderly.
Moreover, the longevity gaps have stayed about the same for 20 years despite increasing national efforts to eliminate obvious racial and ethnic health disparities, he found.
Murray was surprised to find that lack of health insurance explained only a small portion of those gaps. Instead, differences in alcohol and tobacco use, blood pressure, cholesterol and obesity seemed to drive death rates.
Most important, he said, will be pinpointing geographically defined factors — such as shared ancestry, dietary customs, local industry, what regions are more or less prone to physical activity — that in turn influence those health risks.
For example, scientists have long thought that the Asian longevity advantage would disappear once immigrant families adopted higher-fat Western diets. Murray's study is the first to closely examine second-generation Asian-Americans, and found their advantage persists.
A report states that life expectancy is higher among Americans living in the rural Northern Plains. (AP Graphics)
The 25 counties with the highest and lowest life expectancy, according to a study in the online science journal PLoS Medicine:
Highest life expectancy
County Life Expectancy
Clear Creek, Colo. 81.3
Eagle, Colo. 81.3
Gilpin, Colo. 81.3
Grand, Colo. 81.3
Jackson, Colo. 81.3
Park, Colo. 81.3
Summit, Colo. 81.3
Montgomery, Md. 81.3
Lyon, Iowa 81.3
Sioux, Iowa 81.3
Nicollet, Minn. 81.1
Story, Iowa 81.0
Carver, Minn. 81.0
Collier, Fla. 81.0
Benton, Ore. 80.9
Polk, Ore. 80.9
Fairfax City, Va. 80.9
Fairfax County, Va. 80.9
La Paz, Ariz. 80.9
Yuma, Ariz. 80.9
Winneshiek, Iowa 80.8
Morgan, Utah 80.8
Summit, Utah 80.8
Archuleta, Colo. 80.8
Gunnison, Colo. 80.8
Lowest life expectancy
Washabaugh, S.D. 66.6
Todd, S.D. 66.6
Shannon, S.D. 66.6
Mellette, S.D. 66.6
Jackson, S.D. 66.6
Bennett, S.D. 66.6
Baltimore City, Md. 68.6
Petersburg, Va. 69.6
Marlboro, S.C. 69.6
Phillips, Ark. 69.8
Coahoma, Miss. 70.1
Union, Fla. 70.2
Baker, Fla. 70.2
Mcdowell, W.Va. 70.4
St. Louis City, Mo. 70.8
Pemiscot, Mo. 70.9
Sunflower, Miss. 71.1
Crittenden, Ark. 71.1
Richmond City, Va. 71.1
Washington, Miss. 71.1
Tunica, Miss. 71.2
Tallahatchie, Miss. 71.2
Quitman, Miss. 71.2
Logan, W.Va. 71.2
Martin, N.C. 71.2
___
Life expectancy by state, according to a study in the online science journal PLoS Medicine:
State Life expectancy Rank
Ala. 74.4 48
Alaska 77.1 26
Ariz. 77.5 22
Ark. 75.2 43
Calif. 78.2 10
Colo. 78.2 12
Conn. 78.7 4
Del. 76.8 29
D.C. 72 51
Fla. 77.5 21
Ga. 75.3 41
Hawaii 80.0 1
Idaho 77.9 15
Ill. 76.4 33
Ind. 76.1 37
Iowa 78.3 7
Kan. 77.3 24
Ky. 75.2 42
La. 74.2 49
Maine 77.6 20
Md. 76.3 35
Mass. 78.4 5
Mich. 76.3 34
Minn. 78.8 2
Miss. 73.6 50
Mo. 75.9 38
Mont. 77.2 25
Neb. 77.8 16
Nev. 75.8 39
N.H. 78.3 6
N.J. 77.5 23
N.M. 77.0 27
N.Y. 77.7 19
N.C. 75.8 40
N.D. 78.3 8
Ohio 76.2 36
Okla. 75.2 44
Ore. 77.8 17
Pa. 76.7 31
R.I. 78.3 9
S.C. 74.8 47
S.D. 77.7 18
Tenn. 75.1 45
Texas 76.7 30
Utah 78.7 3
Vt. 78.2 11
Va. 76.8 28
Wash. 78.2 13
W.Va. 75.1 46
Wis. 77.9 14
Wyo. 76.7 32
___
On the Net:
Harvard data: http://www.globalhealth.harvard.edu
Cuz if it's not, I'm pretty sure that's a form of intolerance...!
As far as I can tell, drinking plenty brandy, staying sedentary for 9 months of winter, going to the State Fair and gorging on pronto pups, honey lemonade and mini donuts, will get you through to a ripe old age. Well, works for me. Yah, you betcha!
"He cites American Indians as another example. Those who don't live on or near reservations in the West have life expectancies similar to whites'."
The EPA should close down reservations to human occupancy until we can determine the health hazards.
Poi bump!
I'll bet Asian-American women don't have nearly the lard on them that other groups do, hence their longevity.
I wonder what factors are in effect? Can't be climate-Hawaii is number one, but Minnesota is number 2...
Very nice tag line. I couldn't have said it better myself.
1. fish - give fish-oil, omega-3 fatty-acids
2. Green tea - ECGD
3. soba noodles - made of buckwheat
4. lots of soy products
The mix ends up counteracting even heavy tobacco use, I guess...
"Tallahatchie, Miss. 71.2"
Well, I do know that Billie Jo McAllister didn't make it to that age in Tallahatchie!
I think we'd have to look at the numbers to tell.
Why would your congressman know? Why assume that the government has anything to do or say about how you choose to live?
Some of the disparity in life expectancy is due to genes: for instance, black Americans, probably largely due to genetic factors, have a tendency to develop hypertension. That's not something any government in the world can change. But some of the discrepancy is due to factors that are within the control of the individual: losing weight, refraining from smoking, eating a healthy diet, exercising regularly, and taking your anti-HTN drugs as prescribed make a big difference. People choose not to do these things and then everyone is shocked and saddened when they die young.
Same thing in Appalachia. Everybody there seems to have money for cigarettes. Only the poor and uneducated smoke these days. The government is not forcing people to smoke or sit in front of the TV; that's a choice. It's not the government's duty to fix a situation that's under the control of individuals.
Drinking. I think anyone that works in the health fields will tell you alcoholism knocks 20 years off a person's life.
When I saw a man dying of "old age" related diseases in hospitals in their 50s, they were often alcoholics. It's a killer.
So much of it is behavior-related. For example, the average Texan has a life expectancy of 76-odd years. The average Texan with a "I'm Gay, I'm For Gore, And I'm Here To Take Your Guns" bumper sticker, somewhat less.
L8R READ
Most of the reservations in the Plains are basically independent countries so they can't blame whitey for their issues, but they will anyway.
On average, people from Hawaii have the longest life expectancy of any state in the union by far.
On average, people in Hawaii eat more spam-per-capita than any state in the union by far.
SPAM IS THE KEY TO LONG LIFE!!!
EAT MORE SPAM
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