Middle and low income levels across the country are contributing to vastly different life expectancies across racial boundaries, but so is location. What's troubling is that the medical community doesn't know why folks live longer in one part of the country than another, even when they make less money.
According to a new study called the Eight Americas: Investigating Mortality Disparities Across Races, Counties, and Race-Counties in the United States, a joint effort by researchers with the Harvard School of Public Health, Harvard University Initiative for Global Health, Harvard Center for Population and Development Studies, and the University of California, there is a gap between the highest and lowest life expectancies when data from counties and races are combined.
In an attempt to explore the causes of the disparities, the researchers identified eight "Americas," based on race, location of the county of residence, population density, race-specific county-level per capita income, and cumulative homicide rate.
- Asian - 10.4 million - average per capita income $21,566, life expectancy 84.9 years
- Northland low-income rural white - 3.6 million - $17,758, 79 years
- Middle America - 214.0 million, $24,640, 77.9 years
- Low-income whites in Appalachia and the Mississippi Valley - 16.6 million - $16,390, 75 years
- Western Native American- 1.0 million - $10,029, 72.7 years
- Black Middle America - 23.4 million - $15, 412, 72.9 years
- Southern low-income rural black - 5.8 million - $10,463, 71.2 years
- High-risk urban black - 7.5 million - $14,800, 71.1 years
With the risk of mortality from certain diseases, availability of health insurance, and health care utilization also considered, the shocking results were that there are as many as 20 years difference in the life expectancy of some groups over others.
For example, the life expectancy between 3.4 million high-risk urban black males and 5.6 million Asian females was 20.7 years in 2001. Asian males live 15.4 years longer than high-risk urban black males. "These gaps are 2.4 and 2.8 times those between white and black life expectancies for the nation as a whole for males and females, respectively," says the report.
Mortality disparities were largest for the young (15 - 44 years) and middle-aged adults (45 - 59 years), particularly men. Between Americas' 1 and 8 groups, the gap in life expectancy expanded by half a year since the 1980s, widening in part with higher HIV and homicide rates, says the report.
"The observed disparities in life expectancy cannot be explained by race, income, or basic health-care access and utilization alone," concludes the researchers. "Because policies aimed at reducing fundamental socioeconomic inequalities are currently practically absent in the U.S., health disparities will have to be at least partly addressed through public health strategies that reduce risk factors for chronic diseases and injuries."
