What's the Life Expectancy in Your County?

There are some rather remarkable disparities in life expectancy by county in the United States.

Across US counties, life expectancy in 2007 ranged from 65.9 to 81.1 years for men and 73.5 to 86.0 years for women. When compared against a time series of life expectancy in the 10 nations with the lowest mortality, US counties range from being 15 calendar years ahead to over 50 calendar years behind for men and 16 calendar years ahead to over 50 calendar years behind for women. 

Some of the disparities are sadly predictable. For example, here are the top counties in the US in terms of male life expectancy:

1. Marin, Calif.         81.6 years
2. Montgomery, Md.       81.4
3. Fairfax, Va.          81.3
4. Douglas, Colo.        81.0
5. Island, Wash.         80.9
6. Los Alamos, N.M.      80.7
7. Gunnison, Colo.       80.7
8. Pitkin, Colo.         80.7
9. Collier, Fla.         80.7
10. Santa Clara, Calif.  80.6

What do these counties tend to have in common? (hint--income).


These were among the many interesting facts that came to light in a story on the website of msnbc.com today, linking back to a paper published last year, but publicized last month by the Institute of Health Metrics and Evaluation at the University of Washington. At this latter link there is a PowerPoint presentation that you can download to look at in detail, or it will play directly on your computer. The media had especially picked up on one angle of the story--that the gap in life expectancy between men and women has been narrowing, after having widened over most of the 20th century. If you have read Chapter 5 of my text, you know that most research suggests that this narrowing of the gap has to do with smoking--women took up smoking later than men, and so the health effects of smoking, which take a long time to catch up with you--are now catching up with women, so their life expectancy is not rising as quickly as that for men. Therein lies that tale (OK, it's not quite that simple, but close to it).


More interesting from my perspective is the spatial pattern of differences in life expectancy for both men and women. Blacks have been catching up with whites over time, but predominantly black counties in the US still lag behind in life expectancy. The lack of a national health insurance scheme almost certainly accounts for a major fraction of these differences. Not all, to be sure. We know from the UK that spatial disparities can exist even when a national health insurance system has been in place for a long time. On the other hand, the UK has higher life expectancy at lower cost per person than the US.