Income Gaps and Longevity Gaps Go Together

As the income inequality topic continues to gain momentum, an article by Annie Lowrey in today's NYTimes reminds us that higher or lower income is associated with higher or lower life expectancy. That relationship is true everywhere in the world, but the story itself builds on a set of county life expectancy data produced by the Institute for Health Metrics and Evaluation (IHME) at the University of Washington. Here is a map of female life expectancy in 2010 by US County from the IHME site:

The darker the red the lower the life expectancy, and the darker the blue the higher it is. In general, counties in Appalachia and along the lower Mississippi River are most disadvantaged with respect to longevity, and they also tend to be the most disadvantaged in terms of average income per household. Indeed the NYTimes has put together a very nice set of scatter plots of life expectancy and median household income, combining IHME data and ACS data. Lowrey then compares two counties that happen to be at the extremes of both measures:

Fairfax County, Va., and McDowell County, W.Va., are separated by 350 miles, about a half-day’s drive. Traveling west from Fairfax County, the gated communities and bland architecture of military contractors give way to exurbs, then to farmland and eventually to McDowell’s coal mines and the forested slopes of the Appalachians. Perhaps the greatest distance between the two counties is this: Fairfax is a place of the haves, and McDowell of the have-nots. Just outside of Washington, fat government contracts and a growing technology sector buoy the median household income in Fairfax County up to $107,000, one of the highest in the nation. McDowell, with the decline of coal, has little in the way of industry. Unemployment is high. Drug abuse is rampant. Median household income is about one-fifth that of Fairfax.

One of the starkest consequences of that divide is seen in the life expectancies of the people there. Residents of Fairfax County are among the longest-lived in the country: Men have an average life expectancy of 82 years and women, 85, about the same as in Sweden. In McDowell, the averages are 64 and 73, about the same as in Iraq.

As always, of course, we need to be careful about imputing personal cause and effect from these aggregated data. Some rich people die young, and some impoverished people live long lives. But overall the set of relationships is powerful. The better off a community is, the longer it residents are likely to live, and that probably feeds back to keep the community well off. Where would you prefer to live if you had the choice?