The University of Washington’s Institute for Health Metrics and Evaluation (IHME), as reported in this Seattle Times article (somewhat ominously titled “How long will you live? Depends on the county”), released a study today which has collected county-by-county life-span data for 20 years, comparing it to national averages as well as to other nations.
The numbers revealed gaps everywhere — between counties, between black and white residents, and between men and women.
The study (itself somewhat ominously titled) “Falling Behind: Life expectancy in US Counties from 2000 to 2007 in an International Context” — found life expectancies in most American counties failing to keep up with gains in the 10 longest-living nations.
“We are finally able to answer the question of how the US fares in comparison to its peers globally,” said Dr. Christopher Murray, IHME Director and one of the paper’s co-authors. “Despite the fact that the US spends more per capita than any other nation on health, eight out of every 10 counties are not keeping pace in terms of health outcomes. That’s a staggering statistic.”
Some interesting points from the IHME’s website :
- When compared to the international frontier [the ten nations with the longest life expectancies worldwide] for life expectancy, US counties range from being 16 calendar years ahead to more than 50 behind for women. For men the range is from 15 calendar years ahead to more than 50 calendar years behind. This means that some counties have a life expectancy today that nations with the best health outcomes had in 1957.
- The researchers suggest that the relatively low life expectancies in the US cannot be explained by the size of the nation, racial diversity, or economics.
- Instead, the authors point to high rates of obesity, tobacco use, and other preventable risk factors for an early death as the leading drivers of the gap between the US and other nations.
- Change in life expectancy is so uneven that within some states there is now a decade difference between the counties with the longest lives and those with the shortest.
The authors propose that state and local policymakers use the life expectancy data and the county comparisons to tailor strategies that will fit the dynamics of their communities. This resonates with local policymakers, such as Dr. David Fleming, Director of Public Health – Seattle & King County. “It’s not the health care system that’s having the biggest impact on health; it’s the community,” Dr. Fleming said. “The average person in the US spends one hour annually in a physician’s office unless they are really sick. So until we start moving our interventions out into the communities where people live, we are not going to get ahead of these problems.”