Life Expectancy in Some U.S. Counties Is No Better Than in the Third World

National Journal

There's little good news in a report on American life expectancy from the Institute of Health Metrics and Evaluation at the University of Washington. We'll begin with the silver lining: Between 1985 and 2010, life expectancy in the U.S. climbed from 78 to 80.9 years for females and from 71 to 76.3 for men.

But this is no cause for celebration.

Dig into the numbers of the report and two troubling trends become apparent. One: Compared with the rest of the industrialized world (OECD countries), America is falling behind. "These improvements are much less than what countries of similar income per capita have seen," the report states. The U.S. now ranks 39th and 40th out of 187 countries for life expectancy for males and females respectively. 

But here's the thing. The United States isn't uniformly underperforming in life expectancy. The county with the highest life-expectancy in the U.S. for males is Fairfax County, Va., where males live 81.67 years. That's better than the life expectancy of Japan and Switzerland, which are atop the list for worldwide longevity.

This is the second troubling aspect of the report: There's a huge disparity between the country's highest- and lowest-performing areas. For men, the difference in longevity in the top and lowest counties is 17.77 years. For women, that number is 12.37 years. Progress in national longevity can be attributed to increases in the highest-performing counties (and mainly among men). "Many counties have made no progress," the report states, "or for the period 1993 to 2002, there have been declines for females in several hundred counties."

The life expectancy of the U.S.'s poorest-performing counties is similar to the mortality rates of some of the world's poorer nations.

Life expectancy for males in 11% and for females in 14% of US counties was below that of Nicaragua. In some counties, such as McDowell County, WV and Sunflower County, MS, life expectancies are lower than Bangladesh for males and Algeria for females. The complete failure by some communities to increase life expectancy from levels seen now in very poor countries likely has many distal and proximate causes. But most importantly, this slow progress should be viewed as a call for action to improve health and reduce inequalities in the US. 

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Bottom counties for life expectancy for females

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Top counties for life expectancy for males

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Bottom counties for life expectancy for males

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