Stark Inequality: Study Finds 20-Year Difference in Life Expectancy Between Counties in United States

By Hank Dart

Differences in life expectancy in the United States can vary greatly depending on the county in which you live.  That’s the finding of a new analysis out of the University of Washington and published in the journal JAMA Internal Medicine.

Using data from the Human Mortality Database, National Center for Health Statistics, and U.S. Census Bureau, researches calculated the average life expectancies of counties between the years 1980 and 2014.  They also assessed factors in the counties that could impact health – and therefore life expectancy – such as health behaviors, socioeconomic status (SES), and access to health care.

The analysis revealed a very large 20-year difference in life expectancy between the counties with the longest life expectancy and those with the shortest.  While average life-expectancy for women and men combined was 79 years in 2014, counties with the highest life-expectancy averaged 87 years.  Those with the lowest averaged just 66 years. Comparing the top 1 percent of counties with the lowest 1 percent, the life-expectancy gap was 11 years. Comparing the top 10 percent of counties with the lowest 10 percent, the gap was 6 years.

Counties on the lower half of the Mississippi River and those on some Native American reservations in South and North Dakota had some of the lowest life expectancy in the nation, while those in central Colorado Counties had some of the highest.  A related online dynamic tool allows users to explore life expectancy and mortality rates for counties across the nation.



Looking at trends since 1980, the researchers conclude that inequality in life expectancy in United States is “large and increasing.”  Though such inequality has dropped in younger groups, it remains stark in older groups and populations as a whole.

In trying to tease out the causes of these disparities, the researchers found that certain health and behavioral factors had the biggest influence.  Obesity, lack of physical inactivity, smoking, high blood pressure, and diabetes were found to account for 74 percent of the life expectancy differences between counties.

This new analysis further confirms the importance of addressing growing inequality in the United States. Populations with lower incomes, less education, and more discrimination are more likely to suffer from lifestyles and diseases that result in premature mortality.  Programs and policies need to be put in place to narrow these gaps and address these issues.

How long you live and how healthy you are should not depend on where you live.  Right now, it can.  And we need to change that.

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