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Geographic Differences in Life Expectancy in the USA.

New Work on Population Aging

NASbookThe chapter Geographic Differences in Life Expectancy at Age 50 in the United States Compared with Other High-Income Countries by CEDA members John R. Wilmoth, Carl Boe, and Magali Barbieri appears in the National Academy of Sciences volume, International Differences in Mortality at Older Ages: Dimensions and Sources. Washington, DC: The National Academies Press, 2011.

This research was cited in the New York Times article, Life Spans Shrink for Least-Educated Whites in the U.S., Sept. 21, 2012, by Sabrina Tavernise.

US Ranks Last in Female Life Expectancy

USA Female e0 relative to OECD countries
Source: Human Mortality Database [accessed September 11, 2012].

 

Summary of Findings

Whereas the geographic variability of life expectancy at birth in the United States diminished during the 1960s and 1970s, disparities across states and counties have increased since 1980. The divergence of the geographic distribution of mean lifespan in the U.S. during the last two decades of the 20th century coincided with a rapid fall in the country's position in international rankings according to common measures of mortality or longevity (see graph above). This deterioration of international position is most notable for adult mortality and especially for women. Given the coincidence of timing (from the early 1980s until recently), we investigated whether the increasing geographic variablity was related in some causal fashion to the reduced pace of increase in life expectancy for the United States and thus to the country's loss of position in international rankings for this key indicator of population health.


Our study demonstrated that the slower progress achieved by the U.S in recent decades is only partially due to its increasing regional variability compared with other high-income countries. Indeed, by contrast with the increasing disparities observed across states of the U.S. since the early 1980s, most other high-income countries have experienced stability or an ongoing decline of geographic variability.  For men, the difference of trends in regional disparities explains up to 50 percent of the relatively slower pace of increase in  for the U.S.  For women, however, rather little (under 10 percent in the most relevant cases) of the slow progress recorded by the United States compared to other countries can be attributed to differential trends in regional disparities.


This analysis helps to rule out an increase in geographic disparities as a dominant explanation for the deteriorating position of the United States in international rankings of life expectancy, especially for women.  Any proposed explanation of the divergence in levels and trends of life expectancy observed among high-income countries in recent decades needs to acknowledge that even the most advantaged areas of the U.S. (at the state or county level) have been falling behind in international comparisons.

Acknowledgements

This project received financial support from the National Institute on Aging, grants no. R01-AG011552 and 2P30AG012839, and from the Institut National d’Études Démographiques, INED research project no. P05-3-7. A CEDA Pilot Project supported development of this investigation.