FoxysGraphic/iStock/Thinkstock(NEW YORK) — Residents in the poorest counties in the U.S. face a life expectancy up to decade shorter than their counterparts in the wealthiest areas, according to a study published Thursday in the American Journal of Public Health.
Researchers from East Tennessee State University wanted to better understand how socioeconomic status was associated with health outcomes. To find out they reconfigured the country’s 3,141 counties into 50 new “states” (with 2 percent of the counties in each) based on median household income as opposed to geographic proximity.
The researchers broke down the data by county since they found state-level data may hide some “impact of socioeconomic disparities on both the best-off and worst-off counties.”
They then examined health data from the wealthiest and poorest “states” (top and bottom 2 percent) to see how residents differed on factors like obesity, smoking, clinical care and excessive drinking.
Researchers found that there was nearly a 10 year gap in the life expectancy of men with an average of 79.3 years in the wealthy counties compared to 69.8 years in the poorest. For women, the difference was slightly less — 83 years in the wealthiest counties and 76 years in the poorest.
Researchers examined data from the 2015 County Health Rankings National Data — maintained by the Robert Wood Johnson Foundation and the University of Wisconsin Public Health Institute — and found residents in poorer counties were more likely to have health risk factors including higher rates of obesity, smoking and an increased likelihood of being physically inactive.
Men and women in the poorest counties had a life expectancy equivalent to that of the overall U.S. life expectancy in 1980 and 1975 respectively.
Dr. Steven Woolf, Director of Virginia Commonwealth University Center on Society and Health, but not a part of this study, said the study helps show how economic policies and income inequality is associated with health outcomes.
“A lot of our work is about connecting the dots,” said Woolf. “There is a tendency in our country to talk about health issues as medical problems and not realize that decisions that the new administration will make about economic policy and lowering taxes…are all health issues.”
The wealthiest “state” had a median income of $89,723, whereas in the poorest “state,” the median income was $24,960, barely over the federal poverty line for a family of four.
While it may seem apparent that higher incomes would lead to better health outcomes, since people will be better able to get preventive medical care and treatment, Woolf says there are other seemingly unrelated factors that can affect health as well.
He said that children who grow up in an economically depressed area with high levels of stress due to financial strain can end up with chronic “toxic” stress. These children are at increased risk of developing diabetes, heart disease, pulmonary disease and hypertension.
“A lot of those conditions trace themselves back to childhood exposures, said Woolf.
The counties that made up the poorest “state” came from Alabama, Arkansas, Georgia, Illinois, Kentucky, Louisiana, Mississippi, Oklahoma, South Carolina, South Dakota, Tennessee, Texas and West Virginia. The counties in the wealthiest “state” came from Arkansas, California, Connecticut, Colorado, Georgia, Illinois, Indiana, Kentucky, Maryland, Maine, Minnesota, Ohio, New Jersey, New Mexico, New York, Pennsylvania, Utah, Tennessee, Texas and Virginia.
The study authors caution that while they found a connection between socioeconomic status and health outcomes, they did not analyze cause and effect. But they suggest that the data shows how policy makers should not just focus on state-wide initiatives but more targeted efforts to help those most at risk.
“With limited and finite resources, methods of pinpointing the poorest counties can assist in the allocation of resources and programs to those communities that are in the greatest need,” the study authors wrote.
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