Life Expectancy in the US: How Race, Income, and Location Make a Difference, Study Shows

A recent study published in The Lancet highlights the growing disparities in life expectancy across different groups in the United States, revealing a gap of up to 20 years between the longest- and shortest-lived groups. The research emphasizes how race, income, and geography play key roles in these disparities, with the COVID-19 pandemic exacerbating the situation.

Professor Christopher JL Murray, Senior Author and Professor Director of the Institute for Health Metrics and Evaluation (IHME) at the University of Washington, Seattle, pointed out that these findings reflect deep-rooted issues within the U.S. healthcare system. Despite the country's high healthcare spending, some groups face significantly worse health outcomes due to a combination of social, economic, and systemic factors.

The "Ten Americas"

The study divided the U.S. population into ten groups, known as "Americas," based on a combination of geography, race, ethnicity, income, and whether individuals lived in urban or rural settings. Death records and population data were analyzed to determine life expectancy trends for these groups over time.

What the Study Found

The study, which analyzed death rates and population data from 2000 to 2021, revealed that life expectancy differences have worsened, particularly due to the pandemic.

Key Findings

• The Growing Gap: The difference in life expectancy between groups grew from 12.6 years in 2000 to 20.4 years by 2021, with COVID-19 worsening these disparities.

• Racial and Regional Differences: Black Americans in low-income rural areas and segregated urban neighborhoods had the lowest life expectancy, around 70.5 years. Asian Americans, on the other hand, had the highest life expectancy at 83.1 years.

• Rural vs. Urban: While most groups saw life expectancy rise between 2000 and 2010, some, like American Indians and Alaska Natives (AIANs) in the West, experienced a decline.

• Pandemic Impact: The pandemic caused a drop in life expectancy across nearly all groups, with Black Americans in rural, low-income areas losing about four years, and White and Asian Americans losing about 1.4 years.

Struggles for Marginalized Groups

AIANs in the Western U.S. experienced the most extreme disparities, with life expectancy in 2021 reaching only 63.6 years—20.4 years lower than that of Asian Americans, who lived an average of 84 years. These disparities are compounded by a lack of access to healthcare, high unemployment, and insufficient public health services.

Why Are There Differences?

Several key factors contribute to these gaps:

• Income and Education: Individuals with lower income and education levels generally have shorter life expectancies, especially among Black Americans in poor, rural areas and AIANs in the West.

• Other Issues: The study also highlights the significant role of racism and discrimination in exacerbating these health disparities.

What Needs to Change?

Professor Murray stresses the need for targeted policies to close these health gaps, including increased investment in healthcare, education, and employment, particularly for marginalized communities. Addressing systemic discrimination is also crucial to improving health equity.

The study authors acknowledged limitations, such as potential inaccuracies in race and ethnicity reporting on death certificates.

Reference:

1. Dwyer-Lindgren, L., et al. (2024). Ten Americas: a systematic analysis of life expectancy disparities in the USA. The Lancet. doi.org/10.1016/s0140-6736(24)01495-8.

(Input from various sources)

(Rehash/Dr. Sreelekshmi P/MSM)