That's what Harvard's School of Public Health concluded in a study published in PLos Medicine this week. They studied death rates from 1982 - 2001 in a number of counties across the country. They divided their population into eight groups based on race, county, population density, homicide rate and income.
They found marked differences in life expectancy. The life expectancy of Asian-American women living in Bergen County, NJ is 91; that for Native-American men in South Dakota is 58. These women are living more than half as long as these men. The Americans with the best health lived three to four years longer than those thought of as long-lived, such as Japanese and Icelanders. Yet, those Americans in the groups with poorer health had a life expectancy associated with a developing country.
The diseases that affect the lower health groups are ones you would expect: chronic diseases with high risk factors, such as alcohol, tobacco, obesity, high blood pressure, high cholesterol and glucose. The study concluded that it is these factors rather than the presence or absence of health insurance that seemed to be primary reasons for the gaps in life expectancy. To improve our health we should focus more money and effort on preventing and treating these diseases. For example, only a half of those with high blood pressure and a third of those with high cholesterol are being treated.
Significantly, the study found that a great degree of the difference in mortality occurred not among children and elderly (who are the focus of much of our medical care) but among young and middle-aged adults.
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