While the world’s leading industrialized nations report considerable increases in life expectancy annually, the majority of US counties are falling further behind, researchers from the Institute for Health Metrics and Evaluation (IHME) at the University of Washington and Imperial College London reported today.

The authors wrote that 80% of counties in the USA have fallen further behind the life expectancy average of the top ten countries in the world.

Co-author, Dr. Christopher Murray, IHME Director, said:

“We are finally able to answer the question of how the US fares in comparison to its peers globally. Despite the fact that the US spends more per capita than any other nation on health, eight out of every 10 counties are not keeping pace in terms of health outcomes. That’s a staggering statistic.”

The study, called “Falling behind: life expectancy in US counties from 2000 to 2007 in an international context”, is published in Population Health Metrics, a Biomed Central open access journal.

The IHME is also publishing a series of life expectancy rates for 3,138 counties in 10 US cities from 1987 to 2007.

The authors wrote:

“When compared to the international frontier for life expectancy, US counties range from being 16 calendar years ahead to more than 50 behind for women. For men the range is from 15 calendar years ahead to more than 50 calendar years behind. This means that some counties have a life expectancy today that nations with the best health outcomes had in 1957.”

The researchers believe that high obesity rates, smoking status and other preventable risk factors are key factors in America’s poor life expectancy figures, rather than the size of the country, economics or racial diversity.

In Mississippi, five counties have female life expectancy rates below 74.5 years – lower than Peru, El Salvador and Honduras. Four of those counties have male life expectancies below 67 years, less than the Philippines, Latvia and Brasil.

In Collier County, Florida, women have a life expectancy of 86 years, which beats Spain, Switzerland and France. Life expectancy for males in Fairfax County, VA, at 81 years is the highest in the country, beating Australia and Japan.

The longest female life spans were found in San Mateo and Marin, California; Montgomery, Maryland; Teton, Wyoming. While for males Montgomery, Maryland; Douglas, Colorado; Marin, California; Santa Clara, California did best.

In approximately 40% of American counties (1,373 counties), women were over five years behind the countries with the longest life expectancies, compared to US males in 661 counties.

In all counties, African-American men and women have lower life expectancies than Caucasian males and females.

Life expectancy for African-American females ranges from 69.6 to 82.6 years, and for African-American males from 59.4 to 77.2.

Within some US states some counties’ life expectancies are 10 years longer than others’. Arizona, Virginia, Georgia and Florida have counties whose life expectancies have risen by at least five years during the two decades leading up to 2007, while other nearby counties have either remained the same or even dropped. In Yuma County, Arizona, male life expectancy rose by 8.5 years, compared to La Paz County next door which saw a one-year drop.

American life expectancy overall for both sexes rose 4.3 years between 1987 and 2007.

Lead author, Dr. Sandeep Kulkarni, said:

“By creating this time series, which has never been available at the county level, we hope states and counties will be able to take targeted action. Counties in one part of the state should not be benefiting from big increases in life expectancy while other counties are actually seeing life spans shrink.”

Dr. David Fleming, Director of Public Health – Seattle & King County, said:

“It’s not the health care system that’s having the biggest impact on health; it’s the community,” Dr. Fleming said. “The average person in the US spends one hour annually in a physician’s office unless they are really sick. So until we start moving our interventions out into the communities where people live, we are not going to get ahead of these problems.”

IHME and Seattle & King County health department are working on the Monitoring Disparities in Chronic Conditions (MDCC) Study, one of the largest studies of its kind. Researchers are gathering and integrating data from pharmacy records, hospital discharge databases, emergency medical services, and other sources to determine what the main health challenges of King County are. The study involves 9,000 participants. Blood samples are taken to analyze for a range of diseases and risk factors.

MDCC study leader, Dr. Ali Mokdad, said:

“We are building the evidence for focused interventions that will make an impact locally. If we as a society are going to fund programs to improve health, we must ensure that we are measuring the impact, because these life expectancy numbers show that what we have been doing up until now clearly is not working.”

Top Ten Life Expectancy Countries, plus USA

    1. Iceland
    2. Switzerland
    3. Sweden
    4. Japan
    5. Australia
    6. Norway
    7. Canada
    8. Spain
    9. France
    10. The Netherlands
    37. The USA (37th place)

“Falling behind: life expectancy in US counties from 2000 to 2007 in an international context”
Sandeep C Kulkarni, Alison Levin-Rector, Majid Ezzati and Christopher JL Murray
Population Health Metrics 2011, 9:16 doi:10.1186/1478-7954-9-16 Published: 15 June 2011

Written by Christian Nordqvist