Place Matters: Life expectancy is influenced not only by income but also by location


Individuals who are well educated and possess a higher income live longer than those who are less educated and live at the poverty level in America’s cities, as demonstrated by studies such as Socioeconomic Disparities in Health in the United States: What the Patterns Tell Us published in the American Journal of Public Health.

A recent NPR report on the topic states that, “Since 2001, life expectancy in the United States has increased by 2.3 years for the wealthiest 5 percent of American men and by nearly 3 years for comparable women.” Meanwhile, life expectancy has not much for the poorest 5 percent. Most attribute life expectancy increases to resources attained by the wealthy. However, a recent study in The Journal of the American Medical (JAMA) demonstrate that place matters-i.e., differences in life expectancy are influenced not only by income level but also by where you live. Researchers find that the poor of the wealthiest cities are living longer than the poor in the poorest cities. The study, The Association between Income and Life Expectancy in the United States, 2001-2014, shows that the wealth disparity in life expectancy is lower in a city such as San Francisco as opposed to Detroit, where living conditions may be worse. Place-based conditions such as better neighborhoods, healthier foods, and less stress brought on by living in segregated impoverished neighborhoods may explain some of these differences in the wealth-life expectancy relations by place.

Our own research, to be included in an upcoming special issue of the Women and Girls Report, demonstrates an important role of place in the health of women and girls, particularly for reproductive health outcomes. The report determines that there is greater health disparity between wealthier parishes and poorer parishes utilizing poverty, education, and employment as indicators. This disparity shows a negative health impact on poorer parishes. Furthermore when race is added to the health equation, the negative disparity broadens for Black women when compared to their White counterparts in the same parish. Consequently, due to poorer health outcomes, exclusion from educational attainment and employment, women of color are more likely to experience adverse birth outcomes. Based on the level of neighborhood concentrated disadvantage they are at greater risk for experiencing low birth weight and preterm babies.

Impoverished neighborhoods are often characterized by other factors that together shape the resources and opportunities available to residents, which in turn influence the health of the community. If those resources and opportunities are in close proximity to an environment where healthy lifestyles are prevalent, then the low income community will, through exposure to better resources, live longer than those in low income areas who do not experience such exposure.