8 Americas of lilfespan

Eight Americas: Investigating Mortality Disparities across Races, Counties, and Race-Counties in the United States (Open Access). Here's the most interesting finding for me:

The 12.8-y gap in life expectancy between females in Americas 1 and 7 is approximately the same as the gap between Japan, with the highest national life expectancy for females in 2001 (84.7 y), and Fiji, Nicaragua, and Lebanon...Asian females in the US have a life expectancy that is 3 y higher than that of females in Japan...For males, the 15.4-y gap in life expectancy between Asians (America 1) and high-risk urban blacks (America 8) is the same as between Iceland, with the highest national male life expectancy in 2001 (78.2 y), and Sao Tome, Belarus, and Uzbekistan...In other words, millions of Americans, distinctly identified by their sociodemographic characteristics and place of residence, have life expectancies that are similar to some low-income developing countries....

The fact that the gap in life expectancy between sociological groups in America was so high was not surprising to me. The fact that Asian American females have higher life expectancies than Japanese females was surprising. A relative lack of correlation between income and life expectancies among whites wasn't too surprising, though the wealthy have access to better end of life care I suspect that the wear & tear of cosmopolitan life has a long term deleterious impact. Also, check this figure. The South just isn't healthy...though have you noticed what both whites and blacks eat there???

Via John Emerson.

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There was also no obvious geographical pattern in mortality in America 3 (Figure 1). For example, life expectancy for counties east and west of the Mississippi River was 76.6 and 77.2 y, respectively.

Ah c'mon, I went to school long after they stopped teaching geography, and even I know that geography includes more than just N, S, E, W. Here's a map of the climate zones in the US:
http://en.wikipedia.org/wiki/Image:Climatemapusa2.PNG

The r^2 isn't 1, but it's obviously substantial. The Southeast is a shithole for climatic reasons, and one consequence is a higher pathogen load. Not just the obvious ones, but all the myriad ones we don't even know about. (In a GNXP post, I argued why that's one reason there is no lasting civilization or academia down there.)

It's not just pop density -- look at the Bos-Wash corridor, and the dense areas of the Midwest. Life expectancies aren't shabby at all.

The thing that jumped out at me was the high life expectancies around here in the low-income upper Midwest, which I already knew about. That must have really jumped out of the stats, unless someone was cooking the books, because it's a really small demographic not usually thought of as distinct except by Garrison Keillor.

Climate and ethnicity have been proposed as causal, but this is also the most communitarian area in the U.S.

By John Emerson (not verified) on 12 Oct 2007 #permalink

I might add that obesity and alcoholism are quite prevalent around here, so maybe the health nuts have been lying to us.

By John Emerson (not verified) on 12 Oct 2007 #permalink

There are humid subtropicsl shitholes elsewhere than the southeast USA with life expectancies the same as the highest in the US, if not higher, so I'd guess the climatic factor is no biggie with modern disease control, and any remaining effect is swamped (pun intended) by other factors, most likely diet/lifestyle.

By Sandgroper (not verified) on 13 Oct 2007 #permalink

There are humid subtropicsl shitholes elsewhere than the southeast USA with life expectancies the same as the highest in the US, if not higher, so I'd guess the climatic factor is no biggie with modern disease control, and any remaining effect is swamped (pun intended) by other factors, most likely diet/lifestyle.

all things controlled? that is the question.

Singapore would be the best case to look at.

By John Emerson (not verified) on 13 Oct 2007 #permalink

This map compares poor white Northerners with poor white Southerners. There seems to be about a 3.5-year difference in life expectancy. It's hard to think of this as racial unless you imagine a big divide between continental and British Northern Europeans. The climate explanation may have some plausibility, but the American South isn't even subtropical (except for the tip of Florida, I think). A primarily sociocultural explanation seems most likely by far.

Finding a poor group healthier than the median group seems very unusual. Enough so that, even though the results are pleasing to me, you'd wonder whether some sort of tweaking or dredging was going on.

By John Emerson (not verified) on 13 Oct 2007 #permalink

The climate explanation may have some plausibility, but the American South isn't even subtropical (except for the tip of Florida, I think). A primarily sociocultural explanation seems most likely by far.

it doesn't have to be subtropical (these terms are often imprecise anyway). as early as the 17th century the relative healthfulness of new england re: disease was noted vs. the lowland south (in contrast, black slaves in new england were plagued with respiratory problems). see albion's seed. look at these maps:

http://www.cpc.noaa.gov/products/analysis_monitoring/lanina/us_impacts/…

i think the

1) number of days with freezing temps

2) snowy days

are probably important. that would kill off many bugs i'm assuming which could serve as vectors.

i would assume diet is a big issue...but it isn't like a midwestern diet is that much healthier.

There are so many potential influences, but my prior would be that the primary one is cultural. Look at how south Texas and the Hill Country have substantially longer life expectancy than east and west Texas. I'd bet the bank on that pattern stemming mainly from cultural (mainly diet) differences between hispanics and Germans on the one hand and English and Scotch-Irish on the other. It'd be great for somebody to work through the county-level correlations with religious affiliation, which can be found here:

http://www.valpo.edu/geomet/geo/courses/geo200/religion.html

Check out the Baptist map and tell me that the low life expectancy is the South isn't due to church food! -

http://www.valpo.edu/geomet/pics/geo200/religion/baptist.gif

I'd bet the bank on that pattern stemming mainly from cultural (mainly diet) differences between hispanics and Germans

i noticed south texas too. there's a weird trend for immigrant latinos to be much healthier on vitals signs (blood pressure, etc.) than their offspring. this is probably due to cultural issues (assimilating more american food & lifestyle?).

Raz- nope, controlled for nothing, but if you look at this map:

http://upload.wikimedia.org/wikipedia/en/7/73/Life_expectancy_world_map…

you see tropical Asian Singapore as a green dot in a sea of yellow and orange. Subtropical Asian Hong Kong should also appear as a green dot, but I assume the map compilers subsumed Hong Kong into the rest of China - like Singapore, Hong Kong also has average life expectancies comparable to Japan.

Historically, Singapore and Hong Kong both had all of the usual tropical nasties - malaria, cholera, etc and the usual things that go with dense populations and poor healthcare systems, but they both now have among the highest life expectancies in the world, as a consequence of good nutrition, excellent modern health care systems and good disease control, so the high pathogen load which was influential historically is evidently now not a significant factor.

The other thing to bear in mind is that there are pluses to high temperatures as well as minuses - flu viruses do a lot better at lower temperatures, for example, and the SARS virus emerged in the cooler months in southern China and finally disappeared again when it got to June and the temperatures got high enough to kill it off. There was that curious cluster of cases in Singapore, which is hot year-round, but I think that resulted from person-person transmission inside airconditioned buildings from people who had contracted the virus outside of Singapore (or possibly fecal transmission, as occurred in one high rise building in Hong Kong through the bathroom drainage and ventilation systems).

So, assuming that the standards of disease control and health care are not too different between the southeast and the rest of the USA, and are uniformly pretty high by world standards, then it seems reasonable to assume that the pathogen load normally associated with tropical climate may not be a strong factor in the variation of life expectancy with region in the USA.

In fact, you could compare New Guinea and northern Queensland in Australia and conclude the same thing - high standards of modern health care and disease control counfound the effect of tropical/sub-tropical pathogen loading - as one would hope they would do. But there you have the confounding effect of race, so it's not too conclusive.

So I'm left to assume that diet and lifestyle are a major controlling factor in variations in life expectancy among different groups in the USA, if you normalise for ethnicity. I don't know what else it could be. Well, environmental pollution, I guess, but then that should show up as an obvious pattern.

By Sandgroper (not verified) on 13 Oct 2007 #permalink

I can't document this or spell it out in detail, but the individual poverty of the SE US is matched by public poverty on things like public health, education, and infrastructure, which is exacerbated by systems of class favoritism which deliberately keep resources away from the poor (black and white). In the Upper Midewest Minnesota and Wisconsin have the strongest traditions in the US of public spending on health, education, etc., and also an egalitarian tradition. This is less true of Iowa and the Dakotas, but those states still are far superior to the SE US in these respects (except for Native Americans, especially in SD.)

Thanks John, I didn't know that. I assumed it wouldn't be completely uniform country-wide, but hadn't realised there would be such strong differences.

By Sandgroper (not verified) on 14 Oct 2007 #permalink

The other thing to bear in mind is that there are pluses to high temperatures as well as minuses - flu viruses do a lot better at lower temperatures

i had a roommate from singapore. i wouldn't trade his bout with dengue fever for my many flus ;-)

Neither would I, but flu kills a lot more people than dengue does.

Recovery from both needs a good immune system, for which we need Vitamin D. I knew we'd get back to it sooner rather than later.

By Sandgroper (not verified) on 14 Oct 2007 #permalink