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G.eneral H.ealth : Other N.ews Last Updated: Nov 19th, 2006 - 12:21:58

Race, Location Play Key Role in Determining US Life Expectancy
By Kathy Jones
Sep 12, 2006, 18:15

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12 Sep, ( - Although American life expectancy has increased substantially in recent years, a person's race and location within the US plays a major role in determining the average life span, Harvard researchers indicated in a new report.

Factors like gender, race, and location appear to be linked to how many years a person may live, Christopher J. L. Murray, M.D., D. Phil of the Harvard School of Public Health, and colleagues said. These factors play a greater role than external ones like income, insurance, infant mortality, AIDS or violence, researchers said.

The report is based on an analysis of data from the U.S. Census Bureau and the National Center for Health Statistics.

According to the study an average Asian American woman could expect to live 21 years longer that the average black male living in a high-risk urban area. The researchers used a number of such sociodemographic and geographical indicators to come up with "Eight Americas:" life-expectancy categories.

These categories were arrived at after taking into consideration a person's race, local surroundings and other community characteristics. Surprisingly the contributing factors to disparities in life expectancy appear to be linked to tobacco, alcohol, obesity, high blood pressure, high cholesterol, diet and physical inactivity, Dr Murray said.

"Those seven are likely to explain a lot of the patterns that we see," he said. "They also give us some hints about the types of public health and medical care interventions that could make a difference in these disparities."

The researchers calculated death rates for 1982 to 2001 through the Census data and integrated this into Eight Americas. Each category or group contained millions or tens of millions of people.

The life expectancy for each group was separately tabulated as were the risk of death from specific diseases at different ages, the proportion of people who had health insurance, and the access to health care services.

The Eight Americas as reported by researchers in PLoS Medicine are as follows
* Asian Americans with average per capita income of $21,566, have a life expectancy of 84.9 years.

* Northland low-income rural whites have an average income of $17,758 and a life expectancy of 79 years.

* Middle America (mostly white) earns $24,640 at an average and can expect to live for 77.9 years.

* Low income whites in Appalachia, Mississippi Valley have an average earning of $16,390 and life expectancy of 75 years.

* Western American Indians earn about $10,029 and live for 72.7 years at an average.

* Black Middle America earnings total $15,412, while life expectancy is 72.9 years.

* Southern low-income rural blacks have an average earning of $10,463 and a life expectancy of 71.2 years.

* High-risk urban blacks earn about $14,800 and can expect to live for 71.1 years at an average.

The researchers found that life-span disparities between the Eight Americas were indeed huge. For example, the gap between the maximum and minimum life expectancy in males was a whooping 15.4 years, while it was 12.8 years for females.

"There are millions of Americans that have life spans the same as in developing countries," Murray said. "That alone is pretty remarkable, considering we spend $5,000 a year per person on healthcare."

Locale-wise Asian American women living in Bergen County, N.J have a life expectancy of 91 years, while the lowest life expectancy of 66.6 years, is found in Bennett, Jackson, Mellette, Shannon, Todd and Washabaugh counties in South Dakota. These counties are inhabited mostly by Native American populations.

Clear Creek, Eagle, Gilpin, Grand, Jackson, Park and Summit counties in Colorado, Montgomery County, Md., and Lyon and Sioux counties in Iowa have the longest life span of 81.3 years at an average.

"The counties that started the best just keep getting better. Those at the bottom either stayed the same or got worse," Murray said.

Senior author Majid Ezzati, an associate professor of international health at Harvard School of Public Health said that the inequalities in health care need to be addressed urgently.

"Given the types of diseases that are the cause of these inequalities, disease prevention should have a major role. Instead of thinking about how many lives are going to be saved by lowering blood pressure and cholesterol, etc., we should think about whose lives we are saving," he said.

Dr. David L. Katz, an associate professor of public health and director of the Prevention Research Center at Yale University School of Medicine says the findings are disturbing.

"Culturally tailored interventions that take messages of disease prevention and health promotion to the places they are most urgently needed should be a national public health priority," he said. "A system that allocates both health care and health as inequitably as ours cannot be considered anything but a failure."

The CDC has outlined a policy called Healthy People 2010, which is designed to 1) Increase quality and years of healthy life; 2) Eliminate health disparities. Towards this goal, the Department of Health and Human Services (HHS) has identified six main areas.

These include Infant Mortality, Cancer screening and management, Cardiovascular disease, Diabetes, Immunizations and HIV/AIDS. These six health areas were selected for emphasis because they reflect areas of disparity that are known to affect multiple racial and ethnic minority groups at all life stages, HHS said.

Dr. Wayne Giles of the Centers for Disease Control and Prevention told the Associated Press that the current study would help, as it is a precise measure of health disparities. It will also allow federal officials to better target efforts to battle inequalities.

"It's not just telling people to be active or not to smoke," Giles said. "We need to create the environment which assists people in achieving a healthy lifestyle."

© 2004-2005 by unless otherwise specified

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