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(HealthNewsDigest.com) – Life expectancy is rising generally in America, but some areas have seen death rates going conspicuously in the other direction. These geographical disparities are widening, according to a sweeping report published Monday in JAMA Internal Medicine.
Life expectancy is greatest in the high country of central Colorado, but in many pockets of America life expectancy is more than 20 years lower, according to the report from the University of Washington’s Institute for Health Metrics and Evaluation.
“Life expectancy in many places in this country is declining. It’s going backward instead of forward,” said Ali Mokdad, a co-author of the report and a professor at the university. “These disparities are widening, so this gap is increasing.”
People are less likely to live longer if they are poor, get little exercise and lack access to health care, but even with those factors taken into account, geography matters. Mokdad said that, even where health care is available, the quality of that care varies dramatically. For example, women have much better health outcomes when they have regular screenings for breast cancer and a better chance at detecting any cancer early, he said.
“Once somebody has a condition, how long did it take to get into the medical care? To receive that intervention that they need?” Mokdad said.
The researchers looked at death certificates from 1980 through 2014. Among the places with sharply increased life expectancy and lower deaths over that period are the District of Columbia and Loudoun County, Va. — where life expectancy is up 12.8 and 12.4 percent, respectively. Fairfax County has the lowest all-cause death rate in the metropolitan Washington region, significantly lower than the national average.
Of the 10 counties where life expectancy has dropped the most since 1980, eight are in Kentucky. The other two are in Oklahoma and Alabama. The report includes an interactive map of death rates county by county (and sometimes by city, when a city is not part of a county). The areas with the worst mortality metrics include central Appalachia, the Mississippi Delta and areas in the Dakotas with large Native American populations.
The list of counties with the most improved life expectancy includes a number of remote locations in Alaska, including the North Slope and the Aleutian Islands, and the boroughs of Manhattan (a.k.a. “New York County”) and Brooklyn (Kings County), as well as San Francisco.
An earlier study from the same research organization showed a huge disparity in the death rate from lung cancer. Summit County in Colorado, home to ski resorts and the town of Breckenridge, had almost no lung cancer mortality — a death rate of 11 per 100,000 population in 2014. The county with the highest rate, 231 per 100,000, was rural Union County, Fla., a small county that is home to a large prison population.
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