National College of Physicians
National College of Physicians
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U.S. Life Expectancy Varies By More Than 20 Years From County To County

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.

By Joel Achenbach

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.

A baby born in Summit County, Colorado, has a life expectancy of nearly 87 years, but in some counties the life expectancy is more than 20 years lower, coming close to that in impoverished and war-torn countries such as Iraq or Sudan.

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.

"Geographic disparities in life expectancy among U.S. counties are large and increasing," the authors conclude in the report, titled "Inequalities in life expectancy among US counties, 1980 to 2014,".

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, Virginia - where life expectancy is up 12.8 and 12.4 percent, respectively. Fairfax County, Virginia, 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.