We live in an unequal society and one of the places this shows up is in life expectancy. Turns out that life expectancy is a good marker for a lot of other things relating to our health. If we are unhealthy and not able to afford a good diet or don’t have access to health care, our life expectancy is going to suffer.
Twenty years ago, a study was undertaken of the factors which affect life expectancy in the United States. Looking for new insights, the researchers divided Americans into eight groups that they called the Eight Americas. Recently, they revisited the issue to see what, if anything, had changed. This time they decided to divide us into ten groups that they call the Ten Americas. The two additional groups were created to separately categorize Latinos, who had been included with Whites in the Eight Americas. The differences they saw in life expectancy among the eight groups has become even more pronounced over the ensuing twenty years, and especially during the Covid years.
As they did the first time around, the researchers divided the Ten Americas based on race and ethnicity and a variable combination of geographical location, metropolitan status, income, and Black–White residential segregation. The Ten Americas were loosely defined as follows: America 1—Asian individuals living in majority Asian counties; America 2—Latino individuals other than in the Southwest; America 3—Whites not included in Americas 4 and 8 and the remaining Asians; America 4—White individuals in non-metropolitan and low-income Northlands; America 5—Latino individuals in the Southwest; America 6—Black individuals not living in Americas 7 and 9; America 7—Black individuals in highly segregated metropolitan areas; America 8—White individuals in low-income Appalachia and Lower Mississippi Valley; America 9—Black individuals in the non-metropolitan and low-income South; and America 10—Native Americans living in the West.
In 2001, the gap in life expectancy between Americas was 12·8 years for females and 15·4 years for males. Things were worse in 2021 when the researchers revisited the issue. Life expectancy dropped in all of the Ten Americas in 2020 due to the Covid pandemic. We have fallen even further behind life expectancy in the other industrialized nations. But the most disappointing finding is that the effects of inequality have only increased in the last twenty years.
Not surprisingly, poverty and education strongly influenced life expectancy. The better educated a person is and the more income she or he has, the longer they can expect to live. They are likely to be better informed about health issues, to have access to good health care and to be able to afford it, and to be able to find and afford a healthy diet. Conversely, poverty and low levels of education are often found in tandem and together contribute to a population group that is not able to afford to be healthy and therefore has a shorter life expectancy. Major causes of death in some communities are soaring rates of obesity and diabetes, gun violence, HIV/AIDS, and overdose deaths. These undoubtedly contributed to declines in overall life expectancy and were more acute among some of the Americas than others.
We should be asking ourselves why we permit there to be Ten Americas with such widely different life expectancies. Why are we failing so many of our citizens and why are we falling behind the rest of the industrialized world? Why are we permitting some of our citizens to live in circumstances so unequal that it is almost as though they live in a different country, and perhaps they do. It is time for us to address income inequality, to improve education, and to improve health care delivery for all. It is actually past time.
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