http://www.nationaljournal.com/domesticpolicy/life-expectancy-in-some-u-s-counties-is-no-better-than-in-the-third-world-20130710

Life Expectancy in Some U.S. Counties Is No Better Than in the Third World
There's a huge gap between where Americans live the longest and where they live the shortest.

By Brian Resnick

There's little good news in a report on American life expectancy from the Institute of Health Metrics and Evaluation at the University of Washington. We'll begin with the silver lining: Between 1985 and 2010, life expectancy in the U.S. climbed from 78 to 80.9 years for females and from 71 to 76.3 for men.

Report Link

But this is no cause for celebration.

Dig into the numbers of the report and two troubling trends become apparent. One: Compared with the rest of the industrialized world (OECD countries), America is falling behind. "These improvements are much less than what countries of similar income per capita have seen," the report states. The U.S. now ranks 39th and 40th out of 187 countries for life expectancy for males and females respectively.

But here's the thing. The United States isn't uniformly underperforming in life expectancy. The county with the highest life-expectancy in the U.S. for males is Fairfax County, Va., where males live 81.67 years. That's better than the life expectancy of Japan and Switzerland, which are atop the list for worldwide longevity.

This is the second troubling aspect of the report: There's a huge disparity between the country's highest- and lowest-performing areas. For men, the difference in longevity in the top and lowest counties is 17.77 years. For women, that number is 12.37 years. Progress in national longevity can be attributed to increases in the highest-performing counties (and mainly among men). "Many counties have made no progress," the report states, "or for the period 1993 to 2002, there have been declines for females in several hundred counties."

The life expectancy of the U.S.'s poorest-performing countries is similar to the mortality rates of some of the world's poorer nations.

Life expectancy for males in 11% and for females in 14% of US counties was below that of Nicaragua. In some counties, such as McDowell County, WV and Sunflower County, MS, life expectancies are lower than Bangladesh for males and Algeria for females. The complete failure by some communities to increase life expectancy from levels seen now in very poor countries likely has many distal and proximate causes. But most importantly, this slow progress should be viewed as a call for action to improve health and reduce inequalities in the US.

(Charts are visible in the article or as attachments.)

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Comments from the article:

The most telling is that the bottom counties are all in the south and rural...The bagger voters are dying off at a rapid pace thanks to their elected officials who defund all programs in the safety net and have not expanded the healthcare to get them help...and have created NO JOBS!   SO BE IT!

So in your mind, the richer people are, the fatter they get.  If we were to take your comment as fact, then accepted your assertion that all people in this country are affluent, it would still mean that the United States has a problem in that some affluent fat people live longer than other affluent fat people.  Or maybe you are saying the obesity-related illness is *not* a driver of mortality in the country, because your logic dictates that poor people should be thin and are therefore dying from something else.

Now, if we were to use facts, it's pretty easy to see that the counties of best and worst longevity correlate strongly with median income, and the correlation is positive: As income rises, longevity rises.  Obviously you are trying to make a judgement on entire swaths of the nation that support whatever bias you carry with you, but you really should at least try to stick to manipulable facts.  At least then you might have a chance of sounding smart for a few minutes.

Per Wikipedia, Perry County, Kentucky (which appears on both lists of lowest life expectancies) has a per-capita income of about $12K, vs the US overall per-capita of about $50K. Perry County has a median household income of $20-22K. Fairfax Count, Virginia (on both lists of highest life expectancies) has a per-capita of about $37K, with a median household income north of $90K. Fairfax County also appears to be pretty urbanized, containing 1.1 million people, and sitting right next-door to Washington, D. C. (Also, also: Perry County's major employers are probably all coal mining concerns. Fairfax County: various local and other government. As we all know, coal mining is very safe, while bureaucrats and teachers are at significant risk of paper cuts and other serious injuries.) I didn't bother to look into unemployment data, but I'd wager that it's better to be out of work in the DC metro than in coal country.

I'm too lazy to check on all the counties listed, but I suspect the commenter drawing a correlation between income and life expectancy has probably nailed it. They're mostly in the 'south', and they're probably mostly rural and relatively poor.

2 points.

If you ain't enjoying your life, what's the point of living ?

Everyone has the same life expectancy.  It ends.  1 death per customer, same all over the world.

Both excellent points.

I don't see a real problem, except for the ones in the longest-lived counties.  The reason why, is both of my grandfathers are in their mid-eighties, and one is immobilized and confined to a bed, and the other is too senile (alzheimers) to be left alone.  Neither of them is on their death bed, and I expect both to live at least a few more years.  My grandmothers are both late seventies, and while not quite as bad as my grandfathers, time is taking its tole on them as well.

If they had died when they were the 'KY/MS life expectancy' age, all four would have been in robust health.  They would have gone out on top.  Now all they can hope for, is for it to end quickly.
 
My point is, there is a difference between staying alive, and LIVING.  If you can't do the latter, no sense chasing the former.  Maybe it's better to die young(er).


 
Kaso

As pointed out by Canthros someone living in Washington DC is probably going to have a lot more options for medical care than someone in rural Kentucky, pretty much regardless of income and lifestyle.

That's true, but you can only put so many bandages on the wound, before you eventually bleed out.

Old age sucks, and death is inevitable.  Both of my grandfathers would have died 5-10 years ago, one from cancer, one from clogged arteries... but they had access to the best of health insurance, so they got treatment and survived.  For what purpose?  To extend their lives?  Now their lives suck.

I will readily admit that some old people can have active, productive lives... but others would have done better to have died long ago.  I don't want to live so long, that I wish I was dead.



Kaso

I agree with much of that. My ER doc friend and I have both decided that cancer treatment is off the table. I'm going to spend what's left of my time with my family without financially ruining them or being a physical wreck from the treatments and surgeries. IMO its the quality of the years, not the quantity. My grandad lived 83 years. 80 were full and hearty times but the last three were a torture run of cancer treatments and Alzheimer's. No thanks

DITTO....exactly what almost all of my family has decided.   

I've watched my grandfather waste away and die slowly from a Alzheimers, among other things. My one grandmother is in the end stages of the disease, has been for a year plus now, and probably will be for some time. My other grandmother had a stroke years ago, but mostly recovered. Now, she has almost no use of her left arm or leg, little use of the right, and looks like she's starting with Alzheimers now too.

I look at them, especially my grandmother in the perpetual-end-stage, and can't help but wonder what's the point? Sitting in a chair, unable to move or speak, with no idea who you are or anyone else is, unable to even take a s*** on your own, that's not living. I'd hesitate to say she's even really alive at this point.

My philosophy has become that it's not how long you live that counts, it's how well you live. Have fun. Laugh. Cry. Love. Eat. Drink. Laugh some more. Do stupid stuff that you'll be able to tell your kids and grandkids about years later. And when it's time to go, don't string your end along. Let your loved ones' last memories of you be of a strong, vigorous individual, not a frail, sickly shell of your former self wasting away in a hospital bed.