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Life Expectancy Varies Widely Across the '8 Americas,' Study Shows

Medically Reviewed by Louise Chang, MD on September 13, 2006
From the WebMD Archives

Sept. 13, 2006 -- The U.S. is really divided into eight different Americas when it comes to life expectancy, researchers report.

Those "eight Americas" have a life expectancy gap of almost 14 years, similar to gaps between economically developed and emerging countries, note the researchers.

They included Christopher Murray, MD, DPhil, and Majid Ezzati, PhD, of Harvard School of Public Health in Boston.

"I think that these disparities are large and they are being caused by disease and injuries that we know really well how to control," Ezzati tells WebMD.

"We know how to reduce tobacco ... blood pressure, cholesterol, alcohol," he continues. "So clearly, these interventions are not reaching people who need them the most."

The study appears in Public Library of Science Medicine. The researchers also tallied state-by-state life expectancy, noted later in this story.

Life Expectancy Gaps

The study redraws the U.S. map based on regional and racial life expectancy.

It's well known that life expectancy varies among different groups. For instance, the CDC reported these life expectancy figures in April:

  • Black male: 69.8 years
  • White male: 75.7 years
  • Black female: 76.5 years
  • White female: 80.8 years

Life expectancy also varies from state to state, and even among counties.

The researchers checked life expectancy data from the U.S. Bureau of the Census and National Center of Health Statistics.

They crunched the numbers, teasing out patterns by region, income, and race (white, black, Asian, or Native American).

Eight patterns stood out, which the researchers dubbed the "eight Americas."

Here are the eight Americas, from highest to lowest life expectancy, as of 2001:

America 1

Average life expectancy: nearly 85 years.

Residents: about 10 million Asians.

That's not quite all the Asians in the U.S.

Those in "America 1" live in counties where Pacific Islanders make up less than 40% of Asians. All other Asians living in the U.S. are in "America 3."

America 2

Average life expectancy: 79 years.

Residents: 3.6 million low-income rural whites living in Minnesota, the Dakotas, Iowa, Montana, and Nebraska with income and education below the national average.

America 3

Average life expectancy: nearly 78 years.

Residents: 214 million people -- mainly whites, with small numbers of Asians and Native Americans -- with average income and education slightly above the national average.

America 4

Average life expectancy: 75 years.

Residents: more than 16 million low-income whites living in Appalachia and the Mississippi Valley; 30% of them haven't finished high school.

America 5

Average-life expectancy: almost 73 years.

Residents: 1 million Native Americans living in the western mountains and plains areas, excluding the West Coast.

Most live on reservations in the "Four Corners" area -- where Arizona, Colorado, New Mexico, and Utah meet -- or in the Dakotas.

America 6

Average life expectancy: nearly 73 years.

Residents: more than 23 million blacks who aren't low-income blacks living in the South or high-risk urban blacks.

America 7

Average life expectancy: about 71 years.

Residents: nearly 6 million low-income blacks in the Mississippi Valley and the South.

America 8

Average life expectancy: around 71 years.

Residents: 7.5 million high-risk urban blacks. They were blacks (aged 15 to 74 years) living in urban counties with high homicide rates.

Putting It in Perspective

Murray's team compared the eight Americas to real countries.

"Ten million Americans with the best health have achieved one of the highest levels of life expectancy on record, three years better than Japan," the researchers write.

"At the same time," they continue, "tens of millions of Americans are experiencing levels of health that are more typical of middle-income or low-income developing countries."

For instance, they note that the nearly 16-year life expectancy gap between men in Americas 1 and 8 equals the gap between Iceland and the former Soviet republic of Uzbekistan.

Why the Difference?

Many factors likely created the life expectancy gaps among the eight Americas.

Chronic diseases, injuries, alcohol use, smoking, extra pounds, and high blood pressure, cholesterol, or glucose (blood sugar) are among those factors, Murray's team notes.

Many of those risks can be avoided or managed. Ask your doctor if you can do anything to help make your life healthier and longer.

Life Expectancy by State

Here's a simpler way to look at life expectancy.

This list, provided by Harvard's Initiative for Global Health, ranks life expectancy for all U.S. states and Washington, D.C., as of 1999. Ties are listed alphabetically.

These rankings don't factor in race, income, or other data.

1. Hawaii: 80 years
2. Minnesota: 78.8 years
3. Connecticut: 78.7 years
3. Utah: 78.7 years
4. Massachusetts: 78.4 years
5. Iowa: 78.3 years
5. New Hampshire: 78.3 years
5. North Dakota: 78.3 years
5. Rhode Island: 78.3 years
6. California: 78.2 years
6. Colorado: 78.2 years
6. Vermont: 78.2 years
6. Washington: 78.2 years
7. Idaho: 77.9 years
7. Wisconsin: 77.9 years
8. Nebraska: 77.8 years
8. Oregon: 77.8 years
9. New York: 77.7 years
9. South Dakota: 77.7 years
10. Maine: 77.6 years
11. Arizona: 77.5 years
11. Florida: 77.5 years
11. New Jersey: 77.5 years
12. Kansas: 77.3 years
13. Montana: 77.2 years
14. Alaska: 77.1 years
15. New Mexico: 77 years
16. Delaware: 76.8 years
16. Virginia: 76.8 years
17. Pennsylvania: 76.7 years
17. Texas: 76.7 years
17. Wyoming: 76.7 years
18. Illinois: 76.4 years
19. Maryland: 76.3 years
19. Michigan: 76.3 years
20. Ohio: 76.2 years
21. Indiana: 76.1 years
22. Missouri: 75.9 years
23. Nevada: 75.8 years
23. North Carolina: 75.8 years
24. Georgia: 75.3 years
25. Arkansas: 75.2 years
25. Kentucky: 75.2 years
25. Oklahoma: 75.2 years
26. Tennessee: 75.1 years
26. West Virginia: 75.1 years
27. South Carolina: 74.8 years
28. Alabama: 74.4 years
29. Louisiana: 74.2 years
30. Mississippi: 73.6 years
31. Washington, D.C.: 72 years

Show Sources

SOURCES: Murray, C. Public Library of Science Medicine, September 2006; vol 3. Majid Ezzati, PhD, Associate Professor of International Health, Department of Population and International Health, Harvard School of Public Health.
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