Heterogeneity in Disparities in Life Expectancy Across US Metropolitan Areas. Issue 6 (5th October 2022)

• Record Type: Journal Article
• Authors: Schnake-Mahl, Alina S.; Mullachery, Pricila H.; Purtle, Jonathan; Li, Ran; Diez Roux, Ana V.; Bilal, Usama
• Is Part Of: Epidemiology. Volume 33:Issue 6(2022)
• Page Start: 890
• Page End: 899
• Publication Date: 2022-10-05
• Subjects: Social inequalities -- Health disparities -- Urban health -- Life expectancy -- United States; Epidemiology -- Periodicals; Epidemiology -- Environmental aspects -- Periodicals; Epidemiology -- Periodicals; 614.405
• DOI: 10.1097/EDE.0000000000001537
• Languages: English
• ISSNs: 1044-3983

Abstract

Abstract : Background: Life expectancy in the United States has declined since 2014 but characterization of disparities within and across metropolitan areas of the country is lacking. Methods: Using census tract-level life expectancy from the 2010 to 2015 US Small-area Life Expectancy Estimates Project, we calculate 10 measures of total and income-based disparities in life expectancy at birth, age 25, and age 65 within and across 377 metropolitan statistical areas (MSAs) of the United States. Results: We found wide heterogeneity in disparities in life expectancy at birth across MSAs and regions: MSAs in the West show the narrowest disparities (absolute disparity: 8.7 years, relative disparity: 1.1), while MSAs in the South (absolute disparity: 9.1 years, relative disparity: 1.1) and Midwest (absolute disparity: 9.8 years, relative disparity: 1.1) have the widest life expectancy disparities. We also observed greater variability in life expectancy across MSAs for lower income census tracts (coefficient of variation [CoV] 3.7 for first vs. tenth decile of income) than for higher income census tracts (CoV 2.3). Finally, we found that a series of MSA-level variables, including larger MSAs and greater proportion college graduates, predicted wider life expectancy disparities for all age groups. Conclusions: Sociodemographic and policy factors likely help explain variation in life expectancy disparities within and across metro areas.