Health in America: Life expectancy disparities explained

(Ivanhoe Newswire) -- Smoking, high blood pressure, elevated blood glucose and overweight and obesity currently reduce life expectancy in the United States by an average of 4.9 years in men and 4.1 years in women.

The first study to look at the effects of those four preventable risk factors on life expectancy in the nation was led by researchers from the Harvard School of Public Health (HSPH) in collaboration with researchers from the Institute for Health Metrics and Evaluation at the University of Washington.

"This study demonstrates the potential of disease prevention to not only improve health outcomes in the entire nation but also to reduce the enormous disparities in life expectancy that we see in the U.S.," senior author Majid Ezzati, associate professor of international health at HSPH, was quoted as saying.

The researchers studied the effects of these four risk factors on eight subgroups of the U.S. population, which they called the "Eight Americas." The Eight Americas, determined by race, county location and the socioeconomic features of each county, were defined as Asians, Northland low-income rural whites, middle America, low-income whites in Appalachia and the Mississippi Valley, Western Native Americans, Black middle America, high-risk urban blacks and Southern low-income rural blacks.

The researchers found that a person's ethnicity and where they live is a predictor of life expectancy and how healthy a person is. Asian American men and women had the lowest body mass index (BMI), blood glucose levels and prevalence of smoking. Blacks, especially those in the rural South, had the highest blood pressure while Whites had the lowest blood pressure. Western Native American men and Southern low-income rural black women had the highest BMI. Western Native Americans and low-income whites in Appalachia and the Mississippi Valley had the highest prevalence of smoking.

These patterns of smoking, high blood pressure, elevated blood glucose and overweight and obesity account for almost 20 percent of disparities in life expectancy across the U.S. These four factors also account for three quarters of disparities in cardiovascular mortality and up to half of disparities in cancer mortality.

"It's important that public health policy makers understand that these behavioral and metabolic risk factors are not just personal choices or the responsibility of doctors," lead author Goodarz Danaei, a postdoctoral research fellow at HSPH, was quoted as saying. "To improve the nation's overall health and reduce health disparities, both population-based and personal interventions that reduce these preventable risk factors must be identified, implemented and rigorously evaluated."

SOURCE: PLoS Medicine, March 23, 2010

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