Alina S Schnake-Mahl1,2, Pricila H Mullachery1, Jonathan Purtle3, Ran Li1, Ana V Diez Roux1,4, Usama Bilal1,4. 1. From the Urban Health Collaborative, Dornsife School of Public Health, Drexel University, Philadelphia, PA. 2. Department of Health Management and Policy, Drexel University, Philadelphia, PA. 3. Department of Public Health Policy & Management, New York University School of Global Public Health, New York, NY. 4. Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, PA.
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.
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.
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Authors: Alina S Schnake-Mahl; Pricila H Mullachery; Jonathan Purtle; Ran Li; Ana V Diez Roux; Usama Bilal Journal: Epidemiology Date: 2022-10-05 Impact factor: 4.860