Location, Income Key to Longevity, Study Says Where you live in the United States -- as well as your race and income -- play a big role in the nation's health disparities. A new report tracks mortality disparities and found that Asian-American women living in Bergen County, N.J., lead the nation in longevity, typically reaching their 91st birthday.

Location, Income Key to Longevity, Study Says

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Where you live could influence how long you live. A new report by the Harvard School of Public Health finds that Asian-American women living in Bergen County, New Jersey typically reach their 91st birthday. But Native American men residing in parts of South Dakota tend to die more than three decades earlier, around age 58.

Dr. Christopher Murray is the lead author of the report, and he joins us now on the line from Cambridge, Massachusetts. Good morning.

Dr. CHRISTOPHER MURRAY (School of Public Health, Harvard University): Good morning.

MONTAGNE: This gap is huge. What accounts for it?

Dr. MURRAY: Well, it's an enormous gap by any standards if you look around the globe in terms of life expectancy, so accounting for it actually takes some doing. And that was really a major thrust of what we were trying to understand in this study.

And usually when we think about disparities, we tend to focus in on differences in child mortality. Sometimes people tend to think these disparities are related to homicide or to HIV, or to differences in the elderly. And those contribute a little bit, but that's actually not the major source. It turns out...

MONTAGNE: And the major source?

Dr. MURRAY: Yeah, the major source of the disparities is actually chronic disease in young, 15 to 44 year olds, and middle-aged 45 to 64 year old adults.

MONTAGNE: And what about the question of race and income? I gather your report doesn't necessarily say that is a determinant of one's lifespan.

Dr. MURRAY: Well, I think it's safe to say from a whole accumulated body of research that in any community, richer people live longer for a host of reasons to do with risk factors, to do with access to care. But when you look across communities in the United States, unusual patterns stand out that tell us that things other than race and income must also be very important.

One group in particular that stands out is below median income white Americans living in rural areas in Minnesota, Iowa, the Dakotas, Nebraska, that have some of the longest life spans in the U.S. And clearly, (unintelligible)...

MONTAGNE: And what could explain that? Very quickly, we just have a few seconds left.

Dr. MURRAY: Oh, well, trying to understand that obviously brings you quickly to the main risk factors for chronic disease in young and middle-aged adults. And in order of importance in the United States those would be tobacco, alcohol, (unintelligible) blood pressure, cholesterol, low fruit and vegetable intake, and physical inactivity. So although our study doesn't have detailed data for each county or each group on those risk factors, it's a reasonable view that those unusually long life spans in poor areas in some subsets and groups have to be related to the culture people have acquired related to those risk factors.

I think an important part of our study, though, is - or the interpretation of our study, is that even though those lifestyle factors have got to account for many of these patterns, what we would do about it may be much more closely related to public health and medicine.

MONTAGNE: Dr. Murray, thanks very much.

Dr. MURRAY: Thank you very much.

MONTAGNE: Christopher Murray is Director of the Harvard Initiative for Global Health, joining us on the line from Cambridge, Massachusetts. And you can see a state-by-state comparison of life expectancy at npr.org.

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