Study Paints Grim Picture Of Life Expectancy In US; We Live In 8 Different Americas
Early last month, PLoS Medicine published a disturbing, but very important study that sheds new into the vast gaps in life expectancy rates between people of different racial backgrounds and socioeconomic status. This study has significant implications for people involved in health promotion, social marketing and other efforts to improve the health of diverse communities.
Authors of the study found that (when measured by life expectancy) we live in eight different Americas. See images below for definitions and gaps in mortality (click images to view larger versions).
What’s interesting about the data is that the differences in life expectancy cannot be explained by “race, income, basic healthcare access or utilization alone.†According to the authors of the study: “The causes of death that were mainly responsible for . . . [variations in life expectancy] were various chronic diseases and injury.†In addition, the in mortality rates were between middle-aged Americans of different races and socioeconomic status, not the elderly or children.
In sum, people are dying earlier due to illnesses like high blood pressure, abnormal cholesterol, smoking, obesity, diabetes and pre-diabetes. All of these conditions are highly treatable and preventable.
The study authors note that “expanding health insurance coverage alone will not reduce disparities.†Instead, we need improved disease prevention strategies, especially in the area of cardiovascular disease.
These data indicate that we need to increase efforts to educate diverse populations about risk factors that contribute to early death, including high cholesterol and high blood pressure. Intensive communication, social marketing and behavioral modification programs are needed now more than ever.
March 6th, 2007 at 2:58 pm
Although this interviewee’s synopsis addresses several key conclusions of the paper, I feel that it failed to address some of the most interesting findings of the Harvard study. In fact the synopsis seemed to be a slightly longer version of the paper’s abstract and addressed none of the further issues found in the paper’s discussion. For example, one of the only issues addressed was the rather unsurprising fact that the disparities of morbidity and mortality in the US cannot be “explained by race, income, or basic health-care access and utilization alone”. Additionally, this article pointed out that some of the things that need to be addressed in the future of healthcare are preventable diseases such as diabetes and heart disease. However, one of the most interesting topics that were never addressed is the data showing that the age groups with the least disparities of morbidity and mortality are the groups that the current US health care system is placing the greatest emphasis on. The Harvard study found that the disparities across the eight Americas were smallest in the children and the elderly. These are the two age groups that traditional US health policy has spent the most time, money, and emphasis on. This suggests several interesting conclusions to me that I would have like to see discussed. First, should we therefore conclude that the health policies we have in place are working and are the reason for the smaller gaps in these populations’ life expectancies? But if the childhood interventions really are working at lessening the gap between the eight Americas why are we not seeing that carry into the young adult and middle age group where the major killers remain preventable diseases that are first addressed in childhood lifestyle (ex. heart disease, diabetes, etc.)? Finally, how can we expand the current health policies to the most age groups with the widest gaps without damaging those currently in place and apparently working? Thus, although I feel that it was excellent for this paper to be brought up for discussion, the interview failed to do the researchers and their work justice by ignoring several of their most interesting and unique conclusions.
Ref:
Murray CJL, Kulkarni SC, Michaud C, Tomijima N, Bulzacchelli MT, et al. (2006) Eight Americas: Investigating mortality disparities across races, counties, and race counties in the United States. PLoS Med 3(9): e260. DOI: 10.1371/journal. pmed.0030260