By Dr. Anthony Policastro

No one would be surprised if they were told that life expectancy in different areas of the country varied. They would give a variety of reasons for the differences.

Recently Salve Regina University created a map that showed that the issue is related to regions of the country. The attached map shows the regional differences.

The overall result is not that surprising since we already knew there were differences. So the investigators dug deeper into the data. They wanted to see if they could pinpoint a more accurate cause of those differences.

The first thing they looked at was wealth. The thought was the poorer people would have a shorter life expectancy than those who were more well to do.

That didn’t seem to be the case. The poorest 25 percent of counties were in the large cities of Yankeedom. Their life expectancy was shorter than the average life expectancy of Yankeedom. Therefore, in general in the same location poorer people tend to live shorter lives than more well to do people.

However, the surprise was that that group of individuals from the lower 25 percent of Yankeedom lived longer than the highest 25 percent of people in the Deep South. Therefore just living in Yankeedom meant you lived longer than those living in the Deep South.

They then looked at education. A similar result was noted. Individuals in the lowest 25 percent of people in Yankeedom lived longer than the highest 25 percent of people in the Deep South. Those living in the left coast lived even longer despite level of education.

They then looked at rural vs. urban lifestyles. The differences persisted. Those living in urban counties in Yankeedom lived longer than those living in urban counties in the Deep South. Those living in rural counties lived longer in Yankeedom than those living in the Deep South.

They looked at availability of medical care as the next potential explanation. The same differences existed. So that also was not the cause of the differences.

They looked at race. We know that the Hispanic population has a longer life expectancy than the white population. The white population in turn has a longer life expectancy than the black population. While the differences continued among regions, there was less of a difference from region to region in the black population.

They looked at health related issues like obesity, diabetes, physical activity and access to exercise activities. They also failed to reflect differences.

They then looked at public health measures. This is the area that appeared to have the biggest differences. The best example of this is Medicaid. Many states have expanded their Medicaid programs so that more people can have access to needed medical care without having to pay too much out of pocket. There are 11 states that have chosen not to expand Medicaid. 9 of the 11 are in the Deep South and Appalachia.

Other public health policies like those addressing pregnancy health show similar effects. It appears that the role that public health plays in life expectancy has long been taken for granted.

Think back to 100 years ago. Sanitary measures have been put in place. Immunizations have eradicated deadly diseases like smallpox, polio, diphtheria, pertussis and measles. Public health has had a major effect on life expectancy over the years.

In 1920 life expectancy was 53 years. Over the next 50 years it increased to 70 years. Despite all the wonders of modern medicine in the last 50 years it has increased less than 10 additional years. Public health is more effective than most people realize. The map supports that.