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Eager to tease out socioeconomic disparities that can hide in state-level data, researchers reclassified all US counties based on household income instead of geography. Then they examined longevity, smoking, obesity, childhood poverty and other health information from the richest and poorest places. The results should help better allocate social programs offered by the American government.

Men in the poorest spots died on average nearly 10 years earlier, at 69 years old, than men in the wealthiest ones. Women are less impacted. They lose seven years of life, at 76 years old. “The results should be deeply disturbing to all persons in the country,” says the study published in the American Journal of Public Health.

Several countries in one. Life expectancy in the poorest state falls below that of more than half of the countries in the world. This means that, in essence, there are several developing countries hidden within the borders of the United States. “My expectations were confirmed for differences in smoking and obesity rates,” says Randy Wykoff, senior author of the study and Dean of the College of Public Health at East Tennessee State University, in Johnson City. “Adults in the poorest places were twice as likely to smoke and 50% more likely to be obese.”

Children and Blacks. Non-Hispanic African-Americans were 4.5 times more likely to live in the poorest regions than in the richest. Also, more than 48% of children in the poorest spots lived below the federal poverty line, while less than 9% children in the wealthiest did.

Analysis. “Nearly half of young children grow up in low-income families that cannot provide them with adequate resources to thrive,” said Neal Halfon, director of the Center for Healthy Children, Families and Communities at the University of California Los Angeles, regarding the study he was not involved in. “Individuals born in these low income counties and with few resources are likely to have much lower lifelong health trajectories. The public sector and the civic sector have not been able to put together a comprehensive anti-poverty campaign.”

Conclusions. The study’s authors suggest that public health programs should be targeted more narrowly than by state, focusing instead on the poorest counties. They discovered that five states – Georgia, Illinois, Kentucky, Tennessee and Texas – housed both the richest and the poorest people in the nation, suggesting that poverty stems not only from a lack of resources but from their unequal distribution. Click here for the full article.