The level of “well-being” in a community — including people’s emotional health and life satisfaction — may help explain some of the disparities in life expectancy across the United States, a new study finds.
Americans’ life expectancy can vary hugely depending on where they live. A 2013 study, found that a man born in Fairfax County, Va., could expect to live almost 18 years longer than a man born in McDowell County, W.Va.
Differences in demographics, including income, education and race, only partly explain the disparities.
Well-being includes the general physical health of a county’s population. But it also measured people’s levels of emotional health, life satisfaction, optimism and security. For example it looked at whether they felt safe and had access to housing and health care.
It turned out that counties’ well-being scores were linked to life expectancy, beyond factors such as poverty, education and race.
“We see this substantial variation in life expectancy in the U.S., and it’s not just determined by socio-demographic factors,” said lead researcher Dr. Anita Arora, Robert Wood Johnson Foundation clinical scholar at Yale University.
“It’s also how people feel, how happy they are, whether they have basic access to things like safe housing,” Arora said.
All of those factors could ultimately affect people’s life expectancy in many ways, she noted. If people live in areas with no place to exercise or buy healthy food, it’s hard to follow the healthy lifestyle advice they hear all the time.
Laudan Aron, a senior fellow at the Urban Institute in Washington, D.C., says most people probably understand the need to make healthy choices.
“But the things health professionals ask people to do may not be practical for them to implement,” she said.
According to Aron, the steps that can improve health and well-being do not only play out at the individual level. There’s a collective responsibility, too.
For the study, Arora’s team used data from a nationally representative telephone survey of U.S. adults in over 3,000 counties.
Each county was given a well-being score based on residents’ responses to questions. Topics included physical and emotional health, lifestyle habits, work environment, life satisfaction, etc.
The average life expectancy in different counties varied widely.
- about 73 to 85 years for women
- about 64 to 82 years for men
There was a direct correlation between how a county’s well-being score rose and people’s life expectancy — regardless of the area’s racial makeup and poverty and education levels.
For every one standard deviation (4.2-point) increase in the county’s well-being score, Arora said, life expectancy rose by almost two years for women, and by 2.6 years for men.
Does where you live matter
Arora acknowledged that her study does not answer that question. However, it’s easy to see how a community can either limit or support people’s ability to be healthy.
“It’s important to remember that “health” is not just about physical disease,” said Arora. “The World Health Organization defines ‘health’ as a state of complete physical, mental and social well-being.”
Aron agreed, “Everything from investments in schools to local tax policies and zoning laws, can all ultimately affect people’s health.”
“We need to see the connections between all of these things and well-being,” Aron said.