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Heterogeneity in Disparities in Life Expectancy Across US Metropolitan Areas
Alina S Schnake-Mahl1,2, Pricila H Mullachery1, Jonathan Purtle3
1From the Urban Health Collaborative, Dornsife School of Public Health, Drexel University, Philadelphia, PA.
Background:
Life expectancy in the United States has declined since 2014 but characterization of disparities within and across metropolitan areas of the country is lacking.
Methods:
Using census tract-level life expectancy from the 2010 to 2015 US Small-area Life Expectancy Estimates Project, we calculate 10 measures of total and income-based disparities in life expectancy at birth, age 25, and age 65 within and across 377 metropolitan statistical areas (MSAs) of the United States.
Results:
We found wide heterogeneity in disparities in life expectancy at birth across MSAs and regions: MSAs in the West show the narrowest disparities (absolute disparity: 8.7 years, relative disparity: 1.1), while MSAs in the South (absolute disparity: 9.1 years, relative disparity: 1.1) and Midwest (absolute disparity: 9.8 years, relative disparity: 1.1) have the widest life expectancy disparities. We also observed greater variability in life expectancy across MSAs for lower income census tracts (coefficient of variation [CoV] 3.7 for first vs. tenth decile of income) than for higher income census tracts (CoV 2.3). Finally, we found that a series of MSA-level variables, including larger MSAs and greater proportion college graduates, predicted wider life expectancy disparities for all age groups.
Conclusions:
Sociodemographic and policy factors likely help explain variation in life expectancy disparities within and across metro areas.
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