The Ecology of Economic Distress and Life Expectancy

Area of Science:

• Public Health
• Health Economics
• Sociology

Background:

• Life expectancy (LE) trends vary significantly across the United States.
• Socioeconomic factors, including local economic conditions and rurality, are hypothesized to influence population health outcomes.
• Understanding the interplay between economic prosperity, race, and LE is crucial for targeted public health interventions.

Purpose of the Study:

• To investigate the association between changes in life expectancy (LE) from 2000 to 2019 and factors like race, rural status, and local economic prosperity at the county level.
• To analyze how shifts in local economic conditions correlate with changes in LE for different racial groups and across the rural-urban spectrum.
• To identify key determinants of LE changes to inform policy and public health strategies.

Main Methods:

• Retrospective analysis of county-level data from 2000 and 2019 for 3,123 United States counties.
• Comparison of LE changes across the rural-urban continuum and local economic prosperity quintiles for Total, White, and Black populations.
• Assessment of LE changes in counties with significant improvements or declines in local economic prosperity.

Main Results:

• Life expectancy consistently decreased with declining economic prosperity across all populations and the rural-urban continuum in both 2000 and 2019 (p < 0.001).
• Improving county economic prosperity between 2000 and 2019 was significantly associated with greater gains in life expectancy (p < 0.001).
• Race, rurality, and local economic distress were all independently associated with life expectancy at the county level.

Conclusions:

• Local economic distress and rurality are significant factors associated with life expectancy at the county level.
• Improvements in local economic conditions are linked to accelerated gains in life expectancy, demonstrating a clear health externality of economic policy.
• Policymakers should consider the health implications of economic conditions when aiming to improve overall population health, particularly in economically disadvantaged areas.