Health Outcomes Differ in the 'Eight Americas'

Researchers find that group membership strongly influences life expectancy and mortality

TUESDAY, Sept. 12 (HealthDay News) -- Life expectancy and mortality may depend on which of "Eight Americas" patients belong to, according to a study published in the September issue of PLoS Medicine.

Majid Ezzati. Ph.D., of the Harvard School of Public Health in Boston, Mass., and colleagues divided the population into eight groups based on county of residence, race, and income: Asians, northland low-income rural whites, Middle America, low-income whites in Appalachia and the Mississippi Valley, western Native Americans, black Middle America, southern low-income rural blacks, and high-risk urban blacks.

The researchers found many significant disparities in life expectancy. Among them: a 20.7-year gap between Asian females and high-risk urban black males; a 15.4-year gap between Asian males and high-risk urban black males; and a 12.8-year gap between Asian females and low-income Southern rural black females. They also found that the largest group disparities in mortality were among young (ages 15-44) and middle-aged (45-59) adults, especially men.

"The observed disparities in life expectancy cannot be explained by race, income, or basic health-care access and utilization alone," the authors concluded. "Because policies aimed at reducing fundamental socioeconomic inequalities are currently practically absent in the U.S., health disparities will have to be at least partly addressed through public health strategies that reduce risk factors for chronic diseases and injuries."

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