Population Well-Being Measures Help Explain Geographic Disparities In Life Expectancy At The County Level.
Geographic disparities in life expectancy are substantial and not fully explained by differences in race and socioeconomic status. To develop policies that address these inequalities, it is essential to identify other factors that account for this variation. In this study we investigated whether population well-being-a comprehensive measure of physical, mental, and social health-helps explain geographic variation in life expectancy. At the county level, we found that for every 1-standard-deviation (4.2-point) increase in the well-being score, life expectancy was 1.9 years higher for females and 2.6 years higher for males. Life expectancy and well-being remained positively associated, even after race, poverty, and education were controlled for. In addition, well-being partially mediated the established associations of race, poverty, and education with life expectancy. These findings highlight well-being as an important metric of a population's health and longevity and as a promising focus for intervention.
Anita Arora (Anita.Arora@yale.edu) is a Robert Wood Johnson Foundation Clinical Scholar at Yale School of Medicine, in New Haven, Connecticut.
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Arora
Erica Spatz is an assistant professor in the Department of Cardiovascular Medicine, Yale School of Medicine.
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Jeph Herrin is an assistant professor in the Department of Cardiovascular Medicine, Yale School of Medicine.
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Carley Riley is an assistant professor at Cincinnati Children's Hospital Medical Center, in Ohio.
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Brita Roy is an assistant professor of medicine, Yale School of Medicine.
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Kenneth Kell is senior health outcomes researcher at Healthways, in Franklin, Tennessee.
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Carter Coberley was vice president of health research and outcomes at Healthways when this work was conducted and now works as an independent consultant.
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Elizabeth Rula is executive director and principal investigator at Healthways, in Franklin, Tennessee.
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Harlan M. Krumholz is the Harold H. Hines, Jr. Professor of Medicine at Yale School of Medicine and director of the Yale Center for Outcomes Research and Evaluation (CORE).
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D005260:Female; D005843:Geography / Q000706:statistics & numerical data*; D054624:Health Status Disparities; D006801:Humans; D008017:Life Expectancy / Q000639:trends*; D009111:Local Government; D008297:Male; D000075485:Population Health / Q000706:statistics & numerical data*; D011203:Poverty; D012923:Social Class
life expectancy; population health; well-being