Live long and prosper? It’s untrue for rural poor, especially white women

While the rich tend to live longer and generally prosper in their better health, the poor─and especially now less affluent whites and white women─ don’t fare nearly so well, new research says. And geography may be helpful to some of the poor in surprising ways.

Major newspapers have been full of reports on death rates, especially since a Nobel Laureate and his distinguished researcher wife analyzed data and recently reported that for the first time in recent years the rates were increasing for poorer, less educated white men.

As I’ve written, this sudden mortality shift shocked public health experts, who knew that longevity for blacks in the U.S., while trailing that for whites, has been steadily improving.

The falling life expectancy for white men has been blamed on stagnant or falling economic conditions in ex-urban and rural areas, higher use of alcohol, the epidemic abuse of prescription opioid painkillers, and soaring suicides─all contributing to a disease of despair.

Geography as health destiny

According to a big, new, major study of U.S. income and life expectancy, geography can play a key role, helping some of the poor. Indeed, nifty data visualizations by the New York Times indicate that poor people in urban Washington, D.C., live longer than their counterparts in surrounding areas of Virginia, Maryland, and Delaware. That may be because they smoke less than the poor do on average nationally; DC’s poor also are more likely than counterparts nationally to live in immigrant communities where social bonds may be stronger and there may be encouragement for more healthy behaviors (e.g. religious pressures to not drink, smoke, or take excessive risks).

The average 40.5 year old in the District has a life expectancy of 80.5 years, which is in keeping with national averages. But the poor, those who earn less than $28,000 annually, on average die six years younger than do their more affluent neighbors, those living in households with incomes in excess of $100,000, according to the data displayed by the Times.

The paper said that the differences in life span can amount to 15 years between the top 1 percent of earners versus the lowest 1 percent in the U.S.  The Times said, “in some … parts of the country, adults with the lowest incomes die on average as young as people in much poorer nations like Rwanda, and their life spans are getting shorter.”

The plight of poor, rural white women

The Washington Post, meantime, has turned its analytic spotlight on the plight of poor, rural white women, finding a “slow-motion crisis driven by decaying health in small-town America.” The paper said that death rates have spiked by 30 percent for 40-something white women living in rural areas.

Poorer, less-educated, and rural white men, and especially white women, the Post said, are hastening their deaths with opioid abuse, heavy drinking, smoking and other self-destructive behaviors.

Unhealthy behaviors

Indeed, a major health care foundation has released its research on five unhealthy behaviors─smoking, drinking, inactivity, overweight, and poor sleeping─and their detrimental effect on Americans’ health. The United Health Foundation said that more than 25 million Americans, some 12 percent of the population, say they engage in three or more of these harmful behaviors. The foundation says:

Adults with multiple unhealthy behaviors are 6.1 times more likely to report fair or poor health than those reporting zero unhealthy behaviors. … Adults aged 25 and older making less than $25,000/ year are more likely to report having multiple unhealthy behaviors than those at higher income levels. Similarly, adults who have not graduated from high school are more likely to have multiple unhealthy behaviors than those with higher education levels, and the gap is widest when compared to college graduates.

The foundation, similarly, says that geography matters when it comes to the health of the poor. States with the highest proportion of adults with multiple unhealthy behaviors include: Indiana, Michigan, Ohio, Alabama, Kentucky, Mississippi, and Tennessee. Those states where the poor have the lowest proportion of adults with several negative behaviors include: Minnesota, California, Oregon, Washington, Idaho, Utah, Colorado, Connecticut, Massachusetts, and Vermont.

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