En español | Where you are born can have a profound influence on your future health, wealth and well-being. But where you live at 50 is a good indicator of how long you will live, according to research from AARP.
That's because geographic disparities — how easily one can access health care, housing, healthy foods and stable jobs — affect people throughout their lives, and especially at midlife, when risks for many serious, but preventable, diseases increase.
A new report presented at an AARP Oct. 7-8 summit, Moving Forward: Reimagining How We Invest in Health, Wealth & Aging, looks at life expectancy trends both at birth and at age 50 in counties throughout the United States. While life expectancy rose overall between 1980 and 2014, the gap between the best- and worst-performing counties was larger when measured at age 50 (3.2 years), compared to birth (1.8 years).
In other words, people living in healthier communities in middle age “are benefiting from increasing longevity, while the residents in the worst-performing counties are not given the same opportunity,” the report states.
"I think there's a great consensus that there's a lot you can do [at 50], but having access to health care is important,” particularly when things like routine cancer screenings and chronic disease management are critical to healthy longevity, says Erwin J. Tan, M.D., director at AARP Thought Leadership and author of the report.
Racial disparities play a role in life expectancy gap at 50
Disparities in life expectancy are especially apparent in predominantly Black areas. Gains in life expectancy for 50-year-old residents in majority Black counties lag almost three decades behind gains experienced by residents of counties with less than 5 percent Black residents, the report found. That means it took mostly Black counties until 2008 to experience the same life expectancy that counties with smaller Black populations had in 1980. (Future AARP reports will include additional analyses of trends among Hispanic, Native American and Asian American residents.)
One explanation: “Counties with a higher percentage of residents of color could also have a higher number of segregated neighborhoods and communities,” and segregated communities can concentrate poverty, the report points out, further restricting access to quality schools, safe parks, good jobs, and banks and capital for business development. Chronic stress from systemic racism and discrimination in health care have also put predominantly Black communities at a disadvantage when it comes to life expectancy.
"Evidence is clear that counties with more Black residents are having worse outcomes, and it's incumbent on all of us to make sure that everyone has the opportunity to live a longer and healthier life,” Tan says.
"Those extra years are another anniversary, potentially another grandchild — that's what people are missing out on.”
The coronavirus pandemic and life expectancy
Though the data in the report predates the coronavirus pandemic, Tan says COVID-19 — which has taken an especially heavy toll on adults 50 and older — has the potential to further exacerbate life expectancy disparities at midlife.
For example, COVID-19 hospitalization rates for Black, Hispanic and Native Americans is nearly five times as high as for white Americans, according to data from the Centers for Disease Control and Prevention (CDC). Blacks are also over twice as likely to die from a coronavirus infection as whites.
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"We realize now with COVID-19 that these disparities cannot continue; we need to go forward with a better, more equitable America,” Tan says.
A number of cities and counties are already working on plans to help close the country's gap in life expectancy, Tan says. Solutions highlighted in AARP's report include everything from expanded access to health care, to investing in older workers, to supporting physical activity and food security programs.
"It's a national problem, but the solutions need to be done at the local level as well,” Tan says.