Divergent trends in life expectancy across the rural–urban gradient and association with specific racial proportions in the contiguous USA 2000–2005

Abstract

Objectives

To estimate county-level adult life expectancy for Whites, Black/African Americans (Black), American Indian/Alaska Native (AIAN) and Asian/Pacific Islander (Asian) populations and assess the difference across racial groups in the relationship among life expectancy, rurality and specific race proportion.

Methods

We used individual-level death data to estimate county-level life expectancy at age 25 (e25) for Whites, Black, AIAN and Asian in the contiguous USA for 2000–2005. Race–sex-stratified models were used to examine the associations among e25, rurality and specific race proportion, adjusted for socioeconomic variables.

Results

Lower e25 was found in the central USA for AIANs and in the west coast for Asians. We found higher e25 in the most rural areas for Whites but in the most urban areas for AIAN and Asians. The associations between specific race proportion and e25 were positive or null for Whites but were negative for Blacks, AIAN, and Asians. The relationship between specific race proportion and e25 varied across rurality.

Conclusions

Identifying differences in adult life expectancy, both across and within racial groups, provides new insights into the geographic determinants of life expectancy disparities.

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Acknowledgement

The US Environmental Protection Agency (EPA) Office of Research and Development (ORD) partially funded the research with L.C.M. (contracts EP12D000264, EP09D000003 and EP17D000079), J.S.J (contract EP17D000063), Y.J., J.S.J., and C.L.G. were supported in part by an appointment to the Internship/Research Participation Program at Office of Research and Development (NHEERL), US EPA, administered by the Oak Ridge Institute for Science and Education through an interagency agreement between the US Department of Energy and the US EPA. We also thank Bryan Hubbell, Patricia Murphy, and Stephanie DeFlorio-Barker for their insightful suggestions to this study.

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Correspondence to Danelle T. Lobdell.

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Ethical approval

We used mortality data to calculate life expectancy in this study. Thus, by definition, it is non-human subject research. No human subject ethics approval is needed as determined by the Human Research Protocol Officer from the National Health and Environmental Effects Research Laboratory, United States Environmental Protection Agency.

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The authors declare that they have no conflict of interest.

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Jian, Y., Neas, L., Messer, L.C. et al. Divergent trends in life expectancy across the rural–urban gradient and association with specific racial proportions in the contiguous USA 2000–2005. Int J Public Health 64, 1367–1374 (2019). https://doi.org/10.1007/s00038-019-01274-5

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Keywords

  • Life expectancy at age 25
  • Rurality
  • American Indian/Alaska Native population
  • Asian/Pacific Islander population
  • Specific race proportion
  • Contiguous USA