The US county with the longest life expectancy – and a big error margin

A recent ranking of US counties by life expectancy at birth now found Aleutians East Borough at the top of the list:

This is one of three counties with a life expectancy of “100+.” Out of these three, it is also the one with the largest error margin. If I am interpreting this correctly, the list compilers are 95% confident that the life expectancy of this county is between 67.9 and 100+.

This is most likely due to the relatively small number of people in the county. This is not uncommon in these rankings: of the top 16 counties in life expectancy, the highest population is over 55,000 and several counties have fewer people than the one ranking #1. When there are fewer cases (residents, for this analysis) to consider, it is harder to be confident in the calculated life expectancy. My guess is that this county had the highest expected life expectancy in the statistical model so even with the large confidence interval it ended up at the top of the list.

With fewer people in a number of these counties, the year-to-year predictions could shift more given conditions. Does this mean the rankings should be disregarded? Not necessarily but the confidence interval does provide insight into how the life spans of a small number of residents can change these rankings.

The health costs of initial urbanization and industrialization

In Extra Life: A Short History of Living Longer, Steven Johnson briefly summarizes how the development of big cities around the world in roughly the last two centuries often came at a high cost regarding health. After discussing the first life tables developed in England:

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How could any economy that was creating more wealth than any other place on earth produce such devastating health outcomes? The answer that Farr proposed with epidemiological data was similar to the one Marx and Engels were forming at the same time using political science: the mortality rates were plunging because the defining characteristic of being “Advanced” at that moment in history was industrialization, and industrialization seems to come with an unusually high body count in its initial decades, wherever it happens to arrive. The twentieth century would go on to show the same trends happening around the world whenever people left their agrarian lifestyle and crowded into factories and urban slums, even in economies where communist planners were driving the shift to an industrial economy…

The data told an incontrovertible story: industrial cities were killing people at an unprecedented rate. (73-74)

As Johnson goes on to note, this trend did not necessarily last as many cities and the millions living there became healthier over time. But, that transition period in Liverpool and other industrializing cities, whether in the 1800s or in more recent decades with the development of megacities around the globe, comes at a significant cost.

Even though I have not emphasized the health aspects of this in the past, this is part of the reason that I link the beginnings of sociology, urbanization, and industrialization in my courses. The population shift to big cities plus a new economic and production structure are noteworthy enough. But, these are connected to seismic shifts in societal structures and relations. People had lived in relatively small communities for thousands of years and this was shifting to significantly different kinds of communities, governments, and interaction. Sociology as a discipline emerges at this time to help explain and understand these changes. As noted above, Marx was seeing all of this happen and expressedt his concerns of what it all meant.

And all of this affected the human body in significant ways. This shift required poor health and death for many. We may look now and think it turned out okay – and life expectancy around the globe has increased dramatically – but it influenced bodies and social structures in profound ways.

Reminder: only about one-third of American adults have a college degree

Coverage of a recent study about life expectancy and education provided this reminder about education levels in the United States:

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About one-third of Americans have a four-year college degree, and they are living longer and more prosperous lives while the rest face rising death rates and declining prospects, said researcher Angus Deaton, a professor at the University of Southern California’s Center for Health Policy and Economics.

According to QuickFacts from the Census with July 1, 2019 estimates, 32.1% of American adults have a bachelor’s degree or higher.

For a good segment of Americans, college is the expected path that follows after high school and also leads to future opportunities, particularly regarding jobs. But, many American adults did not or do not follow that path and this has all kinds of consequences. At the least, it can provide a reminder to current college students and instructors that college is an opportunity and/or blessing, not just something to be endured for later outcomes. More broadly, that degree can separate workers in the job market, lead to subsequent educational opportunities, and, as this study suggests, interact with health.

More than ten year gap in life span among rich and poor

New data shows that the difference in life spans between richer and poorer Americans continues to grow:

The poor are losing ground not only in income, but also in years of life, the most basic measure of well-being. In the early 1970s, a 60-year-old man in the top half of the earnings ladder could expect to live 1.2 years longer than a man of the same age in the bottom half, according to an analysis by the Social Security Administration. Fast-forward to 2001, and he could expect to live 5.8 years longer than his poorer counterpart.

New research released on Friday contains even more jarring numbers. Looking at the extreme ends of the income spectrum, economists at the Brookings Institution found that for men born in 1920, there was a six-year difference in life expectancy between the top 10 percent of earners and the bottom 10 percent. For men born in 1950, that difference had more than doubled, to 14 years.

For women, the gap grew to 13 years, from 4.7 years…

It is hard to point to one overriding cause, but public health researchers have a few answers. In recent decades, smoking, the single biggest cause of preventable death, has helped drive the disparity, said Andrew Fenelon, a researcher at the Centers for Disease Control and Prevention. As the rich and educated began to drop the habit, its deadly effects fell increasingly on poorer, uneducated people. Mr. Fenelon has calculated that smoking accounted for a third to a fifth of the gap in life expectancy between men with college degrees and men with only high school degrees. For women it was as much as a quarter.

In the set of the right to life, liberty, and pursuit of happiness, you can’t have as much of the second and third if the first is not the same. While we often discuss inequality of opportunities or outcomes, we spend less time focusing on the body though commentators like Ta-Nehisi Coates have recently drawn more attention to the role of bodies in racial differences.

The article does suggest that evidence shows access to healthcare is not a big driver of this gap.

Big differences in life expectancy across American counties due to income differences

Here is an update on the “longevity gap,” the differences in life expectancy, by county in the United States:

Fairfax County, Va., and McDowell County, W.Va., are separated by 350 miles, about a half-day’s drive. Traveling west from Fairfax County, the gated communities and bland architecture of military contractors give way to exurbs, then to farmland and eventually to McDowell’s coal mines and the forested slopes of the Appalachians. Perhaps the greatest distance between the two counties is this: Fairfax is a place of the haves, and McDowell of the have-nots. Just outside of Washington, fat government contracts and a growing technology sector buoy the median household income in Fairfax County up to $107,000, one of the highest in the nation. McDowell, with the decline of coal, has little in the way of industry. Unemployment is high. Drug abuse is rampant. Median household income is about one-fifth that of Fairfax.

One of the starkest consequences of that divide is seen in the life expectancies of the people there. Residents of Fairfax County are among the longest-lived in the country: Men have an average life expectancy of 82 years and women, 85, about the same as in Sweden. In McDowell, the averages are 64 and 73, about the same as in Iraq…

Since the 1980s, “socioeconomic status has become an even more important indicator of life expectancy.” That was the finding of a 2008 report by the Congressional Budget Office. But dollars in a bank account have never added a day to anyone’s life, researchers stress. Instead, those dollars are at work in a thousand daily-life decisions — about jobs, medical care, housing, food and exercise — with a cumulative effect on longevity.

http://www.nytimes.com/interactive/2014/03/15/business/higher-income-longer-lives.html

This is part of a growing body of research that links demographics and social forces, including social spaces, to different health outcomes. Wealthier counties can offer a wide range of health and social services as well as have more higher class residents while poorer counties have different social structures.

While the county level data is interesting, I would assume there would also be some wide differences in life expectancy within counties. Fairfax County, Virginia is one of the wealthiest U.S. counties but income levels there are not uniform. Cook County, Illinois could include some of the poorest neighborhoods in Chicago as well as Kenilworth, Illinois, one of the wealthiest suburbs with a median household income of over $247,000. Check out these maps from VCU’s Center on Society and Health on life expectancy in metro areas. Here is what they found in Chicago:

So the contrast between a county in Virginia versus one in West Virginia might be notable but one doesn’t have to travel that far to find big differences in life expectancy.

What’s the life expectancy of a Chinese skyscraper with too much sea sand in the concrete?

I think most people assume skyscrapers will last a long time. But, a number of newer skyscrapers in China are endangered because of too much sea sand in the concrete:

A sand scandal is brewing in China, with concerns that low-quality concrete has been used in the construction of many of the country’s largest buildings — putting them at risk of collapse.

The recipe to make concrete is pretty simple — cement, aggregate and water — but the strength of the final batch can vary wildly depending on the kinds of aggregate and cement used and the proportions they’re mixed in. Commonly the aggregate used in many modern building projects consists of crushed gravel or other rock, including sand, and that’s the cause of so much distress in the Chinese construction industry at the moment. Inspections by state officials have found raw, unprocessed sea sand in at least 15 buildings under construction in Shenzhen, including a building which, when finished, was set to become China’s tallest…

It can take only a few decades for a building to become dangerously unsafe if untreated sea sand is used in its concrete — including the possibility of collapse. While this scandal has been confined only to Shenzhen thus far, the possibility of it spreading to other Chinese cities is cause for concern. The country currently has nine of the 20 tallest buildings in the world under construction, while there were reportedly so many skyscrapers under construction in 2011 that it worked out as a new one being topped out every five days right through into 2014.

This raises an interesting question about the life expectancy of major buildings. Just how long will the skyscrapers in the major skylines in the world last? How soon do they need to be replaced? What plans are in place to destroy or gut the buildings before they fall down? I have never heard such a discussion but I hope cities are prepared.

This particular concrete problem wouldn’t arise if only they had built the skyscrapers out of wood

How location, particularly living in the city, affects health

Two sociologists argue that location, particularly living in poor neighborhoods in large cities, can lead to more negative health outcomes:

“When trying to understand a person’s health and well-being, we believe that their zip code may be just as important a number to their physical health as their blood pressure or glucose level,” Fitzpatrick says in a statement.

Fitzpatrick and Mark LaGory of the University of Alabama at Birmingham have authored, “In Unhealthy Cities: Poverty, Race, and Place in America,” about high-poverty urban neighborhoods and the health of Americans…

For example, there have been numerous studies on how a concentration of fast-food restaurants in poor, predominantly minority neighborhoods impacts the health of the residents, while other studies show many of these poor neighborhoods may not have a single grocery store offering fresh, nutritious food or safe places to exercise.

“Some parts of the city seemed to be designed to make people sick,” the authors say.

These conclusions are not surprising though they may contribute to the growing field of the sociology of wellness. I particularly like the last quote: “Some parts of the city seemed to be designed to make people sick.” This leads to a question: how could cities or neighborhoods be designed to make people healthy?

Reading about this reminded me about some of the rationale used by some of the first suburban residents in England and the United States. Among other factors, the suburbs were said to be healthier and have cleaner air. The big city, particularly by the late 1800s, was viewed as dirty and crowded. The single-family home allowed families to spread out and take in more of the country air.

I would be curious to see if this study, or other studies, could provide estimates of life expectancy for people with similar socio-economic status living in different locations.

Japan’s difficulty in tracking people over 100 years old

Japan is known for having a high life expectancy: according to 2008 public data, the world’s life expectancy is 69, the US’s is 78, and Japan’s is 83. With this higher life expectancy, Japan has a large number of centenarians, people who are over 100 years old. But there is a problem: the Japanese government has had problems keeping track of this population group.

More than 230,000 Japanese citizens listed in government records as at least 100 years old can’t be found and may have died long ago, according to a government survey released Friday.

In August, the Justice Ministry ordered a review of records that found about 77,000 people who would be at least 120, and 884 people who would be 150 or older. The head count followed a flurry of reports about how elderly people are falling through the cracks in Japan as its population ages rapidly and family ties weaken.

In all, the survey of family registration records nationwide found that 234,354 centenarians were still listed as alive, but their whereabouts were unknown, the ministry said.

While this could be chalked up as simply a bureaucratic problem, the news story suggests these findings line up with concerns about how the elderly are treated in Japan. This then could be a larger issue that concerns social and family relationships and the fabric of Japanese society.