
American Lifespan By County - astrieanna
http://www.tobiasbuckell.com/2012/05/03/american-lifespan-by-county/
======
Iv
I am sorry, I don't buy the "we are like several countries, you can't compare
us to a single one !" argument. Japan is at 40% of USA population and its
average life expectancy is on par with the highest county you can find in USA
while their GDP per capita (PPP) is only 70% of the one in USA.

That shows a very inefficient use of USA's wealth and a very poor healthcare
policy.

US states may be very different from each other, but their difference is far
less that the ones between European states. You speak a single language, you
have a single president, a federal senate, a federal army, a federal police, a
powerful federal intelligence agency, and many institutions at the federal
level. You have 200 years of common history as a single country, if we except
the Secession period. Actually, I could understand that you could say that US
is an union of two countries because of this episode, but a union of 50, no
way.

Europe on the other hand is a territory that is divided in several countries
with different languages, different religions, different history, several wars
between them (the list is really really long). Being generous, you could say
that we began a common history 50 years ago, but this was in fact only an
economic union on a small set of goods (steel and coal IIRC) between 5
countries.

Apple to oranges, really.

~~~
padobson
_You have a single president, a federal senate, a federal army, a federal
police, a powerful federal intelligence agency, and many institutions at the
federal level._

This one sentence does an excellent job of summing up our failures as a nation
over the last 236 years. One, gargantuan government can never hope to meet the
vastly different needs of 300 million people living in highly diverse
geographies, population densities, and climates.

So while the US should be treated like one country for all those reasons,
those reasons should also be blamed for most of her failures.

~~~
JoeAltmaier
I vote for school board, county supervisor, state governor, representative and
two senators.

One monolithic government is a myth. It could even be argued that the
fractured nature of US govt is responsible for wide variation is schools,
infrastructure, moral laws etc.

~~~
padobson
Your school board, county supervisor, and state governor are flacid, neutered
versions of their virile predecessors of the 19th and 20th centuries. All of
them spend most of their time wrangling federal money.

And your representative and senators vote consistently along party lines, and,
again, get re-elected almost entirely based on how much of their constituents'
money they bring back from Washington.

------
_delirium
This appears to be a reblog with a low-res version. The full interactive maps
(in different forms) are the first three entries here:
[http://www.healthmetricsandevaluation.org/tools/data-
visuali...](http://www.healthmetricsandevaluation.org/tools/data-
visualizations)

------
cdeonier
Probably helpful to realize that the lifespan is determined more than just one
metric, such as healthcare. Cultural differences between different regions
likely plays a significant effect. For instance, my guess is diet leading to
obesity helps to drag down life expectancy in the regions where the life
expectancy is lower:

[http://www.cdc.gov/obesity/data/animated_map_slides/map26.jp...](http://www.cdc.gov/obesity/data/animated_map_slides/map26.jpg)

~~~
yummyfajitas
Not just cultural differences. Things like car accidents and murders also play
a disproportionate role.

If nation A has 60 people living to 79, and nation B has 59 people living to
80 and 1 person being murdered at 20, A and B have the same mean life
expectancy (of 79).

Though I suppose you could call things like murders and road safety
"cultural".

------
mmaunder
I think this is what you're after:

[http://www.healthmetricsandevaluation.org/tools/data-
visuali...](http://www.healthmetricsandevaluation.org/tools/data-
visualization/life-expectancy-county-and-sex-us-1989-2009#/overview/explore)

------
Someone
_"In Collier, Florida, women live 85.8 years on average. In McDowell, West
Virginia, they live to be 74.1. That’s an 11.7-year gap"_

I would guess most of that difference is due to migration of elderly persons
to Florida, not due to Florida being healthier or health care being better
there.

~~~
dredmorbius
Moving somewhere when you're old doesn't change your life expectancy.

You're confusing something else, possibly average age, with life expectancy.

If the elderly populations of long-lived Florida counties still largely come
from migration, longevity may say much more about living and healthcare
conditions elsewhere. As well as wealth effects reflected by the ability to
retire to Florida.

~~~
aes256
_> Moving somewhere when you're old doesn't change your life expectancy._

It may increase the average life expectancy of the area you are moving to,
though.

In other words, while the people who were born and raised in the area may have
a low life expectancy, an influx of wealthy retirees will drag up the average
life expectancy. In some cases the people moving to these areas may already be
older than the average life expectancy.

~~~
yummyfajitas
Exactly - at birth a man is expected to live until age 75. At age 65 he is
expected to live until 81.

<http://aging.senate.gov/crs/aging1.pdf> (see page 8)

~~~
dredmorbius
Fair point. Though we'd be talking moving from a place with a median age of,
well, roughly median age. Greatest mortality is in infancy, again in the teens
/ early 20s (mostly males from violence/accidents), then gradually increases
past 40 due to general mortality (disease, illness, cancer, etc.).

I'm not sure that the delta from, say, 40-ish median to the slightly older
skew of a retirement-centric Florida community would be great.

------
fierarul
What the article doesn't seem to link is this:
[http://www.healthmetricsandevaluation.org/tools/data-
visuali...](http://www.healthmetricsandevaluation.org/tools/data-
visualization/life-expectancy-county-and-sex-us-1989-2009#/overview/explore) ,
a nice visualisation.

------
OllieJones
Tobias wrapped up this fine post writing, the "gap [between developed and
underdeveloped counties] will be, if it continues, a major fissure in a future
America."

WILL be? It already is. It's pretty much in line with the so-called red / blue
divide in the nation.

~~~
cageface
I've been living abroad for well over a year now. I always have to explain
when I get the inevitable questions from people baffled by the inanity of our
politics that the U.S. is really like two different countries stuffed inside
one border.

~~~
dredmorbius
s/two/fifty/

There's a reason it's referred to as the united _states_.

In most of the world, "state" == nation. The US is an exception, but it's
because the initial concept, pre-pivot, was of a confederated union of
independent states.

------
tome
I love heat maps like this: they pack crucial information in an easily
accessible format. However, they should always be scaled for population
density, otherwise it's very misleading. Does the huge swathe of green in
Alaska counterbalance the few red spots in Florida? Probably not!

------
drats
The poor results on the map line up a fair bit with the cotton industry lines
of the 19th century in this article <http://bigthink.com/ideas/21383>

Industry (dots) lined up with Obama voters from the article:
[http://strangemaps.files.wordpress.com/2008/11/strangemapsov...](http://strangemaps.files.wordpress.com/2008/11/strangemapsoverlay1.jpg)

------
bane
I remember one year, while out skiing in West Virginia, my wife fell and broke
her arm. The ambulance ride to the _nearest_ hospital was about 1.5 hrs
through some of the poorest and most ramshackle areas I've seen outside of the
middle east and it ended at one of the smallest hospitals I've ever seen in
the U.S. She received good care, but I can see many health choices being made
in rural areas because

a) Too poor

b) Too far

If a resident of that area can even get their hands on a car, a 3-4 hour round
trip to visit the medical center (not counting time at the center) vs. putting
in another day on the job would certainly give me pause.

------
monkeypizza
Imagine if you live in a university town, but it just gets redistricted to
include a neighboring industrial town. The life expectancy of your town just
dropped, drastically.

But does that change your life at all? No, your life is exactly the same as
before.

Same with these stats. Just because people who have lower life expectancies
move or happen to live near you, it doesn't change anything about your life.

If canada and the US merged, the average life expectancy of the new country
would go up, but that number itself wouldn't change anyone's life.

It's the same with arbitrary county groupings. If you live in a county with
lots of poor people, they will have a lower life expectancy. That doesn't mean
anything about you, though. If the border was different, you might live in a
county with lots of rich people.

------
antr
just proves that having the most expensive (per capita) healthcare system in
the globe does not really contribute to health(y) results

~~~
corin_
I don't think I've ever met anybody who thought America's health care system
was better than that of many/most Europea countries - certainly not of any
fellow English/Europeans I know, but also no Americans I know and have
discussed it with.

~~~
arethuza
I guess it depends what you mean by "best" - if the ability to pay is not a
factor (i.e. you are very wealthy) then I suspect the absolute best care is
probably available in the US.

However, in the UK we went for the option of having pretty good, but perhaps
not the absolute best, available to _everyone_ , free at the point of
delivery, regardless of wealth. With the option to pay for private care if you
want it - either in the UK or abroad. Personally, I think this is a pretty
good compromise.

~~~
corin_
In my book, the fact that the US healthcare system excludes people who can't
afford it automatically drops it to bottom of the list, regardless of how
amazing it might be for the rich.

~~~
JoeAltmaier
Excludes is an extreme view. Anybody with the wit to stand in line can get
free healthcare at an emergency room or local hospital.

I value living in a place where I can work harder to get better things for my
family. Or work less hard and coast, my choice.

Making money is not a sport or game in America. Its real, its important, its
meaningful and it motivates millions of us to work hard and smart.

I can pull out my gold card and get to the head of the line for a heart
transplant, sure. That's not a failure, thats one of the strengths of a
capitalist/free market country. It can be cruel, but life is cruel and
honestly there is no 'fair' way to ration such healthcare. If you tried, the
'black market' (read: free market) would and does compensate anyway.

The free market motivates me. Some hunky-dory view of the world as full of
free services for everybody does not.

~~~
corin_
Countries with free health care for everybody can still offer plenty of
incentives for making money, I don't think anyone would argue the UK isn't a
capitalist country, and if you came to live here I'm confident that the NHS
wouldn't be enough to make you stop caring about wealth.

I'm not in favour of communism, but as far as I'm concerned, medical care
should be considered a right not a priviledge - there's really no benefit to
denying it for the poor.

(For the record, I fit into the group of people who could easily affordto go
private with Bupa here in the UK, and I'm far happier paying more in taxes to
subsidise the NHS.)

~~~
javert
The UK is not a capitalist country in the proper sense of the term, it's a
mixed economy.

I believe keeping what you earn is a right. You believe free medical care is a
right. Not mutually compatible. Glad I don't live in the same country as you.

~~~
corin_
Is there any true capitalist country then? Where do you live that you don't
have to pay any taxes?

~~~
javert
_Is there any true capitalist country then?_

No.

And I do have to pay taxes. I live in a country where there _are_ a lot of
people that _do_ agree with you (the US), so my remark was a bit facetious.

Actually, it's a double punishment to live here, because not only is the
government taking lots of money to pay for the medical system, but Americans
are too incompetent, broadly speaking, to run a centralized medical system. So
the more the government spends, the more it sucks. At least you Europeans can
make socialized medicine "work" in some sense of the term.

------
monkeypizza
life expectancy at 80 is probably 5 years or so. So having a bunch of 80 year
olds move to your county will probably increase it. Similarly, having
successful, rich and long-lived people move out of your country at age 80, a
few years before dying, will mean they don't increase your country life
expectancy at all, despite the fact that they lived there for 80 years.

~~~
JoeAltmaier
Not a lot of 80-yr-olds moving to the country, at least in Iowa. Mostly when
folks get older, they move into the city with family or an apt or home.

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zwieback
It would be interesting to see the spread in life expectancy in Canada or
Armenia. It's easy to shorten your life, even in a rich country but not so
easy to extend it so I would expect increasing asymmetry as you go up. These
comparisons should be done with distributions.

------
caf
It's interesting the places where there's a large apparent change across a
border - for example North Dakota / Montana.

~~~
gyardley
Likely the border of an Indian reservation.

