Thursday, March 12, 2020
Kaiser Health News ran this story, The Startling Inequality Gap That Emerges After Age 65. "[T]hose who reach age 65 are living longer than ever... But there’s a catch: Seniors in urban areas and on the coasts are surviving longer than their counterparts in rural areas and the nation’s interior, according to an analysis from Samuel Preston of the University of Pennsylvania, one of the nation’s leading demographers. ...This troubling geographic gap in life expectancy for older Americans has been widening since 2000, according to his research, which highlights growing inequality in later life."
The article discusses the life expectancy disparity not only between urban and rural areas, but also between various parts of the U.S. For example, "
Notably, 65-year-olds in “rural areas have had much smaller improvements than those in large metro areas,” Preston remarked. “And people living in ‘interior’ regions ― particularly Appalachia and the East South Central region [Alabama, Kentucky, Mississippi and Tennessee] — have done worse than those on the coasts.”
These geographic differences emerged around 1999-2000 and widened from 2000 to 2016, the study found. By the end of this period, life expectancy at age 65 for women in large metropolitan areas was 1.63 years longer than for those in rural areas. For men, the gap was 1.42 years.
Differences were even starker when 65-year-olds who live in metro areas in the Pacific region (the group with the best results) were compared with their rural counterparts in the East South Central region (the group with the worst results). By 2016, seniors in the first group lived almost four years longer. (The Pacific region includes Alaska, California, Hawaii, Oregon and Washington.
The article discusses the explanations of the disparities, including access to health care, smoking history and cardiovascular disease. It also discusses the differences from "death from despair" in younger generations to the older generation "Deaths from opioids, alcohol or suicide aren’t significant in the older population; instead, deaths from chronic illnesses, which take years to develop and which are influenced by social conditions as well as personal behaviors, are far more important .... "
The study is available here.