Population Well-Being Measures Help Explain Geographic Disparities In Life Expectancy At The County Level

Health Aff (Millwood). 2016 Nov 1;35(11):2075-2082. doi: 10.1377/hlthaff.2016.0715.


Geographic disparities in life expectancy are substantial and not fully explained by differences in race and socioeconomic status. To develop policies that address these inequalities, it is essential to identify other factors that account for this variation. In this study we investigated whether population well-being-a comprehensive measure of physical, mental, and social health-helps explain geographic variation in life expectancy. At the county level, we found that for every 1-standard-deviation (4.2-point) increase in the well-being score, life expectancy was 1.9 years higher for females and 2.6 years higher for males. Life expectancy and well-being remained positively associated, even after race, poverty, and education were controlled for. In addition, well-being partially mediated the established associations of race, poverty, and education with life expectancy. These findings highlight well-being as an important metric of a population's health and longevity and as a promising focus for intervention.

Keywords: life expectancy; population health; well-being.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Female
  • Geography / statistics & numerical data*
  • Health Status Disparities*
  • Humans
  • Life Expectancy / trends*
  • Local Government
  • Male
  • Population Health / statistics & numerical data*
  • Poverty
  • Social Class