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Study: Life expectancy getting worse for Appalachian communities.

DISPARITIES in life expectancy and infant mortality between people living in Appalachia and the rest of the U.S. are worsening, research finds.

Published in the August issue of Health Affairs, the study noted that infant mortality rates were not significantly different between Appalachia and the rest of the country in the early 1990s. However, by 2013, infant mortality rates were 16 percent higher in Appalachia, compared with the rest of the nation. On life expectancy, people living in Appalachia as of the early 1990s lived an average of seven months less than their fellow Americans. By 2013, that life expectancy gap had grown to 2.4 years. The Appalachia region encompasses 428 counties in 13 states, including all the counties in West Virginia and some counties in Alabama, Georgia, Kentucky, Maryland, Mississippi, New York, North Carolina, Ohio, Pennsylvania, South Carolina, Tennessee and Virginia.

To conduct the study, researchers examined data from the National Vital Statistics System between 1990 and 2013 as well as poverty data from the American Community Survey. Overall, the region is home to higher poverty and unemployment rates as well as lower educational levels than the rest of the country. Within Appalachia, black infants experienced higher mortality rates than white babies, as did infants in high-poverty areas of the region when compared with low-poverty areas.

When comparing life expectancy between Appalachia residents and people outside the region, the most pronounced gap was among white men, with a difference of 2.6 years. Between 1990-1992 and 2009-2013, people living outside Appalachia experienced larger gains in life expectancy than those living in Appalachia, which researchers said contributed to the widening life expectancy gap.

Researchers also found a stronger association between poverty and life expectancy within Appalachia, compared with the rest of the country. In particular, Appalachia residents in high-poverty areas had a life expectancy of 75.1 years, compared with nearly 80 years for those living in Appalachia's low-poverty areas. All-cause mortality in Appalachia was 5 percent higher than the rest of the U.S. in 19901992, growing to 18 percent higher in 2009-2013. Cardiovascular diseases and unintentional injuries, including drug overdoses, cancers and smoking-related diseases, contributed heavily to the life expectancy gap between Appalachia and the rest of the nation.

The study concluded that while policy interventions that address issues such as smoking cessation and health care access could go far in narrowing disparities in Appalachia, stakeholders must also zero in on the social determinants of health.

For the study, visit

Caption: Infant mortality and overall life expectancy are both worsening for people living in Appalachia, according to a new study.

Photo by Monkeybusinessimages, courtesy iStockphoto

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Author:Krisberg, Kim
Publication:The Nation's Health
Date:Oct 1, 2017
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