264589 Determinants of geographic variation in life expectancy in urban and rural settings

Tuesday, October 30, 2012

Benjamin Evans, MHSA , Center on Human Needs, Virginia Commonwealth University, Richmond, VA
Amber Haley, MPH , VCU Center on Human Needs, Virginia Commonwealth University School of Medicine, Richmond, VA
Steven Woolf, MD , Virginia Commonwealth University, Department of Family Medicine, Fairfax, VA
Emily Zimmerman, PhD , Center on Human Needs, Virginia Commonwealth University, Richmond, VA
Elizabeth Manghi , Virginia Network for Geospatial Health Research, Richmond, VA
Steve Sedlock, MURP, GISP , Executive Director, Virginia Network for Geospatial Health Research, Richmond, VA
Objective: To illustrate the variation in life expectancy that occurs within a community and to examine the social, economic, and demographic characteristics that contribute to the variation.

Methods: Using multiple years of birth and death data, we calculated life expectancy by the smallest geographic unit possible within six cities and two rural communities. We also calculated measurements such as the poverty rate, racial segregation, and educational attainment for all communities as well as additional measurements for some communities such as food access, environmental hazard exposure, social cohesiveness, crime, availability of exercise facilities, and others. Using GIS software and multivariate statistical methods such as linear, non-linear, logistic, and ordinal logistic regression analysis, we analyzed the relationship between life expectancy and its determinants.

Results: Life expectancy within a single community varied by as much as 33 years between smaller geographic units. Lower life expectancy areas were significantly more likely to have higher poverty rates, higher percentage of adults without a high school diploma, large minority communities, and fewer community assets (such as supermarkets or healthcare providers) as well as to exhibit a persistent pattern of these metrics over 4 5 decades compared to high life expectancy areas. GIS maps for specific communities will be presented.

Conclusions: Regional statistics oversimplify important geographic differences that exist between small areas within a community. Geographic disparities in health status reflect, in part, past and present neighborhood contexts and social characteristics. Areas of persistent distress consistently have lower life expectancy and higher morbidity and mortality rates.

Learning Areas:
Diversity and culture
Public health or related public policy
Social and behavioral sciences

Learning Objectives:
1. Examine the distribution of life expectancy of small geographic areas within urban and rural communities. 2. Analyze the relationship between life expectancy with the social, economic, and demographic characteristics of the area. 3. Evaluate the extent to which social determinants impact health disparities within communities.

Keywords: Social Inequalities, Geographic Information Systems

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I served as one of the project coordinators for the production of eight community health equity reports that resulted in the research on which this abstract is based. I have presented on this topic and others related to the social determinants of health at APHA conferences in the past. I am the lead author on four of the final reports and a contributing author on the other four report that resulted from this project.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.