How Long One Lives Should Not Depend on Where One Lives

By Steven Lopez, Senior Policy Analyst, Health Policy Project, NCLR

boy and grandfatherBut unfortunately, it does. Place matters. A recent report by the University of Washington’s Institute for Health Metrics and Evaluation further supports this reality. Researchers found that while life expectancy in the U.S. increased overall for both males and females, in certain counties, life expectancy was no better off than some developing countries. The lowest county-level life expectancies were seen in the South, in states such as Mississippi.

So what does this mean for Latinos?

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We know the conditions many vulnerable Latinos live in are similar to those counties with lower life expectancy. The researchers call for increased attention on socioeconomic factors such as poverty and education, lack of access to quality health care, and risk factors such as poor diet and physical inactivity.  Those in public health like to use the term “Social Determinants of Health” which, according to the Centers for Disease Control and Prevention, are

“the circumstances in which people are born, grow up, live, work, and age, as well as the systems put in place to deal with illness. These circumstances are in turn shaped by a wider set of forces: economics, social policies, and politics.”  http://www.cdc.gov/socialdeterminants/

Simply put,  a variety of factors determine whether we are in poor health or good health and increased attention to these factors can help to narrow health inequities and increase life expectancy.

Policy-wise, the Affordable Care Act (ACA) will be a significant tool to help narrow inequities in access to health insurance and health care, especially for Latinos. While health care alone does not guarantee good health, it is challenging to achieve good health without access to insurance and a doctor. In less than four months, states and federal health exchanges will open for enrollment and beginning January 1, 2014, people can become insured.  For the first time, many will have access to insurance and be able to visit a doctor and not have to worry about getting sick or delaying care until the condition is untreatable or grossly expensive.

As a result of the ACA, health plans will now be required to make prevention affordable and accessible by requiring most health insurance plans to cover prevention and wellness benefits with no cost sharing. This means individuals and families will be able to access preventive services including well-child visits, blood pressure and cholesterol screenings, pap smears and mammograms for women, and flu shots for both children and adults without paying a copayment.

However, the ACA is so much more. The ACA also contains investments to transform communities and make the environments where people live, learn, and play healthier. For example, the Community Transformation Grant program was created to support states and communities by promoting healthy lifestyles, especially among groups such as Latinos experiencing high rates of chronic disease such as obesity, diabetes, and cardiovascular disease. The program aims to transform communities by improving the conditions that contribute to poor health outcomes and lower life expectancy.

While the ACA is not a silver bullet, it does bring much need attention to and investment in new opportunities to improve health and narrow the disparity between where one lives and how long one lives.