Laut Forschern vergrößert sich der Unterschied in der Lebenserwartung in den USA aufgrund „wirklich alarmierender“ gesundheitlicher Ungleichheiten auf 20 Jahre | Ten Americas: eine systematische Analyse der Lebenserwartungsunterschiede in den USA

From the article:

>In the study, published Thursday in The Lancet, researchers analyzed death records from the National Vital Statistics System and population estimates from the National Center for Health Statistics from 2000 to 2021.
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>Large disparities in life expectancy were apparent throughout the study period but grew more substantial over time, particularly during the first two years of the COVID-19 pandemic, the authors noted.
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>”The extent and magnitude of health disparities in American society are truly alarming in a country with the wealth and resources of the USA,” senior author Christopher J.L. Murray said in a news release. “These disparities reflect the unequal and unjust distribution of resources and opportunities that have profound consequences on well-being and longevity, especially in marginalized populations.”
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>In 2000, life expectancy ranged from an average of 70.5 years for Americans at the lowest end to 83.1 years for those in the highest group — a difference of 12.6 years. The gap widened to 13.9 years in 2010, jumped to 18.9 years in 2020, and now in the latest data, 20.4 years in 2021.
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>During those two decades, the study says, “US life expectancy has shifted in the wrong direction, falling further behind that of most other peer wealthy nations.”
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>In 2000, the groups with the lowest average life expectancy included Black Americans in non-metropolitan and low-income counties in the South, as well as in highly segregated metropolitan areas; and American Indian or Alaska Native individuals in the West. The group with the highest average life expectancy was Asian Americans.
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>Between 2000 and 2010, life expectancy increased for all groups except for American Indian or Alaska Native individuals in the West, who saw a about a 1-year decline. For White and Latino populations, outcomes varied depending on the locations where they lived. For example, White Americans in low-income counties in Appalachia and the Lower Mississippi Valley had lower life expectancies than those in other areas.
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>By 2021, after the impacts of the pandemic, the gaps grew substantially wider, with Asian American life expectancy averaging 84 years while American Indian or Alaska Native people in the West averaged 63.6 years. Life expectancy among non-Hispanic Black Americans fell to 71.0 years, from 74.8 just two years earlier, with significant variations depending on where they lived.
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>”During the COVID-19 pandemic, historically marginalised populations experienced the highest mortality rates and horrific losses in life expectancy,” the authors wrote.

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Link to research journal: [Ten Americas: a systematic analysis of life expectancy disparities in the USA](https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(24)01495-8/fulltext)

>Methods
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>In this systematic analysis, we defined ten mutually exclusive and collectively exhaustive Americas comprising the entire US population, starting with all combinations of county and race and ethnicity, and assigning each to one of the ten Americas based on race and ethnicity and a variable combination of geographical location, metropolitan status, income, and Black–White residential segregation. We adjusted deaths from the National Vital Statistics System to account for misreporting of race and ethnicity on death certificates. We then tabulated deaths from the National Vital Statistics System and population estimates from the US Census Bureau and the National Center for Health Statistics from Jan 1, 2000, to Dec 31, 2021, by America, year, sex, and age, and calculated age-specific mortality rates in each of these strata. Finally, we constructed abridged life tables for each America, year, and sex, and extracted life expectancy at birth, partial life expectancy within five age groups (0–4, 5–24, 25–44, 45–64, and 65–84 years), and remaining life expectancy at age 85 years.
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>…
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>Interpretation
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>Our analysis confirms the continued existence of different Americas within the USA. One’s life expectancy varies dramatically depending on where one lives, the economic conditions in that location, and one’s racial and ethnic identity. This gulf was large at the beginning of the century, only grew larger over the first two decades, and was dramatically exacerbated by the COVID-19 pandemic. These results underscore the vital need to reduce the massive inequity in longevity in the USA, as well as the benefits of detailed analyses of the interacting drivers of health disparities to fully understand the nature of the problem. Such analyses make targeted action possible—local planning and national prioritisation and resource allocation—to address the root causes of poor health for those most disadvantaged so that all Americans can live long, healthy lives, regardless of where they live and their race, ethnicity, or income.