Life Expectancy Gaps

Research from Harvard School of Public Health shows that life expectancy has declined or stagnated in some U.S. counties over the last 25 years. As a result, the life expectancy gap between the worst and best counties has grown by about two years for men and one year for women. The Deep South and Appalacia saw the largest divergence.

The obvious explanation is that health care is getting more expensive and some groups, primarily minority and low income populations, have seen their access to quality health care diminished. Here are a few alternative explanations:

1. Nonrandom immigration adds groups with different endowments of health and genetics to some communities.
2. Migration trends have sorted communities based on socioeconomic factors correlated with health and life expectancy.
3. A stronger assortative mating trend means more people are getting married within socioeconomic boundaries and is contributing to rising inequality in health.
4. Health care is not an easy good to consume and an increasing educational achievement gap contributes to disparity in health outcomes.
5. Life expectancy is not the only dimension on which individuals maximize (surprise!), there are regional differences in preferences, and some goods (which don't contribute to health) have gotten relatively less expensive.

Any others?

I’m not deny that the life expectancy gap is a symptom of a broken health care system. It very well may be. But that certainly isn’t the only candidate explanation. And, contrary to what your SAT prep book may have told you, the most obvious answer is not always the correct one.