County-Level Life Expectancy Change: A Novel Metric for Monitoring Public Health

Aruna Chandran, Ritika Purbey, Kathryn M. Leifheit, Kirsten Mc Ghie Evans, Jocelyn Velasquez Baez, Keri N. Althoff

Research output: Contribution to journalArticlepeer-review

Abstract

Life expectancy (LE) is a core measure of population health. Studies have confirmed the predictive importance of modifiable determinants on LE, but less is known about their association with LE change over time at the US county level. In addition, we explore the predictive association of LE change with COVID-19 mortality. We used a linear regression model to calculate county-level annual LE change from 2011 to 2016, and categorized LE change (≤−0.1 years change per year as decreasing, ≥0.1 years as increasing, otherwise no change). A multinomial regression model was used to determine the association between modifiable determinants of health indicators from the County Health Rankings and LE change. A Poisson regression model was used to evaluate the relationship between change in life expectancy and COVID-19 mortality through September 2021. Among 2943 counties, several modifiable determinants of health were significantly associated with odds of being in increasing LE or decreasing LE counties, including adult smoking, obesity, unemployment, and proportion of children in poverty. The presence of an increasing LE in 2011–2016, as compared to no change, was significantly associated with a 5% decrease in COVID-19 mortality between 2019 and 2021 (β = 0.953, 95% CI: 0.943, 0.963). We demonstrated that change in LE at the county level is a useful metric for tracking public health progress, measuring the impact of public health initiatives, and gauging preparedness and vulnerability for future public health emergencies.

Original languageEnglish (US)
Article number10672
JournalInternational journal of environmental research and public health
Volume19
Issue number17
DOIs
StatePublished - Sep 2022

Keywords

  • COVID-19 mortality
  • health equity
  • life expectancy
  • social determinants of health

ASJC Scopus subject areas

  • Pollution
  • Public Health, Environmental and Occupational Health
  • Health, Toxicology and Mutagenesis

Fingerprint

Dive into the research topics of 'County-Level Life Expectancy Change: A Novel Metric for Monitoring Public Health'. Together they form a unique fingerprint.

Cite this