Conditions of residence affect life expectancy at birth

Neighborhood conditions and resources for children impact life expectancy at birth, according to a recent study.

Life expectancy has been associated with socioeconomic factors in the United States, with location of residence having a major impact. Childhood development, long-term health, and socioeconomic outcomes are affected by neighborhood opportunity and geography of opportunity. These are community-level conditions involving environmental, educational, health, and socioeconomic factors.

Health outcomes in children impacted by community-level conditions include hospital visits, mental health, infant health, acute care visits, and cardiometabolic risk factors. Investigators believed that methods to improve these outcomes and life expectancy were possible but required a greater understanding of the impact community-level factors have on life expectancy.

To analyze the association between neighborhood opportunity for children and life expectancy at birth, investigators conducted a cross-sectional study of neighborhood opportunity and life expectancy for children in the United States. Data was gathered from the Child Opportunity Index (COI) and the US Small-Area Life Expectancy Estimates Project.

COI 2.0 was used to measure neighborhood child opportunity, using 29 weighted indicators of neighborhood conditions which affect children’s health and long-term outcomes. These indicators were divided into 3 groups: educational, environment, and health. Higher COI scores indicated better conditions.

Life expectancy data was gathered from the US Small-Area Life Expectancy Estimates Project of the Centers for Disease Control and Prevention. Cross-sectional mortality data from 2010 to 2015 was included, detailing life expectancy at birth and for infants aged 1 year.

Life expectancy at birth was the primary outcome, based on the US at the Census tract level. Data on life expectancy at age 1 was also evaluated.

There were 65,662 US Census tracts included in the analysis. The mean COI score was 49 from a range of 0 to 100, with the lowest COI score being 10.1 and the highest being 90.2. The mean life expectancy was 78.2 years, with the lowest life expectancy being 56.3 years and the highest being 93.6 years.

Census tracts with low opportunity for children was associated with low life expectancy, while higher opportunity was associated with higher life expectancy. Each category saw significant differences based on opportunity, including low opportunity, moderate opportunity, and high opportunity. 

These results indicate a direct correlation between opportunity for children with life expectancy at birth, life expectancy increasing with opportunity level. Outcomes were similar for life expectancy at age 1, with life expectancy decreasing in census tracts with low opportunity. This is true for all COI domains: education, health and environment, and social and economic.

Investigators concluded that interventions to improve opportunities could improve health outcomes, including life expectancy. They suggested further research and health policies to reduce inequities in opportunities and life expectancy.

Reference

Shanahan KH, Subramanian SV, Burdick KJ, Monuteaux MC, Lee LK, Fleegler EW. Association of neighborhood conditions and resources for children with life expectancy at birth in the US. JAMA Netw Open. 2022;5(10):e2235912. doi:10.1001/jamanetworkopen.2022.35912