Sunday, July 17, 2022

Health outcomes between "unhealthy states" and "healthy states"


Life expectancy by US Census Tract
If you look at the map shown above, you might notice a red, claw-like pattern with the wrist of the claw somewhere near Pensacola, Florida.

That begs the question, "Is there any useful information embedded within that curiosity?"

At a 40,000' fly-over level we can learn that the difference in mortality rates is not concentrated in any particular age group.

The mortality rate disparity peaks between ages 29-and-45. It might be worth a deep-dive to see what causes-of-death drive that disparity.

For example, one might labor under the assumption that people living in West Virginia, Mississippi, Alabama, Tennessee and Kentucky have lower life expectancies than enlightened people in Hawaii, California, New York and Minnesota because decades of poor life-style choices catch up with them and they die by the box-car lot between ages 65-and-75. 

The data does not support that assumption. The mortality rate in WVMSALTNKY is uniformly 1.5-to-2.1 times higher than HICANYMN for every age cohort below seventy.

One defensible hypothesis is that delays in getting professional treatment is a major player. Those red fingers might be rural areas or mountainous areas where land-travel is arduous or emergency services are stretched thin.

Wendell Berry once made the vinegary observation that Christian preachers invariably felt "called by God to serve" congregations that were in regions with deeper collection baskets than his poor, Kentucky neighborhood.

Much the same can be said about medical professionals. They have student debt. Most of them like the amenities of urban life. The Medicaid payments and erratic patronage of patients in Best Friend, Alabama is thin gruel when they have $1M in student debt to pay down.

If there is a "take-home" for those of us in rural areas it is that we need to be our own health advocates. If somebody (perhaps a spouse) tells you it is time to visit the doctor then don't argue. Grab your hat and go.

If they want to call 9-1-1, you have a Golden Hour when it can make the difference between life-and-death. Don't waste it.

If our best understanding of the research is "moderation in all things", exercise, sunshine and avoiding stupid people...then put that information into action.

If we cannot exercise due to pain or worn-out joints...then do something about it.

If we cannot enjoy a healthy diet because our teeth are worn out...find a good dentist and let them ply their craft.


  1. A couple of thoughts on this map:
    - Note that there are red areas in parts of the West that, as far as I can tell, are mostly Reservations.
    - There are large parts of the mountain/ desert West that are FAR more remote than any part of the South in terms of distance and drive time yet they are non red (white, blue or purple) indicating higher life expectancy.
    - Don't forget that red covers 15 years and the other bands are each about 2 years, so the granularity is not the same.

    I suspect poverty or an unwillingness to go to the doctor (or fears of the cost) are a bigger issue than access to a hospital. For example, one town I work in at times has NO doctors at all, with the nearest health care of any kind over 100 miles away, yet it is in the 2nd highest quintile for life expectancy.

    1. The red areas here in the U P of Michigan are reservations. --ken

  2. ERJ, something I read some years ago that I have very much come to understand as true is that we need to be the number one advocates for our health and do everything in our power to maintain it. It really is something we cannot outsource, ultimately.

  3. I would think that those that stay away , far away from the medical soup nazis , the longer they live . Doctors , hospitals , and nurses if they are comely are good for a broken bone or emergency trauma care but anything else is a waste of time and mammon .

  4. I live in rural Alaska with the nearest 24 hour emergency room 40 miles away and the best available hospital 250 miles away. Most of us have air med evacuation insurance. I feel like many doctors do over prescribe meds and it seems like some suggest surgeries that are lacerative from their point of view. None of us will get out of this world alive!

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  6. If you live long enough something's gonna kill you. Much of the time the choice is yours. --ken

  7. yeah, that big red spot in the four corners area is rez. I used to work out that way. That is the most depressing place I've ever been. And the attitude is awful amongst the rez-idents. I always looked forward to going there, and felt depressed when I left. Not a happy place.

  8. It does come down to medical care... or lack of it...

  9. God gives most about 70 or so years.
    Do what needs to be done and prepare to move on.

  10. Some of those areas have a long history of dangerous industries, mining, timber, chemical plants, and the resulting injuries and diseases that go with them


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