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Member Research & Reports

Member Research & Reports

East Tennessee Study: Poorest American’s Life Expectancy Trails Half the World’s Countries

A scholarly article written by several members of East Tennessee State University College of Public Health is receiving national attention for its analysis of the poorest and wealthiest counties in the nation.

Health and Social Conditions of the Poorest Versus Wealthiest Counties in the United States” was written by current East Tennessee  doctoral student Ms. Olivia Egen; Dr. Randy Wykoff, dean of  East Tennessee; Dr. Kate Beatty, assistant professor ; and East Tennessee alumni Ms. Katie Brown and Dr. David Blackley.

The study sought to more clearly articulate, and more graphically demonstrate, the impact of poverty on various health outcomes and social conditions by comparing the poorest counties to the richest counties in the United States and to other countries in the world.  To accomplish the objective, the authors classified the more than 3,100 counties in America by five-year average household incomes, listing them from wealthiest to poorest. They divided those counties into 50 new “states”, organized by income rather than geography.

“We then compared the ‘wealthiest state’ – the richest 63 counties – to the ‘poorest state’ – the poorest 63 counties – for a variety of health and social statistics,” Ms. Egen explained.

According to the findings, compared to the wealthiest counties in the nation, the poorest counties see smoking rates that are twice as high, a 50 percent higher rate of obesity and a life expectancy seven to 10 years shorter.

“Life expectancy in the poorest state is about where the U.S. was between 1975 and 1980,” Ms. Egen noted. “And the U.S., as a whole, is not expected to achieve the life expectancy in our wealthiest state until 2020 or 2025.”

The authors also compared the poorest state to other countries in the world and found that half of the countries in the world have a longer life expectancy than Americans living in the poorest state.

The 63 counties making up the poorest state come from 13 actual states, while the counties in the wealthiest state come from 20 actual states. There are five actual states, including Tennessee, that have at least one county in both the poorest state and the wealthiest state.

“The ‘state’ of poverty in this country is dramatic and deeply disturbing,” Dean Wykoff said. “In essence, there are several developing countries hidden within the borders of the United States – regions defined, in this case, by poverty.”

This analysis graphically demonstrates the true impact of the extreme socioeconomic disparities that exist in the United States. These differences can be obscured when one looks only at state data, and suggest that practitioners and policymakers should increasingly focus interventions to address the needs of the poorest citizens in the United States.