Richest Live Longer but Gap Not as Dismal in Some US Cities
By THE ASSOCIATED PRESS

CHICAGO — The richest Americans live at least 10 years longer on average than the poorest, but that gap isn't as wide in many communities, especially affluent, highly educated cities, a major study found.

The research emphasizes that where you live and what you earn help determine life expectancy, along with changeable behaviors including smoking and lack of exercise.

Stanford University economist Raj Chetty and colleagues analyzed more than 1 billion tax records between 1999 and 2014, along with government records on nearly 7 million deaths. They used the data to estimate life expectancy at age 40 by income and geographic area.

Their analysis was published online Monday in the Journal of the American Medical Association. It comes during an election season marked by heated debate about income equality and the endangered middle class.

The report examines the well-known connection between income and longevity, but with more precision and detail than previous research, Princeton University economist Angus Deaton said in a journal editorial.

"The infamous 1 percent is not only richer, but much healthier," Deaton said.

KEY FINDINGS

Men with the top 1 percent in income lived 15 years longer than men with the lowest 1 percent in income; for women that gap was 10 years.

Between 2001 and 2014, life expectancy didn't change for people in the lowest 5 percent of income, but it increased by about 3 years for men and women in the top 5 percent. Those changes, and life expectancy in general, varied substantially by region.

The poorest Americans lived the longest in areas where smoking, obesity and inactivity were scarce, and access to medical care had less influence than previous studies have suggested.

The study did not include people with no income.

LOCATION, LOCATION, LOCATION

Data from Dallas, Detroit and New York help illustrate the findings. Among the lowest-income men and women, life expectancy was lowest in Detroit and Dallas and highest in New York. Among men at the lowest income level, life expectancy was 72 in Detroit, but almost 80 years in New York — a nearly seven-year difference. Among men at the top income level, it was about 86 years in Detroit and 87 years in New York, a difference of just one year. The gap was smaller among women.

The lowest life expectancies for the poorest men and women — less than 78 years — were in Indiana, Nevada and Oklahoma. For the richest, the lowest life expectancies — less than about 85 years — were in Hawaii, Nevada and Oklahoma.

THE IMPLICATIONS

The poorest Americans fared best in affluent cities with highly educated populations. These tend to be areas with health-related public policies including smoking bans and high levels of funding for public services, the researchers said.

The findings raise the possibility that community-based public health approaches could help address the income-based longevity gap, a journal commentary said.

美最富者比最窮者 至少多活10年

一項重大研究發現，美國最有錢富人比最窮貧民平均壽命至少多十年，但在許多社區，尤其是富裕和教育水準高的城市，兩者差距明顯縮小。

該研究強調，居住地點和收入高低可能影響預期壽命長短，同時可改變的行為如抽菸和缺乏運動，也有影響。該發現意味著，社區的公眾健康措施，可能有助於補救因收入差距影響到壽命長短。

史丹福大學經濟學家契提（Raj Chetty）等分析1999年至2014年的10億餘報稅紀錄，和近700萬人死亡紀錄 ，他們使用這些資料，依據收入和居住地區，來預估40歲民眾的預期壽命。這項分析11日公布於美國醫學會期刊網站，而值此選舉年，收入不平等和中產階級面臨絕跡正是爭論不休的議題。

該期刊評論指出，該報告檢視收入和預期壽命的關係，但比普林斯頓大學經濟學家迪頓過去所做的類似研究更精準和詳細。迪頓指出：「收入在頂層1%的人不僅最富裕，也健康得多。」

根據新研究，收入為頂層1%的男性，比收入為底層1%的男性，多活15年；在女性方面，兩者差距為十年。從2001年到2014年，收入為底層5%的貧民，預期壽命沒有改變，但收入在頂層5%富人，增加約三年。

不過，這些改變和壽命長短卻因居住地區不同而出現明顯差異。由於居住在吸菸、肥胖和缺乏運動者罕見地區的收入最底層民眾，卻活得最長，顯示該地區民眾的收入對壽命的影響較小。

從達拉斯、底特律和紐約的數據來看，說明了這項發現。在收入最低層男女中，底特律和達拉斯的壽命最短，紐約壽命最長。收入最底層的男性，在底特律的預期壽命為72歲，在紐約卻幾乎達80歲，約有七年的差別。收入為頂層的男性 ，在底特律預期壽命為86歲，在紐約為87歲， 差別只有一年。女性的差別更小。

最貧窮的男性和女性，預期壽命最短的是印第安納、內華達和奧克拉荷馬州，均低於78歲。收入頂層者預期壽命最短的為夏威夷、內華達和奧克拉荷馬州居民，均低於85歲。

原文參照：
http://www.nytimes.com/aponline/2016/04/11/health/ap-us-med-income-longevity-gap.html

2016-04-13 世界日報 編譯張玉琴