The typical life expectancy for residents of the low-income Gilpin neighborhood of Richmond, Va., is just 63 years. A short drive across the river to the wealthier Westover Hills finds residents living a full 20 years longer.
Neighborhood life expectancy gaps are fairly common and driven by a range of factors, such as poverty, infrastructure and access to health care. The Center on Society and Health at Virginia Commonwealth University (VCU) is collecting and mapping life expectancy data for several cities. In the 10 areas reviewed so far, researchers found large gaps -- regardless of how large or densely populated jurisdictions were -- said Derek Chapman, the center’s associate director for research.
Several cities track and report their own data depicting similar disparities. In Baltimore, life expectancies range from the mid-80s on the city’s north side to 66 years in the poorest communities. The Cincinnati Health Department calculated that those living in the city’s Mt. Lookout and Columbia-Tusculum neighborhoods live 88 years, compared to a citywide average of 76 years.
Part of the magnitude of the calculated disparities depends on the geographic boundaries used, making it difficult to compare cities. A Census tract or ZIP code spanning multiple housing projects, for example, will have a lower life expectancy than one encompassing only part of a low-income neighborhood.
A litany of issues contribute to differences in life expectancies. People who live in places like Gilpin, which includes one of Richmond’s housing developments, may not always have access to health care, or may live in food deserts with few, if any, healthy eating options. Lack of exercise also becomes an issue if there aren’t opportunities to engage in physical activity or if residents in high-crime areas opt to stay inside. “It’s really a complex set of factors,” Chapman said. “We’re not going to fully address health concerns without looking at jobs, education and all the other factors together.”
Physical barriers, such as rivers or highways that divide neighborhoods, may further exacerbate gaps. Communities with lower life expectancies are often found near closed manufacturing facilities or in low-lying areas prone to flooding. In Denver, one report found that children in certain neighborhoods were admitted to emergency rooms for asthma treatment at high rates, prompting the health department to study whether living near highways puts them at greater risk.
Neighborhoods with lower life expectancies often have higher infant mortality rates and adolescent deaths related to violence or drug overdoses. Overall, though, leading causes of death in communities with low life expectancies mirror those in more affluent communities. The difference, said Chapman, is that they’re occurring earlier in life.
Given all the factors limiting life expectancies, officials in Richmond are pursuing multiple strategies.
One effort aims to get fresh produce into local corner stores in food deserts, providing residents with healthy options. Nonprofits, along with the local health district, also host community cooking events and distribute recipe cards. “It’s much more complicated than just an access question,” said Danny Avula, the Richmond City Health District’s deputy director. “Part of it is reshaping cultural norms and getting back to a time when people prepared food at home.”
Areas with the lowest life expectancies are concentrated around the city’s public housing developments, so the health district and housing authority converted vacant residential units to on-site clinics where community health workers connect residents with health providers, helping them avoid frequent trips to the emergency room. Nurses also provide on-site screening and clinical services one day a week.
While life expectancy itself doesn’t shed much light on any underlying problems, Chapman views the measure as a valuable tool in raising awareness of the disparities. “It’s a single, broad measure that everyone understands,” he said.
Richmond Life Expectancy Map