Live Long and Prosper: Does CED Impact How Long We Live?

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Maureen Berner

Maureen Berner is a School of Government faculty member. She teaches evaluation and analysis courses for MPA students, and provides similar training and advising to state and local government officials throughout North Carolina.

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I often think about ways in which local government matters in the daily lives of citizens. This month, a major study was released showing how local conditions, and community and economic development, infrastructure, and planning in particular, may have a direct impact on the most basic quality of life indicator for its citizens: life-span. The New York Times featured an article on the study, and its column called the Up-Shot features an interactive map that provides area-specific details.

The study, published last week in the Journal of the American Medical Association, examined anonymous income and mortality data on over a billion people across the U.S. between 2001-2014. The main finding was while wealthier communities have seen life expectancy increase over this time period, the life expectancy of the poor, on average across the country, has remained the same. The gap between the rich and poor in life years has increased.

What is particularly important for CED professionals is the finding, however, that geography matters. For upper income households there are no significant community level differences. In other words, if you are wealthy, it doesn’t matter where you live in the U.S., on average. You are always expected to live about the same length of time. But if you are poor, where you live does make a difference in how long you are expected to live.

How doesImage2 this play out in North Carolina? Some communities are marginally better or worse for lower-income households in terms of life-span. A good example of this pattern can be seen in central North Carolina. For a 40-year old with an average income of less than $28,000, average life expectancy in Orange County and Wake County is 80.3 and 80.2 years respectively, virtually the same, while in neighboring Alamance and Granville Counties it drops to 78.5. Durham County, as you might expect being in between in terms of economic condition, is in between in terms of life expectancy at 79.4 years.

In all of these areas, on average, the poor will die about 8 years before the rich. While  overall difference between rich and poor is disturbing, there are not major differences in the relative disadvantage across this area. (All of the data quoted here takes into account racial differences in the communities.)

However, poor households in the far western corner of the state, around Franklin, do better than average, with a life expectancy for a 40 year-old of 80.7 years. Fortunately, North Carolina does not have areas where the poor fare much worse than average, as is found in Texas and Arizona, or Image7surprisingly to me, parts of Illinois, Indiana, Michigan and Ohio. In Terre Haute, Indiana, for example, for the same poor households, life expectancy is 76.5 years.

The reasons for the differences are complex and the study raises more questions that it answers. But given the strength of the study and the depth of the data, it strongly suggests aspects of the community environment are having an impact on the health and longevity of its citizens. Step in the CED professional. Questions have been raised around what community characteristics are feeding into these differences – is it walkability, business or economic base, pollution, density of housing or quality of educational services? Is it infrastructure or community cohesion? Built environment or services? Why do the poor in some urban environments, on average, live much longer than the poor in other cities? Why is there significant variation even within cities? What local actions, therefore, can improve the situation? The study will generate a tremendous amount of new research. However, clearly the focus will be on the local level. Local conditions, and therefore how we plan, govern and manage our communities in the face of those conditions — are having an impact on human lives. CED makes a difference.

Maureen Berner (23 Posts)

Maureen Berner is a School of Government faculty member. She teaches evaluation and analysis courses for MPA students, and provides similar training and advising to state and local government officials throughout North Carolina.


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