Among the 500 largest U.S. cities, 56 have very large life expectancy gaps between census tracts, where on average people in one neighborhood can expect to live 20 to 30 years longer than their neighbors a few miles away. These large life expectancy gaps occur most frequently in cities that have higher levels of racial and ethnic segregation, according to an analysis by researchers in the Department of Population Health at NYU School of Medicine, using data from the City Health Dashboard.
The City Health Dashboard is an online, one-stop resource that allows users to view and compare data on 500 U.S. cities with populations of 66,000 people or more, from multiple national data sources on health and the factors that shape health to guide solutions that create healthier and more equitable communities.
The research team analyzed Dashboard data to identify factors associated with large gaps in average life expectancy across neighborhoods in 500 U.S. cities. They found that cities with greater degrees of racial and ethnic segregation more often had alarming disparities in life expectancy across different census tracts, which often are used as proxies for neighborhoods in public health research. The census tract life expectancy estimates were prepared by the United States Small-Area Life Expectancy Estimates Project (USALEEP).
According to the analysis, Chicago had the largest gap in life expectancy across neighborhoods at 30.1 years. Washington, DC had a life expectancy gap of 27.5 years, followed by New York City at 27.4 years, and New Orleans and Buffalo, both with gaps of 25.8 years. Each of these cities had neighborhood racial and ethnic segregation scores that were more than double the average score for all 500 cities in the Dashboard. For example, in New York City, which is highly segregated by race and ethnicity, people living in East Harlem live an average of 71.2 years while those living in the Upper East Side, just a few blocks away, live to 89.9 years.
Fishers, Indiana, a suburb of Indianapolis with a population of more than 92,000, topped the list of cities with the smallest life expectancy gap, at only 2.4 years across neighborhoods. Rounding out the top 5 cities with the smallest life expectancy gaps were Cicero, Illinois (4.5), Lynwood, California (4.8), Livermore, California (5.1) and Meridan, Idaho (5.3). Segregation scores in these cities were, on average, less than half that of the average segregation score for the 500 cities on the Dashboard.
The average segregation score among the five cities with the largest life expectancy gaps was more than five times higher than the segregation score among the five cities with the smallest life expectancy gaps.
“We’ve known for a while that conditions in our neighborhoods can have a profound influence on how long and how well we live. But we were surprised to see just how large the gap in life expectancy can be between neighborhoods, and how strong the link was between life expectancy and segregation, across all different kinds and sizes of cities,” says Benjamin Spoer, PhD, MPH, from the Department of Population Health at NYU Langone Health, who conducted the data analysis.
Marc N. Gourevitch, MD, MPH, the Muriel G. and George W. Singer Professor and chair of the Department of Population Health at NYU Langone, is the principal architect of the City Health Dashboard. He agrees that the gaps are compelling, while cautioning against blanket assessments of specific cities.
“Each city has its own history and challenges that influence how long its residents live. The data on life expectancy gaps are an invitation for city leaders to dig deeper into the conditions that influence health, to better target action to close these gaps, and ultimately improve health for everyone,” he says. “Your neighborhood shouldn’t influence your odds of seeing your grandchildren grow up.”
“We created the City Health Dashboard in response to local demand for more accurate and actionable data so city leaders could better understand all of the factors that influence their city’s specific state of health and take action.”
For example, Dr. Gourevitch says, policies and programs that address longstanding, systemic racial and ethnic inequalities and promote equitable neighborhood development, including offering safe and affordable housing, supporting early childhood development in underserved neighborhoods, and addressing issues like air quality, could begin to improve life expectancy gaps in certain cities.
Note that racial and ethnic segregation as defined in the Dashboard is measured by the distribution of the racial and ethnic groups within a neighborhood relative to the distribution across the city.
About the City Health Dashboard
More than 80 percent of U.S. residents live in urban areas. However, until recently, few measures have been available for cities to assess health, the factors that shape it, and the drivers of health equity. The City Health Dashboard provided city leaders with an array of regularly refreshed data to support health-related decision-making.
The City Health Dashboard launched in early 2017 with 26 measures for 4 pilot cities: Flint, Michigan, Kansas City, Kansas, Providence, Rhode Island, and Waco, Texas. With support from the Robert Wood Johnson Foundation, the City Health Dashboard has expanded to offer data on 36 measures for the 500 largest U.S. cities—those with populations of about 66,000 or more—representing approximately one third of the U.S. population. Equipped with these data, local leaders have a clearer picture of the challenges facing their communities and how to address them.