Mateo P. Farina is with the Leonard Davis School of Gerontology, University of Southern California, Los Angeles. Anna Zajacova is with the Department of Sociology, University of Western Ontario, London, ON. Jennifer Karas Montez is with the Department of Sociology and Aging Studies Institute, Syracuse University, Syracuse, NY. Mark D. Hayward is with the Department of Sociology and Population Research Center, University of Texas at Austin.
Am J Public Health. 2021 Apr;111(4):708-717. doi: 10.2105/AJPH.2020.306064. Epub 2021 Feb 18.
To estimate total life expectancy (TLE), disability-free life expectancy (DFLE), and disabled life expectancy (DLE) by US state for women and men aged 25 to 89 years and examine the cross-state patterns. We used data from the 2013-2017 American Community Survey and the 2017 US Mortality Database to calculate state-specific TLE, DFLE, and DLE by gender for US adults and hypothetical worst- and best-case scenarios. For men and women, DFLEs and DLEs varied widely by state. Among women, DFLE ranged from 45.8 years in West Virginia to 52.5 years in Hawaii, a 6.7-year gap. Men had a similar range. The gap in DLEs across states was 2.4 years for women and 1.6 years for men. The correlation among DFLE, DLE, and TLE was particularly strong in southern states. The South is doubly disadvantaged: residents have shorter lives and spend a greater proportion of those lives with disability. The stark variation in DFLE and DLE across states highlights the large health inequalities present today across the United States, which have significant implications for individuals' well-being and US states' financial costs and medical care burden.
为了评估美国各州 25 至 89 岁女性和男性的总预期寿命（TLE）、无残疾预期寿命（DFLE）和残疾预期寿命（DLE），并考察各州之间的模式差异。我们使用了 2013-2017 年美国社区调查和 2017 年美国死亡率数据库的数据，为美国成年人计算了按性别和州划分的 TLE、DFLE 和 DLE，以及最差和最好情况的假设值。对于男性和女性，DFLE 和 DLE 因州而异。在女性中，西弗吉尼亚州的 DFLE 为 45.8 岁，而夏威夷州为 52.5 岁，相差 6.7 岁。男性的差距也类似。女性的 DLE 差距为 2.4 年，男性为 1.6 年。DFLE、DLE 和 TLE 之间的相关性在南部各州尤为强烈。南部地区处于双重劣势：居民的寿命更短，残疾的比例更高。各州之间在 DFLE 和 DLE 方面的显著差异突显了当今美国存在的巨大健康不平等，这对个人的幸福感以及美国各州的财政成本和医疗负担都有重大影响。
