Heterogeneity in Disparities in Life Expectancy Across US Metropolitan Areas

Alina S. Schnake-Mahl, Pricila H. Mullachery, Jonathan Purtle, Ran Li, Ana V. Diez Roux, Usama Bilal

Research output: Contribution to journalArticlepeer-review


Background: Life expectancy in the United States has declined since 2014 but characterization of disparities within and across metropolitan areas of the country is lacking. Methods: Using census tract-level life expectancy from the 2010 to 2015 US Small-area Life Expectancy Estimates Project, we calculate 10 measures of total and income-based disparities in life expectancy at birth, age 25, and age 65 within and across 377 metropolitan statistical areas (MSAs) of the United States. Results: We found wide heterogeneity in disparities in life expectancy at birth across MSAs and regions: MSAs in the West show the narrowest disparities (absolute disparity: 8.7 years, relative disparity: 1.1), while MSAs in the South (absolute disparity: 9.1 years, relative disparity: 1.1) and Midwest (absolute disparity: 9.8 years, relative disparity: 1.1) have the widest life expectancy disparities. We also observed greater variability in life expectancy across MSAs for lower income census tracts (coefficient of variation [CoV] 3.7 for first vs. tenth decile of income) than for higher income census tracts (CoV 2.3). Finally, we found that a series of MSA-level variables, including larger MSAs and greater proportion college graduates, predicted wider life expectancy disparities for all age groups. Conclusions: Sociodemographic and policy factors likely help explain variation in life expectancy disparities within and across metro areas.

Original languageEnglish (US)
Pages (from-to)890-899
Number of pages10
Issue number6
StatePublished - Nov 1 2022


  • Health disparities
  • Life expectancy
  • Social inequalities
  • United States
  • Urban health

ASJC Scopus subject areas

  • Epidemiology


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