Some Places Are Better

healthy longevity place Jan 17, 2024

With the popularity of the Netflix show Live to 100: Secrets of the Blue Zones, more people are recognizing that where one lives not only influences lifespan, but also “healthspan” (the number of years one is in good health). It’s not just living longer, but living better longer. The organization, Blue Zones, identifies several places where people live longer and healthier, including Sardinia, Italy; Okinawa, Japan; Nicoya Peninsula, Costa Rica; and Icaria, Greece. Notably, most blue zones, with the exception of Linda Loma, CA, are international.

However alluring a blue zone may be, relocating to another country based principally on health considerations is unrealistic for the vast majority of people. On the other hand, moving within a country, state, county, or metropolitan area is more possible. Based on an increasing body of research on the impact of place and health, we are learning more about which places in the U.S. promote healthy outcomes.

 

Among cities with a population of at least 150,000 people, the top 20 ranked cities are in blue and the bottom 20 are in red. The Mississippi River seems to be a dividing line. (Source: Index of Deep Disadvantage at the University of Michigan)

 

Some Places are Better in the U.S.

Researchers at Princeton University and Michigan University have taken a data-driven approach to glean a better understanding of which places in the U.S. are more or less likely for people to thrive. The Index of Deep Disadvantage of the University of Michigan was created by Luke Shaefer, Kathryn Edin and Timothy Nelson and incorporated in their recent book, The Injustice of Place. They considered five measures: two traditional income poverty indicators (the official poverty rate and the rate of deep poverty, meaning those with incomes below half the poverty line), two markers of health (low birth weight and life expectancy), and the rate of intergenerational mobility for children who grow up low-income. Their research investigated all counties and cities in the U.S., a database of over 3,500 distinct places.

The researchers found stark differences between the 200 best places and 200 worst places in their database. For example, life expectancy is roughly 10 years higher (83.1 vs. 74.2), poverty is about 1/5 less common (5.6% vs. 26.8%), the percentage of college graduates is more than double (48.6% vs. 22.8%) and residents are significantly more likely to own their home (72% vs. 51.9%). There is a considerable difference in violence, too: deaths from interpersonal violence is 1/6th as frequent (2 per 100K vs. 12.5 per 100K).

 

There are big disparities between the highest and lowest ranking places (Source: Modified table from The Injustice of Place)

 

Go West (and Midwest!) Young Man

The top cities tend to be in the West. For cities with a population of at least 150K, 19 of the 20 highest ranked cities are west of the Mississippi River (Cary, North Carolina is the one exception.) Cities in California, such as Fremont, San Jose and Irvine, Texas, including McKinney and Frisco, and Arizona, including Scottsdale, are the most represented.  

At the county level, the best places are predominately in the upper Midwest, states such as North Dakota, South Dakota, Minnesota, Nebraska, Iowa, and Kansas. The researchers visited small towns for counties that scored well and found them remarkably unremarkable. The towns have “few, if any, imposing homes” and the landscape offer “nothing striking.” Part of their success may be attributed to a lack of inequality within and among these towns and ability to support a middle class made up of small-business owners, managers, administrators, doctors, nurses, and teachers along with electricians, plumbers, and the more prosperous farmers. These places have high social connection and low measures of corruption and violence. 

 

Past as Prologue

The places that struggle most are clustered in the Southeast, Rust Belt and Appalachia. Indeed, for cities with a population of at least 150K, 19 of the 20 locations are east of the Mississippi River (Shreveport, LA is the one exception and lies close to the Mississippi River), with most cities in the Southeast and Rust Belt.

The researchers point to the history of these regions that has led to today’s realities. Many of these places have been struggling for decades, if not longer. Many of them have a legacy of income inequality, unequal schooling, violence, government corruption and weak social infrastructure. These places have also been adversely impacted by globalization. In this sense, past is not just prologue; without sufficient change and intervention, today’s challenges are likely to persist into the future.

Even in these challenged places, there still me be pockets of desirable locations. That said, the reality is that adjoining neighborhoods affect each other for better or worse. They can be seen as swimming in the same pool. You can’t only clean the part of the pool you are swimming in. (This metaphor is from David Brooks’ The Second Mountain: The Quest for a Moral Life.)

 

Home is a Profoundly Personal Choice But Data Matters

Where one calls ‘home’ is often a deeply emotional decision. For those that are “somewhere” people – people that consider a small, finite number of places as home – it is important to understand the data of your place to appreciate how best to thrive. If you live in a challenged place, the information can help you protect yourself or be an agent of positive change. If you live in a thriving place, it can help you appreciate the benefits of your home and find ways to make it even better.

For those that are able and willing to relocate to a different place, pay attention to the what the data tells you. As research evolves and insights become more detailed and accurate, the best places to thrive are likely to become more evident. And, as it did for one best-selling author, don’t be surprised if takes you to the upper Midwest.

 

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