To Live And Die In LA (And Other US Zip Codes)

A new major study in the Journal of the American Medical Association finds that when adjusting for race and income, where you live may have a major impact on your given life expectancy. Wealth is the number one factor and the more money you have, the longer you'll live, but the less money you have, the more geography plays a part in life expectancy.

The poor in some cities — big ones like New York and Los Angeles, and also quite a few smaller ones like Birmingham, Ala. — live nearly as long as their middle-class neighbors or have seen rising life expectancy in the 21st century. But in some other parts of the country, adults with the lowest incomes die on average as young as people in much poorer nations like Rwanda, and their life spans are getting shorter.

In those differences, documented in sweeping new research, lies an optimistic message: The right mix of steps to improve habits and public health could help people live longer, regardless of how much money they make.

One conclusion from this work, published on Monday in The Journal of the American Medical Association, is that the gap in life spans between rich and poor widened from 2001 to 2014. The top 1 percent in income among American men live 15 years longer than the poorest 1 percent; for women, the gap is 10 years. These rich Americans have gained three years of longevity just in this century. They live longer almost without regard to where they live. Poor Americans had very little gain as a whole, with big differences among different places.

And it's not just race that plays a part, either.  Again the paper finds evidence that white Americans are suffering from shorter life expectancies if they are poor.  Money buys options, and being well-educated and prosperous leads to a longer life regardless of race.

Life expectancy for the poor is lowest in a large swath that cuts through the middle of the country, and it appears in pockets in the rest of the country, in places like Nevada. David M. Cutler, a Harvard economist and an author of the paper, calls it the “drug overdose belt,” because the area matches in part a map of where the nation’s opioid epidemic is concentrated.

The new findings dovetail with a much-discussed paper by Anne Case and Angus Deaton published last year. That research showed rising death rates among middle-age white Americans, especially those with low education. It also showed a sharp increase in drug and alcohol poisonings, suicides and accidents in the first years of this century. Research from the Brookings Institution published in February also found a growing gap in life span between the rich and the poor. 

“There is some deeper distress going on among white middle-aged Americans that may continue to propel these mortality rates higher,” Mr. Deaton, a Princeton economist who wrote an editorial critiquing the new paper by Mr. Chetty and his colleagues, said in an interview. “If so, these people at the bottom will live even less long than they’re calculating.”

The places in America with the worst overall life expectancy aren't Detroit or the Appalachians or Chicago, like the media would have us expect.  Rather, it's the Texas-New Mexico border area (Midland-Odessa, Lubbock, and especially Pecos) and southwestern Indiana (Terra Haute and Vincennes) where your average life expectancy is 5-7 years less than New York City or San Francisco.

But if you're poor, that gets even worse no matter where you are.

Something to think about.  If you're poor, avoid the Ohio/Kentucky/Indiana tri-state.  Hell, being poor in the Midwest is worse than being poor in the South.  That should tell you something.

Rally Points

Nate Silver says the math doesn't add up when it comes to Republicans backing Trump, in particular conservatives who've long hated him and found him distasteful, or something.

If a realignment is underway, then it poses a big empirical challenge. Presidential elections already suffer from the problem of small sample sizes — one reason a lot of people, certainly including us, shouldn’t have been so dismissive of Trump’s chances early on. Elections held in the midst of political realignments are even rarer, however. The rules of the old regime — the American political party system circa 1980 through 2012 — might not apply in the new one. And yet, it’s those elections that inform both the conventional wisdom and statistical models of American political behavior. 

This doesn’t necessarily mean we’ll be completely in the dark. For one thing, the polls — although there’s reason to be concerned about their condition in the long-term — have been reasonably accurate so far in the primaries. And some of the old rules will still apply. It’s probably fair to guess that Pennsylvania and Ohio will vote similarly, for example. 

Still, one should be careful about one’s assumptions. For instance, the assumption that the parties will rally behind their respective nominees may or may not be reliable. True, recent elections have had very little voting across party lines: 93 percent of Republicans who voted in 2012 supported Romney, for example, despite complaints from the base that he was insufficiently conservative. And in November 2008, some 89 percent of Democrats who voted supported Barack Obama after his long battle with Hillary Clinton.

But we may be entering a new era, and through the broader sweep of American history, there’s sometimes been quite a bit of voting across party lines. The table below reflects, in each election since 1952, what share of a party’s voters voted against their party’s presidential candidate (e.g., a Democrat voting Republican or for a third-party ticket). There’s a lot of fascinating political history embedded in the table, but one theme is that divisive nominations have consequences.

ELECTION	DEMOCRATS	REPUBLICANS
1952	23%	8%
1956	15	4
1960	16	5
1964	13	20
1968	26	14
1972	33	5
1976	20	11
1980	33	15
1984	26	7
1988	17	8
1992	23	27
1996	15	19
2000	13	9
2004	11	7
2008	11	10
2012	8	7

Silver has a mild point.  Reagan Democrats in 1980 and 1984 did make a difference, as did the Dems who jumped ship on McGovern in 72. and those elections certainly broke that mold, but look at the last 4 presidential elections.  

There's very little party-flipping, and what does happen effectively cancels out.

So no, I see something very close to what we've seen before, somewhere around a meager 10% of voters switching up, and it happening on both sides, effectively neutralizing the phenomenon.  90% of voters are going to stick with their party in November.

Another massive Democratic defection like 1972 or 1980 isn't going to happen in our heavily partisan body politic.  Worst case scenario is 1992, where about 25% of voters switched up, but it happened on both sides, and that was with Perot clogging up the works.

I don't think you'll see mass defections on either side.  Too much tribalism.