Life Expectancy Linked to Population Well-Being Measures at the County Level

A recent study has found a positive association between a county’s well-being score and life expectancy, even after controlling for race, poverty, and education. The findings indicated that investing in local well-being initiatives could improve the quality of life and increase longevity for that community.

The study published in Health Affairs defined population well-being as a measure that includes physical, emotional, and social health. In the study, well-being indicated not only the absence of disease, but the positive feelings of opportunity, happiness, and lack of stress among the individuals within a community. Examples of factors that promote well-being include stable access to food, housing, and healthcare, as well as safe neighborhoods and respectful workplaces.

“Compared with residents of a community with low well-being, residents of a community with high well-being may be more likely to engage in healthy behaviors, develop social connections, and build strong support systems,” the researchers wrote. “Living in a community with high well-being may also promote resilience, buffer the negative impact of stressful events, and improve health throughout the life course.”

To test the hypothesis that these positive effects within a population could result in longer lifespans, the study analyzed county-level estimates of well-being along with county-level life expectancy estimates. It also conducted statistical analysis after controlling for the factors of race, poverty, and education.

For each increase of 1 standard deviation in well-being score, life expectancy was 1.9 years higher for women and 2.6 years higher for men. After adjusting for the 3 other factors, the associations were less pronounced but still significant, resulting in a 0.9 year higher female life expectancy and 1.1 year higher male life expectancy associated with every increase of 1 standard deviation in well-being score.

The dimensions of well-being most strongly associated with gains in longevity were physical health, healthy choices, and basic access (which includes perception of safety and access to housing and healthcare). Each of the other 3 domains, emotional health, life evaluation, and work environment, were also significantly associated with life expectancy.

The study also found that well-being could at least partially account for the association of poverty, race, and education with life expectancy. For instance, poverty was the factor most strongly associated with decreased life expectancy, but some of that effect was mediated by lower well-being among those groups.

Previous studies have found positive associations between life expectancy and specific components of well-being, such as healthy behaviors or safe neighborhoods. However, the authors stated this is the first study to find a relationship between a summary measure of a county’s well-being and the life expectancy for those populations.

The study suggested that community-based initiatives to increase well-being could reduce health disparities and increase life expectancy. It also recommended enacting social and economic policies that promote job opportunities, affordable housing, and social cohesion in the hopes that they will boost well-being and life expectancy.