By Melissa Davlin, Idaho Reports
If you’re a man in north Idaho’s Benewah County, you can expect to live about 74 years.
But if you drive south through the rolling hills of the Palouse, you’ll soon end up in Latah County, where men live an average of 78 years — four years longer than their immediate neighbors to the north.
The disparity demonstrates what sociologists and doctors have long known: How long you live might depend on which county you call home, and there’s no one cause, or solution, to the problem.
The gap between Latah and Benewah is one of many stark examples of Idaho life expectancy differences. If you’re a man who lives in Canyon County, your life expectancy of 76 years is two years less than your neighbors 10 minutes down the road in Ada County. Men in Teton County live an average of nearly 81 years; just south in Bonneville, that drops to 76.5. Blaine County women live more than three years longer on average than women to the south in Lincoln County, and five years longer than those to the east in Custer County.
Those numbers come from the Robert Wood Johnson Foundation, which aggregated five years’ worth of county-level data from the Institute for Health Metrics and Evaluation.
There are some caveats to this data. Some sparsely populated counties located in the same region have the same averages, suggesting they were grouped together for the data analysis. The data also comes from a 2013 report, and health outcomes may have shifted since then. (Click here to see county by county data. You can also see the data for women here, and the data for men here.)
Upon request, the Idaho Department of Health and Welfare provided its own numbers based on analysis of deaths between 2013 and 2017. That data is slightly different than the Robert Wood Johnson Foundation’s, and, in some cases, suggests even larger inequities between counties. For example, Benewah’s life expectancy stayed near 74 years, while Latah’s jumped to 81 years.
Why the disparities? It’s not just medical access and quality of care. Other factors — income, education, economic opportunities, and housing security — play into a person’s life span.
“Social context and statuses play an important role in shaping a person’s life experiences and life chances, and race, gender and geography have all been found to influence life expectancy,” said Rebecca Som Castellano of Boise State University’s Department of Sociology.
Poverty is also strongly correlated with low life expectancies, said Brian Wolf, Department of Sociology and Anthropology chairman at University of Idaho. That holds true in Benewah County, where two-thirds of children qualify for free and reduced lunch at school, and the median household income is about $39,000. (Compare that to Idaho as a whole, with 48.5 percent of kids qualifying for free and reduced lunch, and a median household income of $47,500.)
“Socioeconomic disadvantage and poverty are strongly associated with both rurality and mortality, and many of the parts of the country with the lowest life expectancy are rural places,” Som Castellano said.
Katherine Hoyer, public information officer for the Panhandle Health District, said a number of other social factors could weigh in on Benewah County’s low life expectancies. A recent assessment by the Panhandle Health District showed Benewah’s teen pregnancy rates are higher than Idaho’s as a whole, as are infant mortality rates. Benewah ranks worse than Idaho on average in a number of other categories: Food insecurity, access to fresh fruits and vegetables, high blood pressure, cancer rates, and the number of people with higher education and high school diplomas.
Benewah County also includes part of the Coeur d’Alene Reservation. American Indian communities experience health care and mortality disparity throughout the country, though a breakdown on race wasn’t available in Benewah County’s mortality statistics through the Robert Wood Johnson Foundation. (A representative of the Coeur d’Alene Tribe couldn’t be reached for comment.)
So what’s the solution? With so many factors, there’s no one answer. Supporters of Proposition 2, on the ballot in November, hope to address medical issues by making more people eligible for Medicaid, but that won’t immediately fix all barriers to receiving medical care, such as rural doctor shortages and lack of transportation to medical appointments.
The state has focused on improving go-on rates, or the number of high school students who pursue higher education, but has seen limited success. In Benewah County, the 4-H Extension Office has set up garden boxes for fresh vegetables, and a food distribution program attempts to tackle hunger in the community. And the Panhandle Health District is currently working on updating its Community Health Improvement Plan for its north Idaho counties.
“It is often the intersection of multiple dimensions that leads to a lower life expectancy,” Som Castellano said.
And those multiple dimensions will require multiple strategies to overcome.
Reporter’s note: Journalist Suzanne Bohan explores the concept of social determinants affecting life expectancy in “Twenty Years of Life: Why the Poor Die Earlier and How To Challenge Inequity.” In July, I attended a session on this topic by Bohan at an Association of Health Care Journalists training, through which I have a fellowship.
Over the next year, Idaho Reports is digging deep into healthcare issues throughout Idaho as part of the AHCJ fellowship. Keep following us online and on the air for more.