Those factors haven’t occurred in a vacuum. They’re connected to what the CDC called “the social determinants of health” — “economic policies and systems, development agendas, social norms, social policies, racism, climate change and political systems.”
Americans with the shortest life expectancies “tend to have the most poverty, face the most food insecurity, and have less or no access to healthcare,” Robert H. Shmerling of Harvard Medical School wrote in October. “Additionally, groups with lower life expectancy tend to have higher-risk jobs that can’t be performed virtually, live in more crowded settings, and have less access to vaccination, which increases the risk of becoming sick with or dying of COVID-19.”
The most important governing factor is economics, observes Jeremy Ney, an expert in graphically displaying social and economic disparities.
“There’s a really strong relationship between life expectancy and income,” Ney told me. “Income is tied in with a lot of other things, like your ability to afford healthcare, your housing security, your distance from a toxic chemical site, things like that.”