The U.S. doesn't just have an inequality gap—it also has a lifeexpectancy gap.

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That's according to a study from the University of Washington,published in the journal JAMA Internal Medicine, which finds that the county inwhich you live can add—or subtract—as much as 20 years, or evenmore, from your lifespan.

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Findings from the study, reports The Guardian, reveal thatresidents of specific affluent counties in central Colorado had thehighest life expectancy at 87 years.

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But several counties in North and South Dakota, often home toNative American reservations, could cut that down to just 66.

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Researchers also predict that the gap will become even wider inthe future; during the period studied—1980–2014—11.5 percent ofU.S. counties saw the risk of death for residents aged 25–45increase. No previous study, the report says, “has put thedisparity at even close to 20 years.”

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Says The Guardian, “Previous studies recorded lower variationsranging from 12 to 17 years between counties, with the highest andlowest life expectancies in both 2007 and 2010. These were anunderestimation, according to the University of Washington team,because data from smaller counties was either combined with othersor excluded altogether.”

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“This is way worse than any of us had assumed,” Ali Mokdad,professor of global health at the University of Washington'sInstitute for Health Metrics and Evaluation and one of the authorsof the study, is quoted saying in the report.

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He adds, “You expect disparities in any country, but you don'texpect the disparities to be increasing in a country with ourwealth and might. We spend more money on healthcare than anybodyelse, and we debate the hell out of healthcare more thananybody else, and still the disparities are increasing.”

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Mokdad points to the dispute in Congress over health insuranceas an example of how misleading the mere coverage by a healthinsurance policy can be, and how indicative it is ofinequality.

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“Many people don't have health insurance, but even among thosewho do it's misleading,” he says in the report, adding, “Myinsurance, for example, allows me to go to a doctor for an exam anda blood test and they'll tell me if I have a problem early on. Manydon't have that luxury, only catastrophic insurance, so if they'rehit by a car they'll be treated.”

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He also highlights how location can play a role in other healthfactors, such as those who live in mountainous or rural areas whereit can take two hours to reach a good health facility in the eventof an emergency—or the poor areas within or just outside of richcities that are food deserts for such essentials as freshproduce.

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The study calculates overall average U.S. life expectancy at79.1 years, 5.3 years higher than in 1980—which is the beginning ofthe 35-year period for which researchers compared death records,census returns, the human mortality database and figures from theNational Center for Health Statistics on a county-by-countybasis.

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However, researchers caution that that 5.3-year increase “masksmassive variation at the county level,” adding.

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They added, “Counties in central Colorado, Alaska and along bothcoasts experienced much larger increases, while some southerncounties in states stretching from Oklahoma to West Virginia sawlittle, if any, improvement over this same period.”

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When it came to decline, variation again was key.

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Researchers write, “Similarly, there was considerable variationamong counties in the percent decline in the mortality risk withineach age group. While all counties experienced declines inmortality risk for children 0 to five years, and nearly allexperienced declines in the mortality risk for adolescents andolder adults 45 to 85, 11.5 percent [of counties] experiencedincreases in the risk of death between ages 25 and 45 years.”

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Where does the variation come from?

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The study points to differences in socioeconomic andrace/ethnicity factors, availability of and access to qualityhealth care and insurance, and “preventable risk factors” such assmoking, drinking and physical inactivity.

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But other factors cause problems, too, such as guns, automobileaccidents and drugs, which weigh on male lifespans, as well as theavailability of fresh fruits and vegetables in local markets andpeople's distance from health care providers—factors over whichthey have little or no control.

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Below you'll find the 7 states in which counties have thelongest lifespans or have experienced the greatest increase in lifeexpectancy, as well as the 7 states in which counties have thelowest lifespans or have experienced the greatest decrease in lifeexpectancy.

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The states are not in order, and you'll notice somethinginteresting as you go through both lists:

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7 regions in the U.S. with the longest life expectancy

7. Minnesota.

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Southern Minnesota boasts several counties where the length oflifespan is quite impressive.

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6. Colorado.

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Colorado offers some really impressive longevity statistics,although most of the counties accounting for that are mostlylocated in the central portion of the state.

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5. Wyoming.

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If you follow the admonition to “go west, young man,” you'llfind the majority of the Wyoming counties offering the best chanceat a lengthy life.

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4. Texas.

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Again, the western part of the state houses most of the countieswhere residents live longest—although there have been less notablegains in some other parts of the state.

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3. California.

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Everyone flocks to the coast in California, and the majority ofthe counties offering the chance for the longest life in the stateare coastal counties.

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2. Florida.

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Southwestern Florida offers residents the best chance at a longlife, having experienced a substantial increase in longevity overthe period of the study.

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1. Alaska.

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Some Alaska counties saw major increases in lifespan between1980 and 2014.

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7 regions in the U.S. with the lowest life expectancy

7. North Dakota.

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North Dakota and its neighbor to the south have the dubiousdistinction of having counties with the lowest lifeexpectancy—nothing to boast about.

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6. South Dakota.

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South Dakota shares the misfortune with North Dakota of havingcounties offering the lowest life expectancy.

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5. Oklahoma.

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Southern counties in a number of states, including Oklahoma, sawlittle or no improvement in lifespan over the course of the studyperiod.

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4. Mississippi.

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Rural western Mississippi is home to counties that do verypoorly when it comes to longevity—and they haven't experiencedmuch, if any, improvement over the life of the study.

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3. Kentucky.

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Eastern Kentucky is another state in which a number of countiessuffer from shorter lifespans.

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2. West Virginia.

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Southwestern West Virginia is another area where counties aresuffering.

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1. Alaska.

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Yes, Alaska actually makes both lists—while counties experiencedsubstantial increases in lifespan over the period of the study,life expectancy at birth across the state is nothing to boastof.

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