The Surprising Driver of NYC's Long Life Expectancy

When we take a closer look at the new research and really dig into the data--stay with me!--it appears that we are in fact right on par with the national average, and that the "two years better than average" claim doesn't really fly.
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A report published earlier this year in the journal Population and Development Review shows that average life expectancy in New York City increased dramatically in New York City between 1990 and 2010. During that 20-year stretch, life expectancy for female New Yorkers rose by nearly 4 years, and life expectancy for males increased by 6 years. Much of this increase is attributable to reductions in deaths related to HIV/AIDS, homicide, drugs, and alcohol. Effective public policies and public health interventions have been critical to these improvements, and the City deserves a lot of credit for implementing and spreading approaches that improve health and extend life.

The new paper also looked at New York City's life expectancy compared to other regions'. In recent years, we New Yorkers have bragged that our life expectancy now exceeds the nation's by nearly two years. And, the paper confirms this number.

But when we take a closer look at the new research and really dig into the data--stay with me!--it appears that we are in fact right on par with the national average, and that the "two years better than average" claim doesn't really fly.

How can that be? While it's clear that our public health policies have been responsible for New York City's gains in life expectancy over the last 20 years, our comparative advantage over the national average is attributable almost entirely to our high concentration of immigrants. Nearly 38% of New York City residents are foreign-born, compared to less than 14% nationally. Foreign-born New Yorkers live 83 years on average, but this is also true of foreign-born people living in other parts of the country. U.S.-born New Yorkers live almost 78 years, but so do U.S.-born residents living elsewhere in the United States. So what's happening?

First, it seems clear that New York City's welcoming immigration policies and practices are good news for the health of the overall population.

But for those of us focused on health policy, it's a bit of wake-up call. Despite our impressive gains over the last 20 years, New York has more work to do than we might have realized when it comes to ensuring longer, healthier lives for our native-born residents. We are doing well, but we're not the over-achievers we seem to be at first glance. The gains we achieved between 1990 and 2010--for both native-born and foreign-born new Yorkers--really just made us catch up to the life expectancy patterns in the rest of the country.

The other challenge is that disparities continue to persist when it comes to life expectancy. A New York Times article, aptly titled, "Income Gap, Meet the Longevity Gap," examined the disparities in health and life expectancy between residents of Fairfax County, Va., and McDowell County, W.VA.

We see those same types of differences here in New York City, across boroughs (life expectancy is nearly four years longer for someone living in Manhattan than in the Bronx) and along racial and socioeconomic lines. A report from the New York City Department of Health and Mental Hygiene looked at the association between poverty and longevity. White New Yorkers had a life expectancy of about 81 years in 2010, compared to 77 years for black New Yorkers. That same year, life expectancy for New Yorkers living in low-poverty neighborhoods was 83 years, while for those in high-poverty neighborhoods, it was 79 years.

There is some promising news: we are making progress toward closing these gaps. In 2001, the difference between black and white New Yorkers' longevity was nearly five years; it improved to just more than four years in 2010. And that four-year difference attributable to poverty in 2010 was down from a five-year disparity in 2001. Clearly, we still have work to do, but we are moving in the right direction and we now know improvements are possible.

What more needs to be done? How might New York City become a true leader when it comes to the health and longevity of all of its residents?

We need to double-down on efforts to reduce those gaps, with a relentless focus on improving the health of lower-income and black New Yorkers. A range of ambitious public health measures have been introduced in New York City over the last decade or so, from smoke-free indoor air policies, to nutrition information on restaurant menus, to a ban on trans fats, to efforts to make affordable, nutritious foods more available in low-income neighborhoods, to the introduction of CitiBikes. We need to continue to devise and implement these types of creative ideas to improve the health of all New Yorkers.

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