Wrong Zip Code Can Signal Shorter Life Expectancy

The Treme neighborhood is only a few miles from the Lakeview neighborhood in New Orleans, but in terms of life expectancy those few miles might as well be worlds away.

While residents in Lakeview have a life expectancy of approximately 80 years, which is slightly more than the U.S. average of 79 years, the life expectancy for Treme residents is only 54.5 years, which is lower than the life expectancy in Cambodia, Gabon or Guinea.

A series of maps recently released by the Robert Wood Johnson Foundation, the largest U.S. philanthropy organization devoted to public health, was designed to draw attention to the fact that, in many cities, different neighborhoods can have vastly different life expectancies, some on par with the life expectancies of developing countries.

In addition to New Orleans, the foundation also released maps for Washington, D.C., San Joaquin Valley, Calif., Minneapolis-St. Paul, Minn., and Kansas City, Mo.

For Washington, different metro stops corresponded to the different life expectancies, while in San Joaquin, living off the right exit meant getting a few extra years.

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However, New Orleans had the most significant difference in life expectancies.

Andre Perry, dean of urban education at Davenport University, compiled data on the social factors that determine health in New Orleans neighborhoods as the team leader of the Orleans Parish Place Matters team. The team was part of an initiative created by the Joint Center for Political & Economic Studies.

Perry said the team looked a variety of factors including poverty, education and violence, and how they affect life outcomes.

"I always say people are not genetically disposed to live 25 years less," said Perry. "You should not live a mile away and have a 20-something-year advantage on your life."

However, Perry said the team found no one factor that was the main reason for lower life expectancy in some neighborhoods.

"It's the constant exposure to crime, to processed foods, to low-performing schools, to stress, to violence, to all of these factors. [They] compound and have a dramatic effect on your body," said Perry. "There's a physiological response to these sociological issues."

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According to calculations from the Virginia Commonwealth University Center on Human Needs, residents in the 70112 zip code, which includes the Treme neighborhood, had the highest rates of cardiovascular mortality, stroke mortality, and diabetes mortality. It was also the poorest zip code in the city, with the third largest population of people over 25 without a high school diploma.

Dr. Steve Woolf, a physician and director of the Virginia Commonwealth University's Center on Society and Health, helped with research for the different maps. Woolf said that the staggering differentiations in life expectancy were not limited to New Orleans, but all large American cities.

"[There are] many cities around the country where life expectancy is comparable to developing countries," said Woolf. "The New Orleans example is very dramatic but it's happening all across the country."

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Diagnosis of Early Breast Cancer Doesn’t Shorten Life Expectancy of Older Women

Among women age 67 or older, a diagnosis of ductal carcinoma in situ (DCIS) or Stage I breast cancer doesn’t appear to worsen survival; survival is similar to that of older women without breast cancer. Diagnosis of more advanced breast cancer, however, is linked with worse survival. These results were published in the Journal of Clinical Oncology.

Older women are a rapidly expanding segment of the U.S. population. The incidence of breast cancer increases with age, but it’s been uncertain how a diagnosis of breast cancer (particularly early-stage breast cancer) affects life expectancy among older women.

To explore the impact of a breast cancer diagnosis on the survival of older women, researchers conducted a study among more than 64,000 women who had been diagnosed with breast cancer at age 67 or older. Survival in these women was compared with survival in a group of similarly aged women without breast cancer. In the analysis, the researchers accounted for the other health problems, prior mammography use, and sociodemographic variables.??

Women who were diagnosed with DCIS or Stage I breast cancer and received standard treatment had similar survival to women without breast cancer. The most common cause of death among women with DCIS or Stage I breast cancer was cardiovascular disease. Women with Stage II or higher breast cancer had shorter survival than women without breast cancer. Risk of death was 50% higher among women with Stage II breast cancer, three-times higher among women with Stage III breast cancer, and close to 10-times higher among women with Stage IV breast cancer. The survival differences between women with advanced breast cancer and women without breast cancer decreased with age.

These results suggest that among older women, a diagnosis of DCIS or Stage I breast cancer does not shorten life expectancy.

Reference: Shonberg MA, Marcantonio ER, Ngo L, Li D, Silliman RA, McCarthy EP. Causes of death and relative survival of older women after a breast cancer diagnosis. Journal of Clinical Oncology. Early online publication March 14, 2011.

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