When it comes to health, could geography be destiny?
What if moving from Amarillo to Fort Worth could add about three years to your life? If you’re in El Paso, what if you could move just three miles down the road to add 10 years to your life?
Of course, making moves like this would not magically bestow a longer lifespan. But statistically, people in Fort Worth live longer than those in Amarillo, and those in the Eastwood Park neighborhood of east El Paso tend to outlive those in the Fort Bliss area, even though they’re in adjoining ZIP codes.
There are many reasons for the huge differences in health across geographic areas: Variations in income, education, housing, the availability of healthy food, environmental hazards, opportunities to exercise, transportation options, and prevalence of racial segregation all play into the equation, according to a 2016 report by Virginia Commonwealth University (tma.tips/LifeExpectancyVCU). So does access to primary care doctors and good hospitals.
Eduardo Sanchez, MD, who is chief medical officer for prevention and chief of the Center for Health Metrics and Evaluation for the American Heart Association in Dallas, agrees with other public health experts that your ZIP code is more important to your health than your genetic code.
“Where you live influences what you’re able to do with regard to lifestyle factors and with regard to medical factors,” he said. “And those [lifestyle factors] are going to be the kind of neighborhood you live in, the housing you actually live in, what is in your neighborhood — are there parks? Are there grocery stores? Is it a safe place to live? Is there a pharmacy?”
Dr. Sanchez said physicians can address this in their offices by systematically collecting the data that’s important to know about their patients, such as income level, education level, race, and ethnicity. But he said doctors also need to “make it our business to understand the neighborhoods our patients live in. That way, they’ll know if a patient can’t exercise easily because of concerns about crime, or lack of sidewalks, or heavy air pollution, or poor housing conditions [that] might trigger asthma.”
Tex Med. 2018;114(5):22-27
May 2018 Texas Medicine Contents
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