Evaluating Causes of Geographic Disparities in Life Expectancy Using Partitioning Approach

Igor Akushevich , Duke University
Julia Kravchenko, Duke University
Arseniy Yashkin, Duke University
Anatoliy I. Yashin, Duke University

Persistent interregional disparities in health outcomes and life expectancy (LE) represent an important problem for the U.S. health system. We developed a computational approach involving four scenarios on how these disparities could be evaluated using health measures extracted from Medicare data: regions with lower LE exhibit i) higher disease incidence, ii) worse patient survival, iii) higher multimorbidity, and/or iv) worse health state of individuals aged 65 (time of entry into the Medicare system). Our four-step computational approach includes: i) ranking diseases according their effect on mortality, ii) evaluation of the contribution of the most lethal disease(s) to the disparity in LE, iii) iterative analyses of other disease contributions, and iv) explanation of how the disparities in all scenarios are generated in by clinic and non-clinic-related factors. Evaluation of factors contributing to interregional differences in LE will ultimately inform the design of the strategies to improve public health and healthcare systems.

See extended abstract

 Presented in Session 5. Health & Mortality 1