Society of Certified Senior Advisors: Want To Live Longer? Move.

A new study has found that older adults who move from low-longevity areas to high ones can increase their lifespan by more than a year.

Where you decide to live at age 65 can make a measurable difference in how long you can expect to live, according to a new study. “There’s a substantively important causal effect of where you live as an elderly adult on mortality and life expectancy across the United States,” says Amy Finkelstein, a professor in MIT’s Department of Economics and co-author of the paper that lays out the team’s findings.

Health Capital vs. Place-Based Factors

Researchers have known for a long time that lifespan is greater in certain parts of the U.S., a fact generally attributed to “health capital,” or links with smoking, obesity, and related factors in the regionalized population. However, scientists were able to account for those differences and still quantify for the location itself and its impact on longevity. Their report, published in the August 2021 issue of American Economic Review, is titled “Place-Based Drivers of Mortality: Evidence of Migration.”

“We wanted to separate out the role of people’s prior experiences and behaviors — or health capital — from the role of place or environment,” Finkelstein says.

Zip Codes Matter

A couple years back, researchers at Stanford University and the Massachusetts Institute of Technology paired up to look at how life expectancy varied on a micro level between individual zip codes. Their groundbreaking work found that in some cities, the gulf between dying in your fifties or dying in your eighties was separated by only a few blocks.

Factors like income, social class, and overall health appeared to be the drivers for the difference. Income and life expectancy are inextricably linked, although it varies substantially across different areas.

The study utilized Medicare records from 1999 to 2014 to examine U.S. residents from 65 to 99 years old, or 6.3 million beneficiaries. It looked at the 2 million people who had moved from one commuting zone (of which the U.S. Census Bureau defines about 700 across the nation) to another in the 15-year time frame. The researchers were able to account for a wide range of diseases and conditions using a standard mortality risk model.

One way to do that was to compare the outcome for two people who had moved from the same place to two different places. “The idea is to take two elderly people from a given origin, say, Boston. One moves to low-mortality Minneapolis, one moves to high-mortality Houston. We then compare how long each lives after they move,” says Finkelstein.

Findings

So where did people live the longest? Perhaps surprisingly, coastal urban centers such as New York City, Miami, and San Francisco had positive effects on lifespan. Some urban Midwestern cities, such as Chicago, also scored high.

By contrast, many Southern states fared poorly, including Alabama, Arkansas, Louisiana, and northern Florida. Older adults also didn’t live as long in the Southwest, including in certain areas of Texas, Oklahoma, New Mexico, and Arizona.

All told, researchers estimated that the health capital component was responsible for about 70 percent of the geographical difference in longevity, while location effects accounted for 15 percent. “Yes, health capital is important, but yes, place effects also matter,” says Finkelstein.

The Charlotte Effect

While conducting the study, economists uncovered another unexpected pattern. Certain places with overall low life expectancy, such as Charlotte, North Carolina, have a positive effect on longevity for those who move there. Conversely, other areas with high life expectancy, such as Santa Fe, New Mexico, had low effects on improving lifespan for older adults who moved there.

“Our [hard] evidence is about the role of place,” Finkelstein says, while noting that the next logical step in this vein of research is to look for the specific factors at work. “We know something about Charlotte, North Carolina, makes a difference, but we don’t yet know what.” Further studies are underway.

One hypothesis is that regional health care practices may impact place-based norms. Health care utilization may also play an important role. “Differences in health care across places are large and potentially important,” Finkelstein says. “But there are also differences in pollution, weather, [and] other aspects. … What we need to do now is get inside the black box of ‘the place’ and figure out what it is about them that matters for longevity.”