Is it possible that where you live could determine how healthy you are and how long you live? There’s mounting evidence that the answer to this question may be yes. I’ve written before about so-called “Blue Zones” — areas around the world that have a higher-than-average number of centenarians (people reaching age 100+). A recent study conducted by researchers at Washington State University (WSU) identified some of the social and environmental factors that may contribute to people’s extended lifespans in these and similar locations.
The study looked at Washington State mortality data for 144,665 people who died at age 75 and older, from 2011 to 2015, using survival analysis to examine who reached centenarian age. The average age of decedents in the sample was 86 years old. Among the 144,665, only 2,698, or 1.8 percent, reached age 100 or more with the oldest centenarian having died at the age of 114.
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Many factors impact longevity
When the data was adjusted for gender, race, education level, marital status, and neighborhood-level social and environmental variables, several factors emerged as having a positive correlation to reaching age 100.
Gender and race
Being female was found to be positively correlated with reaching age 100 among the sample, a common finding in many studies in both the U.S. and abroad. Theories for this gender disparity range from the biological to social differences to environmental factors such as healthy lifestyle choices.
Caucasians also were found to have a better chance of reaching centenarian status by the WSU researchers, another finding similar to many other studies. Studies in the U.S. consistently find higher mortality rates for African-Americans compared to white Americans at all ages (though there is a crossover at very old ages). Hispanics and Asians/Pacific Islanders, on the other hand, have lower mortality rates than Caucasians at all ages.
Researchers postulated that these differences among the races may be related to the effects of discrimination, lower socioeconomic status, and poorer health outcomes.
Increased neighborhood walkability/bikeability
The odds of becoming a centenarian were higher for those who lived in areas with a high walkability index score. The density of walkable (or bikeable) intersections, residential density, and mixed-use land (plus parks) are correlated with increased walking/biking behavior, giving residents of these areas easier access to public transit, healthy food, healthcare, and other services.
A community’s walkability also increases residents’ physical activity and has been directly linked to populations with lower body mass indexes and other measures of health. This is especially important for seniors who may have decreased mobility or who no longer drive.
Lower education level
Somewhat surprisingly, in this WSU study, those who held a high school diploma or university degree were less likely to become centenarians as compared to people with no high school diploma. Some other studies have found higher education levels to be strongly tied to increased longevity. Higher academic achievement often translates to employment opportunities, higher income, and other healthy lifestyle factors like not using tobacco products — all tied to a longer life.
The authors of the WSU study theorized that their unexpected findings were the result of the decreased influence of education level as a determinant of longevity, and an increased impact from biological aging factors. They cite another older study by sociologists from the University of Chicago that found little to no correlation between educational level and mortality for men and women of all ages in the U.S.
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Higher socioeconomic status
When mapped out, the WSU study uncovered geographic clusters with a higher prevalence of reaching age 100. These community clusters were primarily located in urban, higher socioeconomic tracts (per Census data) in the greater Seattle area, as well as in towns with higher socioeconomic areas in the greater Pullman region. Clusters with a lower prevalence of reaching age 100 were found in more rural census tracts of the state.
Socioeconomics has been tied to longevity in many studies, possibly because higher income is associated with healthier lifestyle choices (not smoking, exercise, etc.), as well as the ability to afford healthcare and enjoying more social connections and opportunities.
Living in an area with a higher percentage of working-age population (people age 15 to 64 who are employed) was associated with living longer. Relatedly, individuals living in small towns or rural areas were less likely to become a centenarian compared to those living in metropolitan areas.
Larger towns and cities are more likely to have younger populations and more people in the workforce, which also is linked to higher educational levels and increased income. Working-age populations are drawn to cities because of the greater availability of jobs, better access to services and programs (including from community organizations), and often, working-age people have a preference for a more metropolitan lifestyle (restaurants, shopping, arts, entertainment, etc.).
Communities with more working-age residents have higher socioeconomic status, more government support, and better access to transportation and healthcare services — factors that themselves increase longevity and the likelihood of reaching age 100. Perhaps tying these factors together, younger people moving away from rural areas to more urban communities also means less support and services for the elderly who are left behind in those rural places.
Another surprising finding from the WSU study: People who were never married, divorced/separated, or widowed at the time of their death were more likely to become centenarians as compared to those who were married. Being widowed appeared to offer the greatest benefit, followed by never having married, and then being divorced/separated.
Countless other studies have consistently found that being married is associated with longer survival than being divorced or never having married. The theory of “marriage protection” found in these other studies refers to the environmental, social, and psychological factors that make being married healthier. The WSU study, however, specifically focused on those aged 75 and above, so some of those marriage “protective factors” may not be as pertinent.
For example, this study’s finding of a strong correlation between being widowed and becoming a centenarian may be in part due to the fact that those who lost their partner earlier in life may no longer experience the extreme stress tied to this traumatic event, which can degrade health when it occurs later in life. Additionally, strained marriages can cause increased stress and lead to poorer health, thus being divorced/separated may logically lead to a higher likelihood of becoming a centenarian.
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Controlling the controllable
Obviously, there are factors contributing to longevity revealed by this study that you can’t control, e.g., race and gender, and to a lesser degree, education level and marital status. But what if choices that you consciously make about where you live as a senior could help you live longer?
As you can see, this WSU study presents a number of compelling arguments for seniors to opt to live in a more metropolitan area.
- Many cities are more walkable than rural areas, which offers health benefits ranging from increased physical activity to easier access to healthy food, public transportation, healthcare, and social opportunities.
- They also have more people of higher socioeconomic status and income, which is tied to better healthcare, and likely more social opportunities, not to mention more government resources from the higher tax base.
- Cities attract more working-age people, which contributes to the availability of better services and programs, often via community organizations. These urban areas provide people of all ages an appealing range of shopping and dining, plus opportunities to enjoy the arts, sports, and other entertainment.
- Cities’ availability of more working-age people to help care for aging members of the population also means better access to care, whether in the home or in a healthcare setting.
As you are exploring where you would like to live as you grow older, it may be worth taking these factors into consideration. Whether you choose to remain in your own home or relocate to a senior living community (such as a continuing care retirement community [CCRC]), this WSU study suggests that the location you choose can directly impact your likelihood of reaching centenarian status.
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