[This is an article I wrote for The Huffington Post for June 6, 2017.]
My wife has been going to the gym a lot lately, a gym with lots of older folk, people in their 70s and 80s. She says that, along with super-fit older women in her classes, there are some who are barely moving, carrying the tiniest weights and lifting them the tiniest amount, performing a kind of symbolic exercise. But they are obviously having a good time. They’re chatty in class, and chatty in the locker room. It’s social time at the fitness center in Reno.
Exercise is obviously helpful for living a long life, but I wonder if these women have hit upon something just as important. In his book The Blue Zones, about small regions where people often live past 100, Dan Buettner says that one of the common traits of people in these longevity hotspots—from Sardinia to Okinawa—is that they have strong and persistent social networks. They stay connected to family and friends even into extreme old age.
The gym in Reno might not be the greatest example of a social support group, but, quite possibly, it’s a lot better than nothing.
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I was thinking about those old women the other day, while poring over a map of the United States. This map, which has been all over the internet, comes from a study headed by a public health researcher named Laura Dwyer-Lindgren, and shows life expectancy by county for the whole country. Counties with long life expectancy are in blue, and the best of the best are in the deepest shade, so the longevity Blue Zones are easy to pick out.
Life expectancy for the United States, by county, for those born in 2014 (both sexes combined). The lowest values are in dark red, the highest in dark blue. Map from the Institute for Health Metrics and Evaluation (IHME) at the University of Washington.
I love a good map, and this one is a thing of informative beauty. It’s a window onto the character of the nation, onto racial inequalities and cultural diversity, onto immigration and assimilation, onto the vigor or decrepitude of regional economies, in short, onto endless social, political, and economic complexities. But some quick insight into the links between culture, wealth, and longevity can be had through a small part of this mapping project, namely, a list of the ten counties with highest life expectancy.
So here’s that Top Ten, a set of American Blue Zones:
The top ten United States counties for life expectancy, from a study by Dwyer-Lindgren and colleagues. Income rank is the per capita rank among 3,143 counties from the American Community Survey, 2009-2013. Ethnic makeup is from the 2010 U.S. Census. The Aleutian Islands combine data for the Aleutians East Borough and the Aleutians West Census Area. The income rank for the Aleutians is the average for those two areas.
One thing that’s immediately apparent is that most of these counties are wealthy and white (meaning non-hispanic white). That’s not surprising; wealth usually means relatively good health care, and, more importantly, it probably often means being well-informed about healthy living habits, along with the means to easily make those habits a reality. To put it simply, wealth usually equals health, and most wealthy people in this country are white.
There’s a lot more to ponder here as well. Why all those Colorado counties? And why the remote Aleutian Islands? But what I want to focus on is the most obvious outlier on the list. That would be Presidio County, in West Texas, along the Mexican border. Presidio County is more than 80% Hispanic, and it’s not just poor, it’s really poor, ranking in the bottom 5% of all U.S. counties.
The flip side of “wealth equals health” is that poor Americans tend to be unhealthy and short-lived. So, one wonders, is there something peculiar about the way people live in Presidio County that opposes that tendency? It certainly doesn’t look like it: despite some Bohemian-style gentrification of Marfa, the county seat, Presidio County is pretty much as bad as you’d expect it to be when it comes to standard indicators of healthy lifestyles. For instance, people there are far more likely to be obese and far less likely to exercise regularly than the average American. And, too, measures of health care in Presidio County are toward the low end, as you’d expect for a poor county.
In other words, by its obvious measurables, Presidio County ought to be much closer to the bottom of the lifespan list than the top. Yet there it is at number 9, in the top third of the top 1 percent.
So what’s the story?
Well, the story at this point is incomplete, but it almost certainly has to do with something called “the Hispanic Paradox.” It turns out that, in the U.S., Hispanics as a group are poor, yet they’re relatively healthy and long-lived. In fact, for the country as a whole, the life expectancy for Hispanics is about 2.6 years longer than for non-hispanic whites.
Getting back to the map, notice that almost all of the counties along the Mexican border are in those good, blue shades, in spite of the fact that nearly all of them are poor. It’s a 2,000-mile-long incarnation of the Hispanic Paradox, stretching from the Pacific to the Gulf of Mexico. Presidio County does stand out as a Blue Zone even within that collection of border counties, but it no longer looks so extreme. It’s just a moderate outlier within a larger anomaly.
Researchers don’t all agree on what explains the Hispanic Paradox, but a likely key factor is what many of us would identify as the key to life in general: it’s about connections to other people. Hispanics tend to have strong ties to family and community, and are more religious than Americans as a whole; that’s probably intuitive to anyone familiar with Hispanic communities, but it’s also been confirmed by scientists who put numbers on such things. And there is now evidence from many studies that those sorts of ties—positive social networks, to put it a bit simplistically—translate to better mental and physical health.
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The idea that strong social ties can help explain Buettner’s Blue Zones and the Hispanic Paradox is food for thought. It brings to mind all our striving for some kind of recurring connection, from monthly book clubs to Sunday family dinners, from meditation groups to stitch ‘n bitch clubs to middle-aged men meeting up to play soccer or basketball. More specifically, the fact that, for most of us, those endeavors tend to be short-lived makes me wonder how a society might offer ways to sustain such connections in the face of a modern world that doesn’t value them enough.
These thoughts bring me back to the old women in the gym, the women who don’t exercise much, but chat a lot. The gym is part of a hospital, and it’s a place where the old, flabby, and weak don’t really stand out. You can go there and not feel self-conscious lifting very light weights, or displaying your startling lack of flexibility, or doing almost nothing at all. In short, it’s a comfort zone.
Is it possible to translate that comfort to other situations, to promote those social activities that tend to fall by the wayside? The message from Presidio County is that doing so might have a substantial influence on our health and longevity. And, in any case, whether those connections make us live longer or not, they’ll probably make us happier for whatever time we do have.
The Monkey's Voyage 