The separation of powers from any reservation to the Federal Trust is completely arbitrary and is only active when it is convenient. Congress can do anything it wants to a reservation and faces zero consequences. Host States can and actually do almost anything to reservations and face zero consequences.
and that can extend to building up and improving conditions closer to a base line. even when recognizing that each reservation is entirely different, despite some common outcomes.
The IHS itself is the culprit. It's hard to improve life expectancy when your only access to medical care is through a system that's not only overcrowded and underfunded, but which has truly zero incentive to provide quality medical care to its patients (and a long, documented history of corruption and outright exploitation of its patients).
It absolutely, 100% does matter, because Native American reservations receive their healthcare exclusively through the IHS. The IHS is a completely separate system that is exclusively used by Native Americans, and it has massive documented logistical and ethical problems going back all the way to its founding.
It's downright deceptive not to mention that the data is so heavily shaped by this structural problem, because it completely changes the message people take away from it.
> Healthcare has the largest influence on life expectancy from infant mortality, but the 0.5% increase only changes life expectancy by ~6 months.
That is simply not true for the IHS. The IHS is way, way worse than anything you can imagine in the rest of the US. It has literally committed genocide (intentionally) under the ruse of medical care, and genocide has a funny way of decreasing life expectancy.
I am not defending IHS, if you say it's doing a poor job then it likely is.
However, other factors are still important. EX: "At 43%, adult obesity rates in Oglala Lakota County were 17 percentage points higher than rates of adult obesity nationally and 13 points higher than statewide rates."
Further, you can find several other counties with rather similar life expectancy results that don't have IHS. So, simply pointing at IHS is not the complete story.
This data is meaningless for analysis without exposing the racial breakdown. That South Dakota county is almost certainly nearly all American Indians. The big red patch in the south is very likely largely influenced by lower African American lifespans.
How does that make it meaningless? Yes, certain segments of the population are even more underserved than others, but that’s just more evidence for the fact that we’re doing a crap job of keeping people healthy.
Because race is genetic and genetic variations lead to wildly disparate "outcomes." Your zip code is one of the weakest influences on your health and lifespan, relative to other scientifically proven factors.
> How does that make it meaningless? Yes, certain segments of the population are even more underserved than others, but that’s just more evidence for the fact that we’re doing a crap job of keeping people healthy.
Because by not breaking out the single largest compounding factor, it's masking the real problem underlying this issue: there's a massive disparity in outcomes for people of different races.
Race in fact does play a big factor in health disparities. For example, African Americans are at much higher risk for heart health related issues. And when heart disease is the number 1 killer of people of all races.. well that just doesn't bode well for the life expectancy of AA.
And it's not just because minority populations have worse access to healthcare. There are in fact genetic components that predispose different races to different diseases.
Japanese people, Glaucoma.
AA, heart disease.
White people, Celiac.
Basically there's multiple components: Race, Healthcare access, Poverty, Education, Local Cultural proclivities for: diet, exercise, etc.
It's pretty shocking, because I don't think most Americans would suspect there is that much regional variation within the country. The US is frequently regarded as basically monolithic, with people moving from one place to another for jobs, family, cost-of-living reasons, basically assuming that life in one part will be largely similar to life in another part. This assumption is not backed up by data.
(That said, I would be interested in an analysis of whether or not your life expectancy varies with where you live, or where you are born. I.e. if I am from Boston but move to Mobile, do I end up with a Bostonian's life expectancy or a Mobilian's? How long does it take for the shorter life expectancy of someone from Mobile to override the longer life expectancy of someone from Boston? Or does it never do that? All would be interesting questions for research.)
So roughly half as much for a continent with over twice the population and 44 sovereign countries? The difference between areas in South Dakota and Colorado is bigger than that between Luxembourg and Moldova
Going by state in the US the difference is 6.3. If you go by all US states and territories it’ll go up to 7.9. The smaller your unit of measurement the greater the range will be. Counties are already prettt ridiculous given that some have populations in the millions and some I’m sure are in the hundreds.
If you want to compare European life expectancies you might be able to do it by Eurostat statistical region but none will have populations in the single digit thousands.
> Native American Reservations with very specific issues around unemployment, alcoholism, etc.
Native Americans typically receive their healthcare from the IHS, which is known for being an absolute disaster. It's not surprising (or news) that life expectancy is much lower for a population which receives its healthcare exclusively through a system which has a track record of neglecting its patients or using them as test subjects without their consent.
You'd need to also do the exact same thing in Europe and look at what kind of spreads exist inside of Europe as well.
Let's see the worst life expectancy areas of Russia for example. You're nearly dipping into the 50s for life expectancy in that case, and you're going to see a 30+ year gap from top to bottom across peak Europe vs the lowest areas. This has recently come to the fore with the Russian Government's move to push the retirement age so low that it nearly clips the average man off of it.
"A stroll around the Zapadnoye Cemetery reveals how few Novgorod men actually make it to old age. It’s easy to find graves of young men who died in accidents, wars or gangster feuds—many with epitaphs such as “came to a tragic end.” For the rest, the typical age of death is around 62. Graves of men who lived beyond 70, however, are pretty hard to find."
There are still places in the US where electricity isn't used, the primary languages aren't European, and the gdp per person is that of a third world country. If it's fair to compare those places to New York or San Francisco, France vs Ukraine doesn't seem terribly far-fetched.
It's kind of disappointing, but I'm not at all shocked to see the South having the largest area in the red, and the North East and the West coast doing well. I'd really like to see this map over time, though. I think that would be a really interesting addition to the data, as it would give a really good picture of which areas are getting better or worse.