U.S. Regional Differences in Healthy and Total Life Expectancy for Persons with and without Diabetes

Scott M. Lynch, Duke University
J. Scott Brown, Miami University

Type 2 diabetes has become increasingly prevalent in the US. While some view diabetes as a health outcome itself, diabetes contributes to numerous poor health outcomes, including cardiovascular disease, stroke, and various neuropathies. Although regional disparities in diabetic prevalence are well known, no research has examined whether life expectancy and health differences between diabetics and nondiabetics exist across regions; that is: is diabetes equally consequential to health throughout the country? Furthermore, does the region in which one was raised have an impact over one's current region of residence? In this paper, we use data from a long-term panel (the Health and Retirement Study) and cross-sectional study (the National Health Interview Survey) to examine the interaction between region of residence and diabetes status in predicting total and healthy life expectancy. We employ two recently developed multistate life table methods, and illustrate some extensions of them, in answering these questions.