If you live in King County, your life expectancy exceeds the national average — and it grew more than life expectancy in some Washington counties in recent decades.

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The gap in life expectancy between Washington’s counties is growing, pointing to increasing inequality in the health of Americans.

If you lived in King County, your life expectancy increased by six years from 1980 to 2014, to 81.37 years, according to a new study by the Institute for Health Metrics and Evaluation (IHME) at the University of Washington.

But Cowlitz County residents gained only three years of life expectancy in that span and died at the average age of 77.51.

The trend was reflected in another southwest Washington county — Grays Harbor — that had the state’s lowest life expectancy and among the smallest increases in life span over the years covered by the study.

(Courtesy of Institute for Health Metrics and Evaluation)
(Courtesy of Institute for Health Metrics and Evaluation)

Researchers examined factors behind the inequality in life expectancy. The leading ones were risks such as obesity, lack of exercise and smoking, said Ali Mokdad, an author of the study and professor of global health at IHME.

Socioeconomic factors including education, income and race were next in importance, Mokdad said. Better-educated people are more likely to seek medical care and adhere to medical messages, he said.

Access to and quality of health care ranked third, the study reported.

“Health insurance is a very important and very strong determinant,” Mokdad said.

It’s unclear what the future of health care will look like for many Americans as the Senate is now reviewing a Republican health-care bill passed last week by the U.S. House of Representatives.

Although the Congressional Budget Office has not yet released its analysis of the bill, an analysis of a previous version of the bill projected that 24 million Americans would likely lose their health coverage by 2026.

Mokdad declined to comment on the bill specifically.

But he said prevention measures, such as checking and controlling blood pressure, or helping people afford fresh fruit and vegetables, could be helpful in reducing health and life span disparities.

In terms of the inequality gap, Mokdad said rural areas used to fare better in life expectancy than cities did. Rural men with high-school diplomas were able to find good-paying jobs with good health insurance and retirement plans in industries such as timber, he said.

“But life changed. Those people in many ways were left behind in terms of economic advantages and health,” he said. Meanwhile, cities such as New York and Seattle advanced public-health measures, such as anti-smoking campaigns.

All of Washington’s counties saw an increase in life expectancy between 1980 and 2014, according to the national study, published Monday in JAMA Internal Medicine. It reported that 13 U.S. counties, mostly in Kentucky, had decreased life spans in that period.

Americans spent an average of $9,237 per person on health care in 2014, according to IHME. Australia, where life expectancy is three years longer than in the U.S., spent $4,032 per person.

Australia has more restrictions and enforcement around drunken driving, smoking and gun ownership, Mokdad said. “Australians are more aggressive and willing to experiment” with public-health initiatives, he said.

The nation’s lowest life expectancy was found in Oglala Lakota County, South Dakota, which includes the Pine Ridge reservation, at 66.8 years, comparable to countries like Sudan (67.2) and Iraq (67.7).

The longest lives were in a cluster of Colorado counties, with Summit County leading the way at 86.8 years, followed by Pitkin County (home to Aspen) at 86.5 years.

Life expectancy in most Washington counties grew at close to the national average. The state’s life expectancy averaged 79.99 years in 2014; the national average stood at 79.08 years.

The state’s longest life expectancy was found in San Juan and Island counties, at 83.7 and 81.9 years, respectively. King County ranked fourth just behind Whitman County’s 81.4 years.

Women outlived men in Washington by 4.1 years, according to the study, close to the national average. But the gap was wider, at 6.3 years, in Cowlitz County.