Published May 31st, 2023 at 6:00 AM6 minute read
A recent study underscores a growing body of research recognizing that it’s not just how a person eats and exercises that affects how long, and healthily, someone might live. A person’s mental well-being, sleep and social connections are all key factors in life expectancy.
In the report, States with the Best Outlook for Life Expectancy, Missouri languishes near the bottom, with an overall rank of 42. (Kansas ranks 33.)
Life Extension, a nutritional supplement company based in Fort Lauderdale, Florida, gathered data from the Centers for Disease Control and Prevention, Bureau of Economic Analysis and the Census Bureau to rank states based on the life expectancy of their populations. They looked at factors including obesity rates, fruit and vegetable consumption, prevalence of anxiety and access to parks and other green spaces.
States with the best outcomes include Hawaii, which spends more than double what most states do on outdoor recreation; Minnesota and Colorado, where people seem to get plenty of sleep; and Vermont, where a whopping 83% of residents exercise regularly.
“The whole point of this is to show communities that they can improve longevity,” said Michael Smith, MD, director of education and spokesperson for Life Extension. “Two years in a row now life expectancy rates (in the United States) have dropped. Things like COVID and drug overdoses and gun violence all play a role, but we are not used to seeing a drop like this.”
How long we live and how healthy we are as we age depends on a myriad of factors. Some things can’t be controlled, such as genetics and cell aging. Others are more manageable, like how much we eat and exercise. But a third pillar – and one Smith said this study points to – is to what extent a community can affect a person’s health.
“From the arena of community, it has been established that there are some pillars of life expectancy that are great predictors of longevity and lifespan,” he said. “They are not perfect, objective science, but it’s population-level science which is observational. They offer a snapshot view of what a community can do to improve longevity.”
Two of these measurements in the survey are the number of people who live near a park or school and the state’s share of the gross domestic product spent on outdoor recreation. Missouri’s percentages were 68% and 2.2%, respectively, both near the median for states nationwide. These are included in the study because, Smith said, if it’s easy for a person to get to a park, school with playgrounds or soccer fields, or a beach, they are more likely to get out and exercise.
The Kansas City Health Department works to increase physical activity through projects like its Mindful Steps program, a series of community walks meant to get people outdoors and active in local green spaces.
“We can bring people from the community and take them to a trail or woods just to get out and let people and see something different,” said Marvia Jones, the department’s director of health. “There is a lot of literature on this, and the research is clear that being out in nature reduces stress and anxiety.”
One area that Missouri ranked poorly was the issue of stress. With 31% of its adults reporting symptoms of anxiety, the state had 3% more than the national median and 5% more than people in Kansas.
Another marker, social isolation, is a newer one in the study and has been measured since the pandemic. The Life Extension report gauges this by asking how many people live alone. That, by itself, doesn’t mean someone has no social interactions. But because so many people now work from home, it can be a sign that someone may be isolated.
“There is a connection between mood disorders and loneliness and there are lots of studies showing that people who live alone are more likely to be lonely, more likely to commit suicide and have other risks to their health like depression,” Smith said.
Along with its nature walks, Jones said her department has built relationships within the city, including its public works department, to reduce isolation. The entire metropolitan area is very car-dependent, which can be isolating. To help remedy this, her data person consults with public works to show areas where sidewalks are in disrepair and people report having less physical activity.
“We can layer this data and it has been a great partnership,” she said. “It excites us as public health department.”
They also provide data to Kansas City Public Schools on things like changing start times at schools. Later starting times have been shown to improve graduation rates, and people who graduate live longer, eat healthier and are less likely to be a victim or perpetrator of violence, she said.
University Health also works in area schools as part of its efforts to educate the community on the importance of good health. One of its nurses teaches the high school health class at Lincoln College Preparatory Academy in Kansas City. She has modules that teach students about nutrition, stress, mental health, sexual education and the importance of exercise. She also gives fresh produce to the students a couple of times a week to reinforce the importance of eating well.
“We try to make sure health is real and tangible; we don’t just talk and teach about it,” said Niki Donawa chief community relations officer for University Health. “This doesn’t solve all their issues, but it can make a splash with those kids we do touch.”
They also have wellness connections set up at two locations in the area – the Palestine Senior Activity Center and the Lucile H. Bluford Branch of the Kansas City Public Library. At the library, they have built a weight-loss program where they check people’s body mass index and blood pressure, and help people improve their fitness routine and track weight. At the senior center, they focus on issues for the senior population including sleep education and self-management of chronic diseases.
“With our Community Health Strategies and Innovation team, everything we do is surrounded by education,” Donawa said. “We can’t control all the variables, but we can help people understand how to be more self-sufficient for their health.”
The community can play a key role in people’s health but can only do so much. Jones said a salient point for her department is that Missouri ranks last in the country for the amount it pays for public health at $7 per person. This means her department must focus on the must-dos like free vaccinations, tuberculosis treatment, and testing and risk education around sexually transmitted diseases.
“We would like to have a whole bandwagon of people to do marketing and talking about healthy eating and going to stores to see if there are healthy options,” she said. “But when you have to choose between high-priority things, those others fall to the bottom of the list.”
That’s why personal components of health are so important. And in the Life Extension study, only 29.5% of Missourians came in at a healthy weight – meaning nearly 70% of the population is overweight or obese. Seventy-five percent of Missourians exercise daily and 68% eat fruits and vegetables daily. Both are slightly below the overall national average among states in the report.
Smith said weight, sleep and anxiety are surrogate markers for other things that have a direct impact on health.
For instance, being overweight is a risk factor for several conditions – like diabetes, heart disease and some cancers – which accelerate the body’s aging process. Chronic stress affects a person’s cells and releases cortisol, too much of which can cause inflammation and oxidation in the cells, prematurely aging them, he said.
The same goes for sleep. Depending upon your age, most adults need seven or more hours of sleep a night. Smith recommends between seven and nine. While you sleep, your heart rate and blood pressure lower, hormones are regulated, cells are repaired and the immune system is strengthened. In Missouri, 36% of people said they don’t get enough sleep nightly.
“All of these things have a direct impact on a person’s biological age, which impacts how long you live,” Smith said.
When it comes to weight and exercise, Smith is tired of hearing the ubiquitous and generic, “eat less, exercise more” advice. Instead, he encourages people to focus on portion size and changing the way a meal is composed. On a dinner plate, about 20% should be brown and 80% colorful – in other words, eat your vegetables. When eating meat, a serving of beef is about 4 ounces; chicken and pork about 5 ounces and a portion of fish is about 6 to 8 ounces.
When it comes to exercise, Smith recommends using those parks and green spaces that are available. If you don’t exercise at all, go outside and walk around the park once a few days a week. The next week, circle it twice and keep increasing that number.
“Once you are getting around it a few times, it will improve your longevity and cardiovascular health,” he said.
Tammy Worth is a freelance journalist based in Blue Springs, Missouri.