来源：《时代周刊》2023年5月8日刊
The average U.S. life expectancy has hit its worst decline in 100 years, and America’s standing is dismal among peer nations. But the average obscures a more complex story. The U.S. is facing the greatest divide in life expectancy across regions in the past 40 years. Research from American Inequality found that Americans born in certain areas of Mississippi and Florida may die 20 years younger than their peers born in parts of Colorado and California.
美国人的平均预期寿命出现了100年来最严重的下降，美国在同类国家中的寿命排名令人沮丧。但这个平均值掩盖了一个更复杂的故事。美国正面临着过去40年来各地区预期寿命差距最大的局面。美国不平等组织的研究发现，出生在密西西比州和佛罗里达州某些地区的美国人可能比出生在科罗拉多州和加利福尼亚州部分地区的同龄人少活20年。
The decline is not occurring equally throughout the country. In the land of opportunity, millions of people are not even given a fair shot at life.
寿命降低在全美各地并不是平均发生的。在这片充满机会的土地上，数百万人甚至没有获得公平的存活机会。
America is unique among wealthy countries when it comes to how young its people die, and the trend is only getting worse. From 2019 to 2021, U.S. life expectancy declined by almost two years, according to the Centers for Disease Control and Prevention, the worst two-year decline since 1921 to 1923. When COVID-19 hit, America experienced a larger decline in life expectancy than any other wealthy country. Life expectancy in the U.S. is now 76 years.
在富裕国家中，美国人的早死率是独一无二的，而且这种趋势只会越来越糟。美国疾病控制与预防中心的数据显示，从2019年至2021，美国的预期寿命下降了近两年，这是自1921年至1923年以来最严重的两年下降。当新冠肺炎疫情爆发时，美国的预期寿命下降幅度比任何其他富裕国家都大。美国的预期寿命现在是76岁。
What is driving the differences in who lives and who dies in America? State policies tremendously influence life expectancy. Income support, Medicaid expansion, stronger gun control, drug-overdose prevention, and safe abortion access are among the drivers of regional divides in life expectancy. Overdoses kill more than 100,000 people each year. Guns kill more people than cars do. Digging into communities also sheds light on even more fundamental American divides.
是什么导致了美国谁生谁死的差异？各州政策极大地影响了预期寿命。收入支持、扩大医疗补助、加强枪支管制、预防吸毒过量和安全堕胎是各地区预期寿命差距的驱动因素。吸毒过量每年导致超过10万人死亡。枪支杀人比汽车多。对社区的深入研究还揭示了美国更根本的差异。
American Inequality’s research has found a high correlation between household income and life expectancy. Income is a major driver of higher life expectancies. In the wealthiest places like Aspen, Colo., and Santa Clara, Calif., median household incomes reach the hundreds of thousands of dollars and residents live to 87 on average, the highest in the country. But in poorer places like Owsley County, Kentucky, and Union County, Florida, the median household income is $35,000 and life expectancy floats around 67 on average, the lowest in the country.
美国不平等组织的研究发现，家庭收入与预期寿命之间存在高度相关性。收入是预期寿命提高的主要驱动力。在科罗拉多州阿斯彭和加利福尼亚州圣克拉拉等最富裕的地方，家庭收入中位数达到数十万美元，居民平均寿命为87岁，为全美最高。但在肯塔基州的奥斯利县和佛罗里达州的联合县等较贫穷的地方，家庭收入中位数为35000美元，预期寿命平均在67岁左右，是全美最低的。
Poverty in America is not about income alone. Low-income communities, regardless of state, are more likely to struggle with access to affordable health care; they are more likely to live near toxic sites and to develop lung cancer; they are more likely to live in food deserts and to wrestle with illnesses like heart disease and obesity; and they are more likely to die younger from drug overdoses.
美国的贫困不仅仅与收入有关。低收入社区，无论是哪个州，都更有可能难以获得负担得起的医疗保健；他们更可能生活在有毒场所附近，并发展成癌症；他们更有可能生活在食物沙漠中，与心脏病和肥胖等疾病作斗争；而且他们死于吸毒过量的可能性更大。