Sept. 11 (Bloomberg) -- Asian-American women have the top life expectancy in the U.S., while black men in some urban areas have the worst, a gap of almost two decades, scientists said.

The life expectancy of Asian women was 86.7 years and for black men living in high-risk urban areas, it was 68.7 years, according to a national study in today's PLoS Medicine online. Hawaii led 50 states and Washington, D.C., with life expectancy of 80 years, while D.C. ranked last, with 72 years.

The differences are driven by injury and preventable risk factors for long-term disease such as smoking, alcoholism and obesity, especially in Americans ages 15 to 59, said lead investigator Christopher Murray. He said most health-policy initiatives currently focus on children and the elderly.

"The evidence is really quite clear that most of the gap across these groups is due to differences in mortality in young and middle-aged adult men and women and most of that is due to chronic disease," Murray, Harvard Initiative for Global Health director, said in a telephone interview. "It's not HIV. It's not homicide. It's cardiovascular disease. It's chronic respiratory disease, liver disease and somewhat cancers."

Discovering the factors underlying longevity gaps is important, Murray said in a telephone interview Sept. 8 from Cambridge, Massachusetts. He said the life expectancy gaps won't close until the focus turns to Americans ages 15 to 59.

Seeking Causes

The investigators divided the country into eight groups based on such factors as race, location, population density, income, and homicide rates to look at life expectancy:

-- Asian: 10.4 million people

-- Northland low-income rural white: 3.6 million

-- Middle America: 214 million

-- Low-income whites, Appalachia, Mississippi: 16.6 million

-- Western Native American: 1 million

-- Black middle America: 23.4 million

-- Southern, rural, low-income black: 5.8 million

-- High-risk urban black: 7.5 million.

Gaps in life expectancy have changed little from 1982 to 2001, the investigators said.

Sources for the data included the Census Bureau and the National Center for Health Statistics. The study was financed by the U.S. Centers for Disease Control and Prevention, the Association of Schools for Public Health and the National Institute on Aging.

First to Last

The study looked at life expectancy by states as well. Hawaii led 50 states and Washington, D.C., with a life expectancy of 80 years. Hawaii's State Department of Health cited climate and exercise as among factors that led to that ranking.

"Our ethnic makeup also contributes to the longevity of our residents, with a large percentage of Americans of Asian decent," Chiyome Fukino, health department director, said in an e-mailed statement. "If you're going to live long, Hawaii is definitely the place to live."

Washington, D.C., ranked last, with average life expectancy of 72 years, according to the study.

"I've seen the highlights of the study, and while it has some useful elements, I think the authors have mixed apples and oranges," Gregg Pane, director of the District of Columbia Department of Health, said in a telephone interview Sept. 8. "What they're portraying is really not a valid comparison."

Researchers suggested individuals should take action to improve life expectancy in their towns.

"There's a message here that you should be much more aware of the health circumstances of where you live and hopefully that will, as peoples' awareness goes up, will lead to more public action, individual and public action, civic action to figure out why levels of health in your community may be very poor and what you can do about it," Murray said.

To contact the reporter on this story: Theresa Barry in Washington at Tbarry2@bloomberg.net .

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