As US life expectancies climb, people in a few places are dying younger

That’s according to new research published Monday in the journal JAMA Internal Medicine. Life expectancy for the country as a whole grew by more than five years from 1980 to 2014, to an average of 79.1 years. During that time, however, some areas saw increases of more than 13 years, while a few others saw declines of up to 2.3 years. This new study adds to a growing body of research showing that race, education, wealth and where you live can help determine how long you will live.

A series of papers published over the last couple of years showed a disturbing increase in mortality among white people without a college degree. In the wake of the divisive presidential election, that work drew grim headlines about the death of middle-aged whites. Some argued in response that the focus on whites was misplaced, given that mortality rates for black people and Native Americans are higher than those of other racial groups. But combining these socioeconomic and racial disparities with the variation in geographical outcomes paints a harrowing picture of a stark U.S. reality: The wealthiest country on earth, which also spends the most money on care for the sick, has far from the best health outcomes.