Twenty Years Apart

A child born in one American county can expect to live twenty years less than a child born in another. Same country, same currency, same flag: two entirely different lifetimes. In Twenty Years Apart, William Liu follows the numbers behind that gap, county by county, from the Mississippi Delta to the Dakota reservations to the affluent suburbs where life runs longest. Why do some Americans live so much longer than others? Income, education, geography, race, the closure of a rural hospital, the loss of a factory job, and the long grind of stress on the body all play a part. The book explains deaths of despair, the rural penalty, the stall in heart disease progress, the toll of the pandemic and the way American life expectancy has fallen behind other wealthy nations. It also looks at the places that have closed the gap, and what they did. Drawing on published research, government data and court records, this is a clear, humane, data-driven look at the most important number nobody talks about: how long you get.