Life expectancy for women in North Carolina varies significantly depending on county of residence. That’s according to the latest North Carolina’s Women’s Health Report Card.

The report, which was released by the University of North Carolina School of Medicine, shows Swain County women have an average life expectancy of 74 years. That’s 10 years less than women in Orange and Transylvania counties, which have the state’s highest life expectancy. 

Nathan Dollar, with UNC research center Carolina Demography, says it’s an example of what he calls the rural mortality penalty.

“People residing in more rural areas tend to have less healthy and shorter lives," he says. 

He says 100% of Swain County’s residents live in a rural area, and 17% live at or below the federal poverty line — the state’s average is 11%. Nearly a third of the county’s residents identify as American Indians. 

“The socioeconomic factors of poverty is a big one," says Dollar. "Certainly, racism, there is a mountain of empirical evidence that Black, Indigenous, and other people of color have worse health outcomes than their white counterparts. And that's largely due to the centuries of racism and discrimination. Another factor is social isolation, kind of access to social networks.”

All of these issues can lead to increased stress — another big determinant of health. 

“When you have chronic stress, you have chronically elevated cortisol levels which just creates more wear and tear on the body," he says. 

The study shows women in Forsyth and Guilford counties have an average life expectancy of about 80 years. 

Dollar cautions that the most recent data available is from 2019 before the effects of the pandemic were seen.

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