Features

January/ February 2013 To Live Longer, Move to a New Zip Code

By Phillip Longman

Michelle Obama’s “Let’s Move” campaign emphasizes the importance of physical activity for combating obesity, a point she has driven home by dancing alongside school kids to Beyoncé’s workout video. But another kind of movement may also be important to your chances of living to a ripe old age: moving to a new zip code.

Between 1994 and 1998, the U.S. Department of Housing and Urban Development conducted a demonstration project known as “Moving to Opportunity.” The project randomly assigned low-income families to one of three groups. Those in the first group received a voucher that they could use to help pay the rent on an apartment, provided that the apartment was not in a low-income neighborhood. Those in the second group received a voucher they could use in any neighborhood, while those in a control group received no voucher.

In 2011, HUD researchers published the results in the New England Journal of Medicine. The most dramatic finding was that people assigned to the different groups varied significantly in their weight by the end of the experiment. Going into the program, participants as a whole had been substantially more obese than the U.S. population as a whole. But ten to fifteen years later, those women who had moved to more affluent neighborhoods were one-fifth less likely to be obese than those in the control group, and also one-fifth less likely to have contracted diabetes.

This was true even though there was little difference among all the participants in the numbers who managed to move off welfare, improve their education, or find a better job. This suggests to researchers how powerfully our surroundings alone are to determining our habits and health. Though it might seem strange to say that obesity is contagious, for example, it does seem that people’s risk of it is affected by the weight of their neighbors, as well as by such environmental factors as whether most of the food for sale in their environs is junk food, as is often the case in America’s most impoverished neighborhoods.

The results of the HUD demonstration project are in line with other studies showing the extreme importance of geography and social environment as determinants of health. A dramatic graphical representation of this reality can be seen in the accompanying map of the Washington, D.C., metropolitan area developed by the Commission to Build a Healthier America. It shows how life expectancy improves by nearly a decade within just a few stops along the region’s various Metro subway lines.

Click here to read more from our Jan/Feb 2013 cover package “Race, History, and Obama’s Second Term.”

Phillip Longman is a senior editor at the Washington Monthly and a lecturer at Johns Hopkins University, where he teaches health care policy. He is also a senior fellow at the New America Foundation, where Atul Gawande is a board member.