Introduction · The whole span

Place across an American life

Birth outcomes, schooling, income, housing, health, length of life and well-being differ across American places, many in step with neighborhood deprivation, while some follow other patterns or change when the comparison moves inside a county.

Author: Vishal Singh
Affiliation: NYU Stern
Published: 11 October 2026

Life expectancy at birth was 82.3 years in the least deprived tenth of American census tracts and 74.0 years in the most deprived, for deaths in 2010 to 2015.[1] For births in 2018 to 2024, low birthweight was 7.4% of births in the least deprived tenth of the counties that CDC WONDER names individually and 9.7% in the most deprived (Chapter 2.1, Birthweight and preterm birth). The two comparisons come from different records, places and years. A third comparison, of what renters pay for housing, changes little along the same ranking of places.

One ranking of places from least to most deprived

The three comparisons rank places by the Area Deprivation Index (ADI), a national percentile built from census measures of income, education, employment and housing.[2] Places are sorted on it and split into tenths. Births are ranked by county and the other comparisons by census tract, so the tenths are different sets of places. Low birthweight and life expectancy are worse at each step toward the deprived end of the ranking. Between the least and the most deprived tenths of tracts, life expectancy differs by 8.3 (95% CI 7.9 to 8.7) years, with an interval from resampling whole counties (Chapter 8.4, Place and the length of a life). The two life expectancy averages are weighted by population and describe tracts, not the lifespan of any resident.

A proposition to test across a life

The book's title names the inquiry. An address places a person among schools, housing, jobs, services and other residents, and it also reflects who can afford to live there or chooses to. The word "destiny" is a proposition to test, and each chapter reports how much its evidence supports. "ZIP code" is shorthand as well. Most chapters count census tracts, counties, school districts or survey respondents, and every chapter names its unit.

The life course sets the order of the questions, from the health of newborns through school, the start of adult life, the working years, health and early death, and old age. The order does not follow one person from a birth certificate to a death certificate. Some sources follow birth cohorts into adulthood, some interview different people each year, and some describe a place in a single year. The chapters keep these records apart and do not combine them into one score of a good or a bad place to live.

Diagram

The chapters follow outcomes from pregnancy to deaths before old age, with surroundings and well-being measured at every age

A line of age runs left to right through the six stages of An American life. Birth covers pregnancy and the first year: birthweight, preterm birth, infant deaths, smoking in pregnancy and the number of births. School covers test scores, gender gaps in reading and math, learning growth and school discipline. Becoming an adult covers college, teen births, the adult incomes of children raised in different places and the mental health of young adults. Home, work and money covers jobs and wages, home values, mortgage lending, rent and eviction. Health and care covers health behaviors, chronic conditions, the supply of care, disability, retirement income and Medicare. Early death covers homicide, overdose, alcohol and suicide deaths, the length of a life and the share of the gap that violence accounts for. Beneath the stages, Environment, connection and well-being spans every age, with air pollution, civic life and loneliness, and how people rate their lives. Each chapter names the unit it compares: individuals, neighborhoods, counties or institutions. The chapters use different records and years, and no one person is followed through life.

Stages of life and the outcomes compared

Age

Part II
Birth
Pregnancy and the first year
- Birthweight and preterm birthCounties
- Infant mortalityCounties
- Smoking in pregnancyCounties
- Where births are fallingCounties
Part III
School
The school years
- Test scores, class and raceCounties
- Gender gaps in reading and mathInstitutions
- Learning growth and starting level (planned)Institutions
- School discipline and incarcerationInstitutions
Part IV
Becoming an adult
Adolescence and young adulthood
- College access, price and earningsInstitutions
- Teen birthsNeighborhoods
- Race, income and mobilityNeighborhoods
- Boys and mobility (planned)Neighborhoods
- Mental distress in young adultsIndividuals
Part V
Home, work and money
The working years
- Work, wages and access to jobsCounties
- Home value, income and redliningNeighborhoods
- Mortgage denialsNeighborhoods
- Renting, affordability and evictionNeighborhoods
Part VII
Health and care
Adulthood and old age
- Health behaviors and the supply of careNeighborhoods
- Health behaviors, person by personIndividuals
- Multiple chronic conditionsNeighborhoods
- Disability, retirement and MedicareNeighborhoods
Part VIII
Early death
Deaths before old age, and life expectancy
- Gun homicide and the causes of early deathNeighborhoods
- Overdose, alcohol and suicideCounties
- Mortality trends, 2018 to 2024Counties
- Place and the length of a lifeNeighborhoods
- Violence and the life-expectancy gapNeighborhoods

At every age

Part VI

Environment, connection and well-being

Air pollutionNeighborhoods
Civic life, loneliness and partnershipCounties
Life evaluation and daily feelingsIndividuals
Well-being across the life spanIndividuals

Each chapter draws on its own records, places and years. No one person is followed from birth to death.

Read the stages in order, from pregnancy and the first year to deaths before old age. Each stage lists its chapters and the unit that each chapter compares across places. Air, social connection and well-being sit beneath the stages because their chapters are not tied to one stage of life. The order of the stages arranges the questions and does not follow one person through life or draw a causal link between stages.Source: Author's outline of the book, revised October 28, 2026. Conceptual diagram; no statistical estimates or weights.

Most of the book's own analyses describe places. People differ in where they live, and places differ in who lives in them. A relationship between neighborhood conditions and an outcome does not show what would happen to a person who moved or what a policy would change. Studies with experiments or other stated designs bear on those questions, and the book reports them separately. Chapter 8.4, Place and the length of a life reports a randomized housing-voucher experiment in a box of its own, labeled with the study's design.

Renters' cost burden changes little along the ranking

The third comparison is the share of renter households that spend more than 30% of their income on housing. For 2018 to 2022 it was 44.4% in the least deprived tenth of tracts and 47.6% in the most deprived (Chapter 5.4, Renting, affordability and eviction). Across all ten tenths of tracts, the renter shares over that line stayed within 3.6 points of one another. Among renters with low incomes, at or below 80% of the area median family income, the order runs the other way. Their share over the line was higher in the least deprived tenth, 75.3% (95% CI 72.6% to 78.1%) against 62.5% (95% CI 61.6% to 63.3%) in the most deprived, for the same years. Gross rent and family income are among the census measures inside the index, so this comparison sorts a ratio of rent to income partly on its own parts (Chapter 1.1, What the deprivation index measures).

Some outcomes change steadily with neighborhood deprivation, as birthweight and life expectancy do. Others change little with it, as renters' cost burden does, follow another ordering, or change direction when the comparison moves inside a county. Traffic pollution is lower in more deprived tracts across the country and higher in more deprived tracts within a county (Chapter 6.1, Air pollution). Groups in the same place can also reach different outcomes. The book asks where a pattern holds, where it fails, and how the answer changes when the comparison becomes more specific.

Setting each end of a ranking against the country as a whole shows a second pattern. For most outcomes the most deprived places stand farther from the national value than the least deprived places do, and for some the least deprived places stand farther (Chapter 9.1, How far one ranking goes).

Figure 1

The most deprived places usually stand farther from the national value than the least deprived places do

Mean at each end of the ranking each chapter uses, divided by the value for all the places of the comparison, on a log scale so that twice and half the national value sit the same distance from it

Least deprived end
Most deprived end

Show data

Data for The most deprived places usually stand farther from the national value than the least deprived places do
Domain	Outcome	Least deprived end	United States	Most deprived end	Least deprived end divided by the US value	Most deprived end divided by the US value	Unit
Birth and school	Infant mortality	4.0	5.7	8.8	0.71	1.55	Infant deaths per 1,000 live births
Becoming an adult	Distance to a four-year college	6.1	9.6	29.3	0.64	3.05	Miles to the nearest four-year campus, average resident
Becoming an adult	Incarceration, Black children from low-income families	3.8	5.2%	6.4	0.73	1.23	Percent incarcerated on April 1, 2010
Home, work and money	Mortgage denial rate	7.8	9.0%	13.8	0.87	1.54	Denied share of decided applications (%)
Health and care	Current smoking	9.1	14.5%	22.8	0.63	1.57	Percent of adults
Health and care	Residents per primary care physician	1,159	1,334	2,730	0.87	2.05	Residents per provider
Early death	Homicide death rate, tracts	1.8	5.4	14.8	0.32	2.72	Homicide deaths per 100,000 residents a year
Early death	Life expectancy at birth	82.3	78.8	74.0	1.04	0.94	Life expectancy at birth (years)

Read each row from the national line outward: the open dot is the least deprived end and the filled dot the most deprived end, to the right where the outcome is higher than the national value and to the left where it is lower. Eight of the outcomes in the chapter How far one ranking goes, from birth to life expectancy, each on the ranking its own chapter uses.Note: Eight of the rows of the chapter How far one ranking goes, chosen to cover the stages of life: five where the most deprived end lies farther from the national value and three where the least deprived end does, about the share in the full set. The chapter shows all of them and counts which end lies farther.Note: The national value pools all the places of each comparison into one bin, with the estimator and weights of its chapter, and is published there. It covers the places that the chapter ranks, so places without a rank or an estimate are left out.Source: Figures of the chapters named in each row, data years 1978 to 2024 as each chapter states; estimates as published there: full counts, crude rates, population-weighted means, unweighted survey means or modeled estimates.

How we know

This introduction computes nothing. Each number it prints is copied, with its population, period, weights and interval, from the chapter that estimates it. The births are CDC WONDER natality records for 2018 to 2024, and WONDER names a county individually only above a population threshold, so smaller counties are not in that ranking. Life expectancy is the small-area estimate for deaths in 2010 to 2015, a modeled estimate for non-institutional tracts with the required data. The housing costs come from the Department of Housing and Urban Development's tabulation of the American Community Survey for 2018 to 2022. Every comparison is ranked on an index built from the American Community Survey for 2019 to 2023. That period comes after the deaths behind the life expectancy estimates, and the timing limits what the comparison can show. The report gives every estimate with its interval and sample size.

What these comparisons cannot show

The numbers here are not measurements of the same people. Births, deaths and housing costs are compared across different units and years, and each is ranked on a deprivation index for 2019 to 2023. Some places and groups are missing from the records, and some values are withheld. Some estimates come from models or from data collected years apart, and several chapters describe cohorts born decades ago and not conditions today.

Where to start reading

Reading in order begins with Chapter 1.1, What the deprivation index measures, which asks what the ranking behind these comparisons measures, and then Chapter 1.2, What a county average leaves out, which asks what a county's rank says about the tracts inside it. A reader who wants the life course first can start with Chapter 2.1, Birthweight and preterm birth. A reader who wants the method before either can start with Chapter 8.4, Place and the length of a life, which takes the life expectancy contrast through the steps the other chapters apply to their own outcomes. It asks whether the ordering holds across the middle of the deprivation scale and what a county average leaves out. It also asks how far apart nearby neighborhoods are under a stated rule, and how much of the spread among tracts is estimation error. The contents page lists every chapter with its finding, and the reading guide explains the conventions behind each claim.

Go deeper

The report: every estimate with its interval and sample size.
Tables: every figure of the report as a table.

Data sources

CDC WONDER natalityLow birthweight by county deprivation tenth, 2018 to 2024, as reported in Birthweight and preterm birthYears: 2018-2024 · Weights: births · License: Public domain (NCHS, CDC); WONDER data-use restrictions apply
County Health RankingsLow birthweight by mother's race and county deprivation quartile, births in 2016 to 2022, as reported in Birthweight and preterm birthYears: 2024 release · Weights: births · License: CC BY 4.0 (University of Wisconsin Population Health Institute)
USALEEP life expectancyLife expectancy at birth by tract deprivation tenth, deaths in 2010 to 2015, as reported in Place and the length of a lifeYears: 2010-2015 · Weights: ACS 2019-2023 tract population · License: Public domain (NCHS, CDC)
HUD CHAS housing affordabilityHousing cost burden of renter households by tract deprivation tenth, 2018 to 2022, as reported in Renting, affordability and evictionYears: 2018-2022 · Weights: renter households with a computed burden · License: Public domain (U.S. federal)
Area Deprivation IndexNeighborhood Atlas Area Deprivation Index 2023, the ranking behind every comparison aboveYears: 2023 release (version 4.0.1; built on ACS 2019-2023) · Weights: as in each chapter · License: Free for non-commercial use; cite the Neighborhood Atlas and Kind and Buckingham

All data sources

References

Arias, Elizabeth; Escobedo, Luis A.; Kennedy, Jiaquan; Fu, Chenxi; Cisewski, Jodi (2018). U.S. Small-area Life Expectancy Estimates Project: Methodology and Results Summary. Vital and Health Statistics, Series 2, Number 181, National Center for Health Statistics. www.cdc.gov/nchs/data/series/sr_02/sr02_181.pdf
Kind, Amy J. H.; Buckingham, William R. (2018). Making Neighborhood-Disadvantage Metrics Accessible: The Neighborhood Atlas. New England Journal of Medicine 378(26): 2456-2458. doi:10.1056/NEJMp1802313

How to cite

@misc{singh2026placeacrossanamericanlife,
  author = {Singh, Vishal},
  title = {Place across an American life},
  year = {2026},
  url = {https://vishalsingh.org/zipcode/place-across-an-american-life},
  note = {In ZIP Code Destiny. Published 11 October 2026.}
}