Across America, life expectancy varies drastically between communities separated by a handful of miles.  

In Chicago’s South Side, people from Washington Park live, on average, 16 fewer years than people living in The Loop, downtown, eight subway stops away.

In Detroit, residents of Grosse Pointe can expect to live until about 82; a few miles away, in Midtown, the life expectancy is 69.

In Pittsburgh, it’s no different. In parts of the historically black Hill District, it’s 69.6 years. In gentrified Upper Lawrenceville, 79.4. In Clairton, a city some 10 miles south and home to the nation’s largest coke manufacturing facility: 73.5. The national average is 78.6.

“In our society, we’ve created neighborhoods particularly built along people’s socioeconomic status,” said Kenneth Thompson, a Pittsburgh-based psychiatrist and researcher. “And the socioeconomic status that you have is probably the predominant driver, of a whole community of people, of the average health and the length of life of the population that live there.”

To address inequity at home, government and nonprofit officials in Pittsburgh have entered into a partnership with the city of Glasgow, Scotland, a similarly placed postindustrial city known to fall under the “the sick man of Europe” label due to its poor health outcomes. But Glasgow has made notable improvements in certain mortality rates in recent years, and Pittsburgh officials hope to emulate its turnaround.

“We see a high rate of disease along our rivers, along where there had been industrial production years and years ago that is now gone, but the waste and the byproducts have infected the soil and the air that these individuals breathe,” said Lou Ann Jeremko, executive director of Pittsburgh’s Consumer Health Coalition and co-investigator in the Glasgow partnership.

She stresses they don’t know causality, only that people who live in such areas are dying at a younger age and show higher rates of chronic disease, ranging from asthma to cancer.

“Those are what we call inequities,” she said. “Individuals in a city [filled] with wonderful, quality healthcare providers, but not always having the same access, awareness, and knowledge.”

Thompson, who puts forth a social-ecological view of health and wellness, notes that while of course genetics and behavior and other factors play a role in health, populations in the same area shouldn’t have average life expectancies that differ by decades.

“How we experience both illness and well-being are heavily influenced by what happens between us and how we organize and make our world,” Thompson said.

In the 90s, Thompson received a grant from the Soros Foundation to become a physician advocate fellow in the United Kingdom, where he focused on health in former industrial cities, including Glasgow, making him an ideal co-principal, alongside Jeremko, for the Pittsburgh-Glasgow partnership.

Funded by the Robert Wood Johnson Foundation, the nation’s largest philanthropy for public health, the grant connects Pittsburgh institutions with Resilient Glasgow and the Glasgow Centre for Population Health so that Pittsburgh can begin to establish a “culture of health.”

A culture of health “is really taking a very holistic perspective to what is needed to achieve health and well-being,” including food, transportation, jobs, and many other factors, said Karabi Acharya, a director with the RWJF.

Both Glasgow and Pittsburgh are part of the 100 Resilient Cities network, a global resiliency initiative sponsored by the Rockefeller Foundation.

“We understood that, looking at both cities’ strategies, that we have a lot of common confluences, both of which begin with the fact that we are those postindustrial cities,” City of Pittsburgh Chief Resilience Officer Grant Ervin said.

Ervin said that Glasgow and Pittsburgh are pursuing a potential sister city relationship, which would allow for further collaboration in the future.

Of particular concern in both cities is the rise of “diseases of despair” — deaths caused by opiates, suicide, and alcohol. Today, Thompson said mortality rates are increasing among poor, undereducated white men and women, particularly men in their 30-60s. “They’re dying younger than they were before, and this is the first time we’ve seen this happen in American history that we’ve kept any meaningful data.”

Thompson said these illnesses come about when a population gives up on some fundamental sense of hope or notion of future opportunity, as was witnessed in present-day Russia around the collapse of the Soviet Union.

“The more opportunities that you have, the healthier you are likely to be,” Thompson said, “and the healthier you are, the more likely you are to have opportunities.”