Edward L. Glaeser is an economics professor at Harvard.

Last week, I began an examination of the remarkable health of New York City by discussing the two-centuries-old fight against urban disease. The vast urban investment in clean water and street cleaning may explain why New York City became a lot healthier, but it doesn’t explain why life expectancy is now 1.5 years higher in New York than in the nation as a whole. Perhaps it isn’t surprising that New York is no sicker than the rest of the country, but why should it be healthier?

Over the past century, the mortality gaps between New York and the nation have converged, widened and converged again. The life expectancy for a boy born in 1901 was about seven years less in New York than elsewhere in the United States, but by the end of the Great Depression, New York had achieved health parity with the nation. In 1940, life expectancy at birth was 62.5 years for a white male in New York and 62.1 years for a white man in the country as a whole. The gap for white women between city and country was even smaller. The increasing health of New Yorkers over this period came from a massive reduction in deaths from respiratory tuberculosis, nephritis and influenza and pneumonia.

Then between 1940 and 1990, the health gap between New York and the nation widened again. By 1990, life expectancy at birth was 75.4 years in the United States but only 72.4 years in New York. The AIDS epidemic and rising homicides are two particularly visible explanations for the city’s deteriorating health, but the difference in death rates also reflected higher death rates from heart disease in New York. These gaps may reflect unhealthy urban lifestyles or the stress of New York City during those years.

But since 1990, the life expectancy gaps first narrowed, and by the end of the 1990s, New York managed to have a higher life expectancy than the United States did as a whole.



Wealthier and better-educated people tend to be healthier, but these factors can’t explain the health of New York City. The average household in New York City, as opposed to the average person working in Manhattan, earns less than the national average. Yes, there are more college graduates in New York per 100,000 residents than anywhere else in the country, but there are also more high school dropouts. These factors can’t explain the gap.

It is easiest to understand why New York is less deadly for younger adults. About 81 of every 100,000 New Yorkers aged 25 to 34 died in 2006, as opposed 106 out of every 100,000 in the nation. Accidents and suicides are the two leading causes of death for these younger people. The suicide rate in New York City among this younger group is substantially less than the rate in the nation as a whole. Ten years ago, David Cutler, Karen Norberg and I studied youth suicides. We noted the tendency of suicide rates to be highest in low-density areas, which may be explained by the strong relationship between suicide and gun ownership, as measured by hunting licenses per capita.

The gap in accidents between city and country is even larger. New Yorkers between 25 and 34 are more than 75 percent less likely to die in a motor vehicle accident than their counterparts nationwide. Driving drunk is far more deadly than taking the bus while tipsy.

But the bulk of the mortality difference between New York and the nation occurs among older cohorts, and here the situation is far murkier. The death rates in the nation are 5.5 percent higher for 55-to-64-year-olds than in New York, 17 percent higher for 65-to-74-year-olds and more than 24 percent higher for 75-to-84-year-olds. There is no single smoking gun for these groups. Deaths from cancer are lower for these groups, but deaths from heart disease are not.

Perhaps Mayor Bloomberg’s anti-smoking policies play a role, but New York became healthier than the nation during the Giuliani years. Perhaps walking around a city makes New Yorkers healthier, but then why isn’t heart disease rarer in New York? I’d like to think that the robust nature of life in a big city is keeping people alive, but I suspect that selection may play a role. If really sick people are more likely to leave the city, this could then create an illusory appearance of Big Apple healthiness.

The health of New York City’s older cohorts remains something of a mystery, but there is no doubt that the city is no longer a place marked by death and disease. Not only are big cities places of remarkable economic productivity and cultural vitality, but they are also healthy places to live.