As the woman sat next to her husband at a local meeting, Jayla Sanchez-Warren noticed that she would answer questions for him as soon as he started talking.
Sanchez-Warren, who was leading the community meeting for older adults, thought it was funny. The two seemed close and upbeat. Both were in their 80s.
After talking to her a bit more, Sanchez-Warren, whose official title is director of the Area Agency on Aging at the Denver Regional Council of Governments, remembers the woman breaking down into tears. The woman, a Latina, had recently learned her husband had diabetes. During a previous cooking class, she had essentially been told the food she had been feeding him -- mostly homemade tortillas and beans -- was worsening his condition.
It was too many carbs and not enough fresh food. The woman thought because the food was homemade, it would be healthier.
"If you don't have a lot of money, it's expensive to buy fruits and vegetables," Sanchez-Warren said. "It's a lot cheaper to buy beans and rice."
Sanchez-Warren's agency focuses on helping people ages 60 and older, providing things like meals, transportation, health and wellness programs, and caregiver support for older adults. The agency serves about 32,000 people annually in the metro area.
Sanchez-Warren said she has noticed that people of color and low-income folks tend to use her services earlier in their lives, when they're in their early and mid-70s, than white or wealthier people. She said that for a lot of her customers, the council's programs might be the first time they learn about things like nutrition.
She said that many social services focus on children and the elderly, not middle-aged adults.
"That's a huge gap," Sanchez-Warren said.
During that gap, people can develop poor eating habits, often because they don't have access to information about nutrition or to fresh food. That can all impact their life expectancy.
A map the Colorado Department of Public Health and Environment released in 2018, the most recent available, shows life expectancy can range from 72.8 years old in Globeville -- the lowest in Denver -- to 85.9 years old in Hilltop, the highest. The citywide average is 79.7 years, which is comparable to the statewide life expectancy of 80.5 years.
So what is life expectancy, exactly?
According to Vital Statistics Program Manager Kirk Bol, who helps oversee this kind of stuff for the state's health department, "What it ultimately represents is the average number of years a person could expect to live if they spent their entire life in this area."
Bol said CDPHE came up with its map using Census data and death certificates registered with the state's health department. Bol said the Centers for Disease Control and Prevention will take information from states to create a larger picture of mortality in the U.S.
Life expectancy data isn't exactly broken down by neighborhood, Bol said. It's actually cut up according to Census tracts, which are federal geographical tags Bol said usually encompass about 5,000 to 10,000 people. Denver has 144 Census tracts, much more than the city's 78 neighborhoods. The Census offers life expectancy data for 130 of its 144 tracts.
Why are the differences in life expectancy so stark in Denver?
It's all about genetics, access and long-standing inequality, said Metropolitan State University of Denver professor Amy Dore, whose work focuses on health disparities and long-term care.
For example, someone who has a full-time job may have better access to transportation since they can afford it, which means it's easier for them to visit a grocery store where they can get fresh, healthy food. Someone who doesn't have reliable transportation might rely more on fast food or food from a corner convenience store. Or, someone might live in an area with significant environmental stressors, like high air pollution. Because of historic and current systemic racism, a resident's race and/or ethnicity often factors into whether they have access to a car or a full-time job or clean air.
"I would look at it as the resources people have to make those choices," Dore said. "We are looking at education. We are looking at where they live, we are looking at what they have available even where they live. So things like infrastructure, we're looking at built environments, and having the safe spaces that you feel you can participate in life, like we all dream of doing."
Sanchez-Warren noted how zip codes can be more important than your genetic code when talking about life expectancy.
"Life expectancy is tied to living standards," Sanchez-Warren said, listing off things like access to healthcare, education, and housing. "So when you don't have those, or when you have fewer of those (options), your life expectancy is less."
Dore points to the I-70 corridor and its environmental impact as an example of something that could potentially affect life expectancy. The construction work on the corridor has been a major source of stress for people who live nearby. They say they experience things like noise pollution and physical vibrations from the project. Residents there even sued the Federal Highway Administration in 2017 to stop the highway's expansion, citing its environmental impact.
The highway passes through Globeville, which has the lowest life expectancy rate in the city. It's also one of the poorest and least-educated neighborhoods in Denver.
Pollution has long plagued the area, and a study in 2014 from the city said Globeville and Elyria-Swansea experience "higher incidence of chronic health conditions such as cardiovascular disease, diabetes, obesity, and asthma," than other neighborhoods in Denver. (The study also noted that while the two neighborhoods were closer to air pollution due to their proximity to highways, the average annual air pollution rate wasn't higher than other areas of the city.)
"Opportunities for outdoor physical activity are also limited in the neighborhoods due to disconnected streets and sidewalks, lack of nearby goods and services, and concerns about crime and safety," the study read.
Has COVID-19 impacted the city's life expectancy?
Overall, people are living longer than in other times in history. But big public health crisis can impact numbers. Life expectancy in the U.S. decreased in 2015 due to an increase in drug overdoses and suicides. And the CDC released a report last month showing the average life expectancy in the U.S. dropped by a year during the first half of 2020, from 78.8 years in 2019 to 77.8 in 2020. More than 525,000 people have died from COVID-19 in the U.S. More than 6,000 Coloradans have died from the disease.
It's too early to tell whether deaths from the coronavirus pandemic are impacting Denver's life expectancy. Local data shows more than 750 Denverites have died either directly from COVID-19 or with the disease. That number includes probable cases as well.
Bol said the state will start figuring out the impact COVID-19 had on the state's life expectancy this spring or summer. Data from 2020 is still being processed.
That work should be done by May, he said, which could help generate a new life expectancy estimate for the state and some larger counties, including Denver.
