WASHINGTON (AP) - Asian-American women living in Bergen County, N.J., lead the nation in longevity, typically reaching their 91st birthdays. Worst off are American Indian men in swaths of South Dakota, who die around age 58 - three decades sooner.

Where you live, combined with race and income, plays a huge role in the nation's health disparities, differences so stark that a report issued yesterday contends it's as if there are eight separate Americas instead of one.

Millions of the worst-off Americans have life expectancies typical of developing countries, concluded Dr. Christopher Murray of the Harvard School of Public Health.

Asian-American women can expect to live 13 years longer than low-income black women in the rural South, for example. That's like comparing women in wealthy Japan to those in poverty-ridden Nicaragua.

Compare those longest-living women to inner-city black men, and the life-expectancy gap is 21 years. That's similar to the life-expectancy gap between Iceland and Uzbekistan.

Health disparities are widely considered an issue of minorities and the poor being unable to find or afford good medical care.

Murray's county-by-county comparison of life expectancy shows the problem is far more complex, and that geography plays a crucial role.

"Although we share in the U.S. a reasonably common culture . there's still a lot of variation in how people live their lives," explained Murray, who reported initial results of his government-funded study in the online science journal PLoS Medicine.