To the Editor In an Original Investigation published in a recent issue of JAMA Internal Medicine, Dwyer-Lindgren and colleagues1 showed the existence and growth of alarmingly large inequalities in life expectancy across counties in the United States—up to a disturbing 20-year gap between the highest and lowest life expectancies between counties. I agree with the authors that these findings demand action because inequalities will continue to grow unabatedly in the face of inaction.