If you reside in Burlington County, chances are you'll live five years longer than your neighbors in Philadelphia. In Montgomery County, 61/2 years longer than in Philadelphia.

It's not necessarily about the medical care you get. Availability of fresh fruits and vegetables plays a role. So does the condition of your house, the stress of your job, and the distance to safe parks where you and your children can exercise.

"In order to improve the health status of people in this country, we must address the underlying issues that impact people in the communities where they live," said Rob Simmons, director of Thomas Jefferson University's master of public-health program.

Practical ways to deal with those issues will be presented to an independent commission of influential health-policy experts at a public meeting today at Temple University.

"Where we live matters for our health and it matters a lot," said James Marks, director of the Robert Wood Johnson Foundation's health group. The meeting is the second public hearing by the Commission to Build a Healthier America, which the foundation launched earlier this year to find solutions to the social causes of health disparities.

Philadelphia and its Pennsylvania suburbs offer lots of examples showing that how well-off someone is has an impact on how well she is. And there are plenty of local solutions to showcase.

People living at or below the poverty line here are more likely to have diabetes, heart disease and high blood pressure, according to Public Health Management Corp.'s community health database.

For example, children in low-income households often live in older homes where they are exposed to asthma triggers.

"It appears that poverty runs through all of these things," said Francine Axler, director of the database project. Obesity, which can contribute to those health conditions, is also more common among the poor.

While such disparities are most evident when comparing the poorest to the richest, experts say those with the least are not the only ones whose health suffers.

"This is a problem that cuts across our society," said Marks. "The health of the middle class and upper middle class is not what it should be."

Nationwide, the average life-spans of middle-class Americans are two years shorter than the richest. There are clear regional variations, too, with life expectancy typically less in the Southeast and more in the upper Midwest.

The numbers, from analysis of federal data by researchers at Harvard University, are broken down to the county level. Of course, non-medical factors - from income and education to crime and pollution - also vary among smaller communities and neighborhoods. But those statistics aren't available.

Worldwide, the United States ranks 46th, with an average life expectancy of slightly over 78 years, according to the World Fact Book. That puts us nearly four years behind Japan - and behind Monaco, Liechtenstein and Bosnia as well.

Today, the commission - led by Mark McClellan, a former top health official in the Bush administration, and Alice M. Rivlin, director of the White House Office of Management and Budget in the Clinton administration - will hear about a range of local efforts.

Among the largest is the Pennsylvania Fresh Food Financing Initiative, which is working on 58 projects across the state to provide people access to healthy, affordable food.

That project - a public-partnership led by The Food Trust, The Reinvestment Fund and the Greater Philadelphia Urban Affairs Coalition - has committed $35.1 million in loans and $6.7 million in grants to the effort.

Juan Carlos Romano used a $60,000 grant to transform his grocery in Philadelphia's Juniata Park neighborhood from a typical corner store stocked floor to ceiling mostly with junk food.

"It was like a convenience store," Romano said.

But after two months of renovations, the store reopened in November with a large selection of fresh fruit and vegetables, better lighting and energy efficient refrigerators. Romano said his customers like the cleaner store, and the wide selection of fresh produce.

"For us it has been great," he said. "We helped the community, we are doing better financially, and we have a brand new store."

In West Philadelphia, millions of dollars in grants and loans from the fresh food initiative helped Lucinda Hudson's neighborhood get the supermarket she has sought for over a decade.

"We had not had a supermarket in this area in more than 40 years," said Hudson, president of the Parkside Association.

"This market is helping us get our exercise; it is helping us with our nutrition; it is safe," she said. "It has improved quality of life here immensely."

Besides nutrition, the commission expects to hear today from area advocates discussing efforts to create healthier and safer neighborhoods, and others who will talk about local efforts to promote physical activity and reduce violence.

"It is relatively recently that there has been a fuller recognition that the community context, the circumstances where people live and work, that affects health," said Dennis P. Andrulis, director of the Center for Health Equity at Drexel University.

The new commission's mandate is "to raise awareness of the factors beyond medical care that greatly affects a person's health and then recommend policies and strategies that can improve the health of everybody," said Marks.