Life Expectancy Decreasing in the United States for Some Groups (dateline May 27, 2008)
A new study finds that overall life expectancy in the United States increased over the past several decades but not for all citizens. While men now live to an average age of 74 and women to nearly 80, researchers found that 4% of the male population and 19% of the female population experienced either a decline or leveling off in mortality beginning in the 1980s. They point to disparities in healthcare and behavioral factors, such as smoking and obesity, as factors that may have contributed to these declines.
The study was conducted by researchers from the Harvard School of Public Health and the University of Washington. The researchers performed their analysis by examining mortality data by county. Data were obtained from National Center for Health Statistics and the U.S.Census Bureau between 1959 and 2001.
The results of the study found that, overall, life expectancy increased for both men and women in the United States. Specifically, between 1961 and 1999, the average life expectancy in the United States increased from 66.9 to 74.1 years for men and from 73.5 to 79.6 for women. However, the researchers found that the gains varied by county. And, beginning in the 1980s, the researchers found that 4% of the male population and 19% of the female population experienced either a decline or leveling off in mortality.
However, these declines beginning in the 1980s did not exist across the country. Life expectancy decreased for some counties while still increasing for others--creating a gap between "best" and "worst" counties in the United States, which vary depending on affluence and economic status. For example, the researchers found that men in the most affluent counties lived 9.0 years longer than those in economically stagnated counties in 1983 and women in the most affluent counties lived 6.7 years longer than in the economially stagnated counties. By 1999, the gap had increased to 11 years for men and 7.5 years for women.
The researchers noted that increases in diabetes, cancers, chronic obstructive pulmonary disease, and other conditions may be to blame for decreased longevity in some of the stagnated counties. Also, there has been a leveling off in the declines of death from heart disease. The researchers also found an increase in HIV/AIDS and homicides among men.
Lifestyle factors that may contribute to these health issues include smoking, obesity, and high blood pressure. The researchers note that disparities in healthcare systems may exist between rich and poor counties, and that robust healthcare systems are needed in the worst-off counties to guard against lifespan decreases.
"There has always been a view in U.S. health policy that inequalities are more tolerable as long as everyone's health is improving. There is now evidence that there are large parts of the population in the United States whose health has been getting worse for about two decades," said lead author Majid Ezzati, Associate Professor of International Health at Harvard School of Public Health, in a Harvard School of Public Health news release.
According to the study, the areas that show the greatest decline in longevity were Appalachia, the Mississippi River Valley, the Deep South, the southern part of the Midwest, and Texas.
Researchers are particularly concerned about the steep declines in women's life expectancies in over 1,000 counties beginning in the 1980s (nearly four times the rate for men). They noted that large numbers of women took up smoking years in the United States long after men initially did, and health complications resulting from smoking may be partly to blame for the decline in longevity. Obesity is another factor that may contribute to decreased longevity among women--about one third of all women are obese.
Aside from addressing disparities in healthcare across the country, the researchers point to behavioral actions that could help reverse the downward trend in mortality rates. Weight control, maintaining normal blood pressure, not smoking, and a healthy diet could all contribute.