Life spans decline in some U.S. areas

By Janet Kornblum
28 april 2008--While most Americans enjoyed a clear jump in life expectancy from 1960 to 2000, a startling number — especially women — living primarily in the Deep South and in Appalachia actually saw a drop in life spans beginning in 1983, says a study that came out Monday.
In sum, where you live makes a difference in how long you can expect to live.
Researchers at the Harvard School of Public Health and the University of Washington found that 4% of the male population and 19% of the female population experienced either declines or stagnation in their life expectancy in the '80s and '90s. The paper appears in the online non-profit journal The Public Library of Science.
Most counties with the worst downward swings were in the Deep South, along the Mississippi River, and in Appalachia, extending into the southern portion of the Midwest and into Texas.
While race and poverty explain some of the disparity, they don't account for all of it, says Majid Ezzati, an associate professor at the Harvard School of Public Health and lead author.
Researchers found contributing causes: an increase in diabetes, cancers and chronic obstructive pulmonary disease, illnesses often caused and exacerbated by smoking and obesity.
While more research needs to be done on causes of the disparity, Ezzati hopes it will prompt some "pretty serious discussion at the national, state and arguably county level" about how to reach people in affected communities.
Researchers have long known that generally wealthier and better-educated communities have longer life spans than those that are worse off. But many also thought that all communities were steadily improving. That wasn't the case.
From 1983 to 1999, the gap between men living in the best- and worst-off counties widened from nine to 11 years. The gap for women widened from 6.7 to 7.5 years.
"The worse off are getting worse," Ezzati says. "There's just more inequality."
It's not the type of inequality that one would expect in the United States, says Richard Suzman of the National Institute on Aging.
"One generally associates declines in life expectancy with Russia and the USSR after the fall … and countries in Africa in the midst of wars, etc." Suzman says. "The fact that life expectancy has actually declined in quite a few counties is quite surprising."
The declines should not just worry those living in the places affected, says James Marks of the Robert Wood Johnson Foundation. They "should worry us all. These counties may be the canary in the coal mine (indicating) the deterioration in the U.S. health standing relative to the rest of the world."