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Last Updated: Apr 23, 2008 - 6:26:23 AM |
TUESDAY April 22, 2008 (foodconsumer.org) -- The overall life expectancy in the U.S. increased more than seven years for men and more than six years for women in the United States between 1960 and 2000, according to a new study released on April 21.
The new, long-term study of mortality trends in U.S. counties over the same four decades showed the gains were not the same. In fact, the life expectancy of a significant segment of the population was declining or at best stagnating. The key probably lies in controlling smoking, blood pressure and obesity, the study pointed out.
Researchers at the Harvard School of Public Health (HSPH) and the University of Washington said 4% of all men and 19% of all women experienced either decline or stagnation in mortality starting in the 1980s.
"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 Majid Ezzati, at HSPH and lead author of the study.
The majority of the counties that had experienced decline in life expectancy were in the Deep South, along the Mississippi River, and in Appalachia, extending into the southern portion of the Midwest and into Texas, according to the researchers.
The study is published in the April 22, 2008, edition of the open-access journal PLoS Medicine.
For the study, the researchers analyzed mortality data from the National Center for Health Statistics and population data from the U.S. Census Bureau between 1959 and 2001.
They found between 1961 and 1999, average life expectancy in the U.S. increased from 66.9 to 74.1 years for men and from 73.5 to 79.6 for women.
But looking at individual counties, the researchers also found beginning in the 1980s, while the best-off counties continued to improve, there was a stagnation or worsening of life expectancy in the worst-off counties.
In the best-off counties, men lived 9.0 years longer than those in the worst-off counties in 1983, but by 1999 the gap had increased to 11.0 years. For women, the 1983 life expectancy gap of 6.7 years increased up to 7.5 years by 1999.
In comparison, over the past few decades, life expectancy in high income countries around the world had gradually risen without exceptions. There was a consistent trend of declining mortality rates while in the U.S. large segments of the population experienced stagnating or worsening health conditions.
Ezzati said, "The finding that 4% of the male population and 19% of the female population experienced either decline or stagnation in mortality is a major public health concern."
"Life expectancy decline is something that has traditionally been considered a sign that the health and social systems have failed, as has been the case in parts of Africa and Eastern Europe. The fact that is happening to a large number of Americans should be a sign that the U.S. health system needs serious rethinking," added Christopher Murray, Director of the Institute for Health Metrics and Evaluation at the University of Washington and co-author of the study.
The stagnation or worsening mortality may result from an increase in diabetes, cancers, and chronic obstructive pulmonary disease combined with a slowdown in improvements in cardiovascular mortality, the researchers concluded after analyzing data on deaths from different diseases. HIV/AIDS and homicides were also a factor for men's mortality, but not for women's.
The chronic diseases responsible for the trend appeared to be mostly related to smoking, high blood pressure and obesity, which are preventable to a large degree.
"Smoking and blood pressure have a long history of being controlled through both personal and population strategies. There is good evidence on relatively low-cost and effective ways of dealing with these issues if one of the health system’s imperatives becomes to close this widening life expectancy gap," said Ezzati.
© 2004-2008 by foodconsumer.org unless otherwise specified
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