Life Expectancies Declining for Poor, Rising for Rich

Between 1961 and 1999 life expectancies in the United States increased by between six and seven years for both men and women. A recent Harvard Medical study has found that these are unfortunately just general trends, and in certain parts of the country, most notably poorer areas, life expectancies actually declined or remained constant in these “counties”.

According to the study, average life expectancy in America increased from 66.9 to 74.1 years for men and from 73.5 to 79.6 for women between 1961 and 1999 (1999 is the last year taken into consideration in the study due to limitations in the data). Although there were disparities in mortality between counties at the time, “between 1961 and 1983 no counties had a statistically significant increase in mortality; the major cause of mortality decline for both sexes was reduction in cardiovascular mortality.” This statement indicates that during the first 22 years of the study, across all of America, life expectancies either increased or remained constant, due in large part to better cardiovascular disease treatment.

Following 1983 though, a trend begins to be seen in which the poorer counties have increased or “stagnant” mortality rates, while the wealthier segments of society continued to exhibit mortality decline. Following 1983 though, a trend begins to be seen in which the poorer counties have increased or “stagnant” mortality rates, while the wealthier segments of society continued to exhibit mortality decline. “From 1983 to 1999, life expectancy declined significantly in 11 counties for men (by 1.3 y) and in 180 counties for women (by 1.3 y).” The study attributes the decreased life expectancy in these counties to “increased mortality from lung cancer, chronic obstructive pulmonary disease (COPD), diabetes, and a range of other noncommunicable diseases, which were no longer compensated for by the decline in cardiovascular mortality. Higher HIV/AIDS and homicide deaths also contributed substantially to life expectancy decline for men, but not for women.”

The large number of counties exhibiting decreased life expectancy for women is primarily “because of chronic diseases related to smoking, overweight and obesity, and high blood pressure,” in the “worst-off segment of the population,” according to the study. Examples are lung cancer caused by smoking, diabetes caused by obesity, and COPD caused by high blood pressure. These trends were also significantly present in males, but to a lesser degree than women.

The geographic breakdown of these trends is also very informative as well, as there is a clear identification of regions where life expectancy is declining, as well as increasing. The study states that “Of the counties with statistically significant life expectancy decline, all for males and all but seven for females were in the Deep South, along the Mississippi River, and in Appalachia, extending into the southern portion of the Midwest and into Texas. There were also a number of counties with significant female life expectancy decline in the Rocky Mountain area and the Four Corners region, and one in Maine. Between 1983 and 1999, above-average mortality gain also became geographically more concentrated, and shifted to the Northeastern and Pacific Coast counties.” The regions with declining life expectancy represent the characteristically poorer sections of American society, while the Northeast and Pacific Coast regions have had considerably more wealth and growth over the given time period.

The continued rise in life expectancy in affluent segments of America, along with the decline in life expectancy in poorer counties, indicates a troubling disparity in health care, health education, and life style choices in different segments of American society. Better health care for those that cannot afford it, and more information and informed lifestyle choices, such as better nutrition and exercise habits, should help to limit this unfortunate trend.

Source: Defeat Diabetes Foundation: Ezzati, Majid. Friedman, Ari. Kulkarni, Sandeep. Murray, Christopher. PLoS Medicine. “The Reversal of Fortunes: Trends in County Mortality and Cross-County Mortality Disparities in the United States.” April 2008.