Losing Ground For Life Expectancy

This article published with permission from The Burrill Report.

Women living in five counties in Mississippi have the lowest life expectancies for women in the United States — 74.5 years — less than their counterparts in Honduras, El Salvador and Peru. Men in four of those same counties, as well as one other in the Magnolia State, have life expectancies lower than men in Brazil, Latvia and the Philippines, at 67. In all, a new report finds that people living in some counties in the United States have the same life expectancies today that nations with the best health outcomes had in 1957.

The grim numbers are contained in a report from researchers at the University of Washington’s Institute for Health Metrics and Evaluation and Imperial College, London. The study, published in BioMed Central’s open-access journal Population Health Metrics, finds that between 2000 and 2007, the average life expectancies of counties fell in standing against the average of the 10 nations with the best life expectancies in the world, known as the international frontier -- a sort of Dow Jones index for life expectancy by which the counties are compared.

The fall in life expectancies in much of the United States comes as people in other developed countries such as Japan and Canada are seeing significant gains in life expectancy, the report says.

“Despite the fact that the U.S. spends more per capita than any other nation on health, eight out of every 10 counties are not keeping pace in terms of health outcomes,” says Dr. Christopher Murray, director of Institute for Health Metrics and Evaluation and one of the paper’s co-authors. “That’s a staggering statistic.”

The researchers say that neither the size of the nation, racial diversity, nor economics explain the relatively low life expectancies in the United States. Instead, they blame high rates of obesity, tobacco use and other preventable risk factors for an early death as the leading drivers of the gap between the United States and other nations.

In measuring life expectancies relative to the international frontier, researchers compared the current state of life expectancies in U.S. counties to where they historically would have been on par with the international frontier.

Nationally, life expectancy increased 4.3 years for men and 2.4 years for women between 1987 and 2007. But for many people in the United States, there is a growing gap between their life expectancies and the international frontier. Women are faring worse than men in their decline in relation to the international frontier. The researchers found that women in 1,373 counties — about 40% of all U.S. counties — fell more than five years behind the nations with the best life expectancies. In other words, life expectancy for these women is equivalent to what it was in the international frontier five years ago. Men in about half as many counties — 661 total — fell that same distance.

Black men and women have lower life expectancies than white men and women in all counties. Life expectancy for black women ranges from 69.6 to 82.6 years, and for black men, from 59.4 to 77.2 years. In both cases, no counties are ahead of the international frontier and some are more than 50 years behind. That’s to say life expectancies for these people are what they were for the international frontier more than 50 years ago.

Change in life expectancy is so uneven that within some states there is now a decade difference between the counties with the longest lives and those with the shortest. States such as Arizona, Florida, Virginia and Georgia have seen counties leap forward more than five years from 1987 to 2007 while nearby counties stagnate or even lose years of life expectancy. In Arizona, Yuma County’s average life expectancy for men increased 8.5 years, nearly twice the national average, while neighboring La Paz County lost a full year of life expectancy, the steepest drop nationwide.

The authors of the report say they hope the data will be used by policymakers to tailor strategies for different communities. To that end, the Seattle & King County health department is collaborating with Institute for Health Metrics and Evaluation on a detailed analysis of King County to identify the biggest healthcare challenges.

“It’s not the health care system that’s having the biggest impact on health; it’s the community,” says David Fleming, director of public health for Seattle & King County. “The average person in the U.S. spends one hour annually in a physician’s office unless they are really sick. So until we start moving our interventions out into the communities where people live, we are not going to get ahead of these problems.

Copyright 2011 Burrill & Company. For more life sciences news and information, visit http://www.burrillreport.com.