Life expectancy falls for some U.S. women

For the first time since the Spanish influenza of 1918, life expectancy is falling for a significant number of American women.

In nearly 1,000 counties that together are home to about 12 percent of the nation’s women, life expectancy is now shorter than it was in the early 1980s, according to a study published Tuesday.

The downward trend is evident in places in the Deep South, Appalachia, the lower Midwest and in one county in Maine. It is not limited to one race or ethnicity but it is more common in rural and low-income areas.

The trend appears to be driven by increases in death from diabetes, lung cancer, emphysema and kidney failure. It reflects the long-term consequences of smoking, a habit that women took up in large numbers decades after men did, and the slowing of the historic decline in heart disease deaths.

It may also represent the leading edge of the obesity epidemic. If so, women’s life expectancy could decline broadly across the United States in coming years, ending a nearly unbroken rise that dates to the mid-1800s.

“I think this is a harbinger. This is not going to be isolated to this set of counties, is my guess,” said Christopher Murray, a physician and epidemiologist at the University of Washington who led the study. It is being published in PLoS Medicine, an open-access journal of the Public Library of Science.

The study found a smaller decline, in far fewer places, in the life expectancy of men in this country. In all, longevity is declining for about 4 percent of males.

The phenomenon appears to be not only new but distinctly American.

“If you look in Western Europe, Australia, Japan, New Zealand, we don’t see this,” Murray said.

In the study, Murray and collaborators at the Harvard School of Public Health examined mortality and cause-of-death data for the United States from 1961 through 1999. They divided the country into 2,068 units, including cities, counties or combinations of counties.

Across that four-decade period, average life expectancy nationwide increased from 66.9 years to 74.1 years for men, and from 73.5 years to 79.6 years for women.

From 1961 to 1983, life expectancy went up everywhere for both sexes. This was largely because the death rate from heart attacks, which had been rising for half a century, began to fall in the late 1960s.

By the early 1980s, however, the rapid gains were coming to an end. The low-hanging fruit on the tree of heart-attack prevention and treatment had been picked. Further strides tended to happen mostly in places where people were already healthy and long-lived.

As a consequence, the rise in longevity began to stagnate in places with the least-healthy people. In those counties, life expectancy increased by only one year (from 74.5 to 75.5) between 1983 and 1999, while in the healthiest places the life expectancy of women had reached 83.

It was during this interval that women’s life expectancy fell in nearly 1,000 counties. If one adds counties where it rose only insignificantly, then 19 percent of American women – nearly 1 in 5 – are now experiencing stagnating or falling life expectancy.