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U.S. counties fall behind in life expectancy

Wednesday June 15, 2011
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While people in Japan, Canada and other nations enjoy significant gains in life expectancy every year, most counties in the United States are falling behind, according to a new study by the Institute for Health Metrics and Evaluation at the University of Washington.

IHME researchers, in collaboration with researchers at Imperial College London, found that between 2000 and 2007, more than 80% of counties fell in standing against the average of the 10 nations with the best life expectancies in the world, which the researchers called the international frontier.

“We are finally able to answer the question of how the U.S. fares in comparison to its peers globally,” Christopher Murray, MD, DPhil, IHME director and one of the paper’s co-authors, said in a news release. “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. That’s a staggering statistic. … Some counties have a life expectancy today that nations with the best health outcomes had in 1957.”

The researchers suggest that the relatively low life expectancies in the U.S. cannot be explained by the size of the nation, racial diversity or economics. Instead, the authors point to high rates of obesity, tobacco use and other preventable risk factors for an early death as the leading drivers of the gap between the U.S. and other nations.

Five counties in Mississippi have the lowest life expectancies for women, all below 74.5 years, putting them behind nations such as Honduras, El Salvador and Peru. Four of those counties, along with Humphreys County, Miss., have the lowest life expectancies for men, all below 67 years, meaning they are behind Brazil, Latvia and the Philippines.

Nationwide, women fare worse than men. The researchers found that women in 1,373 counties — about 40% of U.S. counties — fell more than five years behind the nations with the best life expectancies. Men in about half as many counties fell that far behind.

Black men and women have lower life expectancies than white men and women in all counties. Life expectancy ranges from 69.6 to 82.6 years for black women and from 59.4 to 77.2 years for black men. In both cases, no counties are ahead of the international frontier, and some are more than 50 years behind. The researchers were not able to analyze other race categories because of low population levels in many counties.

Change in life expectancy is so uneven that within some states there is now a decade difference between the counties with the longest life expectancy and those with the shortest. States such as Arizona, Florida, Virginia and Georgia have counties that leaped forward more than five years from 1987 to 2007 while nearby counties stagnated or even lost years of life expectancy. Nationally, life expectancy increased 4.3 years for men and 2.4 years for women between 1987 and 2007.

The study, “Falling behind: life expectancy in US counties from 2000 to 2007 in an international context,” was published June 15 in Biomed Central’s open-access journal Population Health Metrics. View the data at http://www.pophealthmetrics.com/content/9/1/16/abstract.

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