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Life expectancy for large segment of US 'worsening'

22/04/2008

Life expectancy in a significant segment of the US population is declining or at best reaching a plateau, according to new research.

Between 1960 and 2000 overall life expectancy in the US increased by more than seven years for men and more than six years for women.

But a new study of long-term mortality trends in US counties released today shows that these gains are not reaching many parts of the country.

Researchers at the Harvard School of Public Health and the University of Washington found that while life expectancy in the best-off counties continued to improve, four per cent of the male population and 19 per cent of the female population experienced decline or stagnation in mortality in the 1980s.

In 1983 men in the best-off counties lived nine years longer than those in the worst-off counties, but by 1999 that gap had increased to 11 years; for women the 1983 life expectancy gap of 6.7 years increased to 7.5 years by 1999.

The majority of the counties that had the worst falls in life expectancy were in the Deep South, along the Mississippi River, and in Appalachia, extending into the southern part of the Midwest and into Texas.

Writing in the journal PLoS Medicine, the researchers say stagnation and worsening mortality was primarily a result of an increase in diabetes, cancers and chronic obstructive pulmonary disease, combined with a slowdown or halt in improvements in cardiovascular mortality.

An increase in HIV/Aids and homicides also played a role for men, but not for women.

The study's lead author Majid Ezzati said the findings are a "major public health concern".

"There has always been a view in US health policy that inequalities are more tolerable as long as everyone's health is improving," he added.

"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."

Dr Ezzati said health inequalities could be reduced if they become one of the health system's main goals.