Life expectancy in US in a free fall

U. WASHINGTON (US) — More than 80 percent of counties in the United States have life expectancies behind the 10 nations with the best records.

The low numbers can be attributed to high rates of obesity, tobacco use and other preventable risks, rather than the size of the nation, racial diversity, or economics.

“We are finally able to answer the question of how the United States fares in comparison to its peers globally,” says Christopher Murray, director of the Institute for Health Metrics and Evaluation at the University of Washington.

“Despite the fact that the United States 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.”

In conjunction with the study, published in the journal Population Health Metrics, researchers are releasing a complete time series for life expectancy from 1987 to 2007 for all counties.

When compared to the 10 best countries, called the international frontier, US counties range from being 16 calendar years ahead to more than 50 behind for women, and 15 calendar years ahead to more than 50 calendar years behind for men.

This means that some counties have a life expectancy today that nations with the best health outcomes had in 1957.

Five counties in Mississippi have the lowest life expectancies for women, all below 74.5 years, putting them behind nations including 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, putting them behind Brazil, Latvia, and the Philippines.

Nationwide, women fare more poorly than men. In 1,373 counties—about 40 percent of U.S. counties—women fell more than five years behind the nations with the best life expectancies. Men in about half as many counties—661 total—fell that far.

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. Some are more than 50 years behind. The researchers were not able to analyze other race categories because of low populations 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 lives and those with the shortest.

States such as Arizona, Florida, Virginia, and Georgia have seen some of their  counties leap forward more than five years from 1987 to 2007 while nearby counties stagnate or even lose years of life expectancy.

Researchers from Imperial College London contributed to the study.

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