Life expectancy worsening or stagnating

One of the major aims of the U.S. health system is improving the health of all people, particularly those segments of the population at greater risk of health disparities. In fact, overall life expectancy in the United States increased more than seven years for men and more than six years for women between 1960 and 2000.

Now, a new, long-term study of mortality trends in U.S. counties over the same four decades reports a troubling finding: These gains are not reaching many parts of the country; rather, the life expectancy of a significant segment of the population is actually declining or at best stagnating.

Researchers at the Harvard School of Public Health (HSPH) and the University of Washington found that 4 percent of the male population and 19 percent of the female population experienced either decline or stagnation in mortality beginning in the 1980s.

“There has always been a view in U.S. health policy that inequalities are more tolerable as long as everyone’s health is improving. 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,” said Majid Ezzati, associate professor of international health at HSPH and lead author of the study.

The majority of the counties that had the worst downward swings in life expectancy were in the South, along the Mississippi River, and in Appalachia, extending into the southern portion of the Midwest and into Texas. The study appears in the April 22 issue of the open-access journal PLoS Medicine.