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    Death Gap: Life Expectancy Falls for Some

    Analysis Shows Life Expectancy in U.S. Down or Stagnant for 1 in 5 Women, 1 in 20 Men

    Death Gap Greater for Women

    The death gap was greatest for women. After 1983, life expectancy declined in 180 U.S. counties for women and in 11 counties for men. It remained stagnant in an additional 783 counties for women and in an additional 48 counties for men.

    In the counties where life expectancy declined or failed to keep improving, there were increased deaths from causes attributable to obesity, smoking, and high blood pressure.

    Rita F. Redberg, MD, director of Women's Cardiovascular Services at the University of California, San Francisco, says the findings are unsettling.

    "It is disturbing, in a time when we feel like we know more and we should have better health, that the trends don't show everyone is benefitting," Redberg tells WebMD.

    Redberg says much of the problem can be traced to the rise in obesity and to continued smoking.

    "We see higher rates of unhealthy behaviors in those who are stressed," she says. "It is really a concern, with the current downturn in the economy, that people are going to be more stressed and the poorer will get poorer and health behaviors are going to get worse."

    Ezzati says knowing exactly where health problems are worst should help focus public health efforts.

    "If you just look at income disparities, it is hard to know where to start," he says. "But now we are looking at specific geographic areas. We hope it will give those states and regions some place to start and a way to monitor them over time to see how they are doing."

    Redberg notes that obesity and tobacco control are national problems and calls for increased funding of the CDC's public health efforts and of education.

    "Every time a county's education budget gets cut, it is physical education and nutrition programs that are the first to go," she says. "We really need to emphasize healthy diet and exercise -- because we know that these mortality problems are related to obesity."

    Ezzati and colleagues report their findings in the April issue of the journal PloS Medicine.

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