Those are among the conclusions of the study by a team of researchers that has spent years teasing apart the regional and demographic differences in longevity in the United States. It sketches a picture of widening inequality among regions and is likely to add urgency to the debate over health-care reform and spending.
Led by Christopher J. L. Murray and Sandeep C. Kulkarni of the Institute of Health Metrics and Evaluation at the University of Washington, the study covers the years 1987 to 2007 and updates an earlier analysis of U.S. life expectancy through the 1990s. That study identified areas of the country where life expectancy was stagnant or declining; this report found that not only was that still the case, but more places are experiencing a decline. The study will be published Wednesday in the journal Population Health Metrics.
As they had previously, Murray and his colleagues found huge variation in life expectancy in the United States, with some of biggest extremes right around Washington. Fairfax County’s men, for example, had the longest life expectancy in the country, 81.1 years in 2007. In the city of Petersburg, 25 miles south of Richmond, life expectancy was 14 years less, and at 66.9 years among the lowest for men in the country.
The District is one of the places that has seen a big recent jump in life expectancy for a particular demographic group — black men, from 61.7 years in 1997 to 68.9 in 2007, a huge jump in demographic terms. The reason for the big increase isn’t entirely clear.
The region where life expectancy is lowest, and in some places declining, begins in West Virginia, runs through the southern Appalachian Mountains and west through the Deep South into North Texas. Places of high life expectancy are more scattered. In addition to Northern Virginia they include counties in Colorado, Minnesota, Utah, California, Washington state and Florida.
Although the research didn’t look for causes, there are several possible reasons for the slowing of longevity in parts of in the United States. The rising rate of obesity and plateauing of the smoking cessation rate among women are two. Poorly controlled blood pressure and a shortage of primary-care physicians are two others.
What surprised Murray and his team was that despite increased consciousness about disparities and per capita spending on health care that is at least 50 percent higher than European countries, the United States is falling farther behind them with each passing year.
“My expectation was that in the last decade we would at least be keeping up in terms of the pace of progress. But that’s not what’s happening,” said Murray.