Where women live shorter lives

What happened

A new study found that life expectancy dropped for a significant number of women between 1983 and 1999, marking the first such significant decline since the Spanish influenza of 1918. The trend has been driven by rising deaths from diabetes, lung cancer, emphysema, and kidney failure, and it has affected women in nearly 1,000 counties—mainly in the Deep South and Appalachia—where nearly 12 percent of the nation’s women live, according to the study, published Monday in PLoS Medicine. (The Washington Post, free registration)

What the commentators said

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The message of this study is clear, said Sharon Begley in Newsweek’s Lab Notes blog. “Health inequality is rising,” so your health is at risk if you live in a poor county. Death rates fell everywhere in the 1960s and 1970s as deaths from cardiovascular disease fell. In 1983, the difference between life expectancy in the highest and lowest counties was nine years for men and 6.7 years for women; in 1999 it was 18.2 years for men and 12.7 years for women. So, “want to live longer? Move. Or make more money.”

Declines in life expectancy are “rare” worldwide, said Alison Motluk in NewScientist.com, so these findings are “troubling.” People in most parts of the U.S. enjoyed longer life; it was only in poorer pockets where smoking, obesity, and high blood pressure reversed the trend. The disparities wouldn’t be such a problem if everybody were at least headed in the same direction—up. But Majid Ezzati, at the Harvard School of Public Health, and the other authors of the study see the poor’s lonely trajectory as evidence of a failure of the healthcare system.

As life expectancy was falling in all those areas, health-care costs were rising, said Michael Mandel in BusinessWeek's Economics Unbound blog. What’s going on? Doctors simply “know far less about what works and what doesn’t than we think.” But “I choose to interpret this as good news. The implication is that improvements in medical knowledge have the potential to both improve outcomes and reduce costs.” Biotechnology could hold the key.