Spurred on by a post on BlogHer by Health editor Catherine Morgan, I read with some dismay that while life expectancy has steadily risen in this country throughout the 20th century, that the trend is actually leveling off and even declining for some in the U.S., since 1983 actually.
If this trend has been happening for about 25 years why are we only hearing about it now? Well, the study was only published this past week. It's kind of disturbing considering the data stops at 1999, so it's not even taking into account what the policies and economic issues of the last eight years might have done to further exacerbate the problem!
Oh, and the problem? Most disturbing of all it seems to be all about class. Welcome to the Two Americas John Edwards was always talking about. if you didn't want to believe it was true, these studies may shake your faith.
Let's get to some excerpts from the two different NY Times stories i saw on the subject:
"Throughout the 20th century, it was an American birthright that each generation would live longer than the last. Year after year, almost without exception, the anticipated life span of the average American rose inexorably, to 78 years in 2005 from 61 years in 1933, when comprehensive data first became available.But new research shows that those reassuring nationwide gains mask a darker and more complex reality. A pair of reports out this month affirm that the rising tide of American health is not lifting all boats, and that there are widening gaps in life expectancy based on the interwoven variables of income, race, sex, education and geography."
"The most startling evidence came last week in a government-sponsored study by Harvard researchers who found that life expectancy actually declined in a substantial number of counties from 1983 to 1999, particularly for women. Most of the counties with declines are in the Deep South, along the Mississippi River, and in Appalachia, as well as in the southern Plains and Texas."
"The first of the two reports, released two weeks ago by the Congressional Budget Office, declared that the life expectancy gap is growing between rich and poor and between those with the highest and lowest educational attainment, even as it is narrowing between men and women and between blacks and whites."
It's interesting that it's not as simple as to say those with lower income are less likely to have insurance, or to go to the doctor, or to get early diagnoses of ailments...all of which is true. There is also the fact that there are higher incidences of unhealthy behaviors in lower-income populations, such as smoking, alcohol abuse and poor management of chronic disease.
"Dr. Ezzati, of the Harvard School of Public Health, asked: “How much of this is pure material well being, the ability to purchase high-quality food, the ability to have a particular lifestyle? And how much of it is the impact of income on risk behaviors like alcohol and tobacco and stress mechanisms that are more psychosocial? There’s a series of debates around that that are unresolved.”
This may be the money excerpt form the entire series of articles:
"From 1961 to 1983, no county had a statistically significant decline in life expectancy, and reductions in cardiovascular disease led to a generally increasing length of life for both sexes. But after 1983, life expectancy declined an average of 1.3 years in 11 counties for men, and in 180 counties for women.This lack of progress among the worst off was caused by a slowing or halt of reductions in cardiovascular disease, combined with increases in lung cancer and diabetes for women and in H.I.V. infection and homicide for men.
This rise in mortality for chronic diseases runs counter to trends in other developed countries, and the geographical differences are consistent with regional trends in smoking, high blood pressure and obesity. Dr. Ezzati speculates that data after 1999 will show more decreases in life span for the worst-off women. He expects to see a slight increase for men, with improved treatment for H.I.V. and AIDS.
“What’s driving the disparity is the worsening of the worst off,” Dr. Ezzati said. “In the U.S., there has always been a view, stated or unstated, that we can live with some inequality if everyone is getting better. This is the first sign that not everyone is getting better.”
So, is anyone else noticing that this decline started during the Reagan years? I consider that to be the starting point for the new Republican party values that eschewed (and continues to eschew) actual legislative or policy-driven solutions to our widening class gap...and in fact seems to celebrate it.l All while paying lip service to the concept of compassion...as long as it's someone else's problem.
Well, those chickens are coming home to roost, IMHO.
And here's something I found very odd: I scanned my usual suspects of medblogs looking for either concurring or opposing opinions, and found very little blogging about this.
What am I missing? Isn't this news disheartening? Does this not jive with how we think of ourselves here in the U.S.? Is this just old news to the medical community...are they so familiar with the problems that they're hardened to it? Where are the blog posts I'm missing? :(
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