Researcher Calls Findings 'Alarming,' Says Americans Need Help to Improve Preventable Risk Factors
By Kathleen Doheny
WebMD Health News
Reviewed by Louise Chang, MD
June 15, 2011 -- The life expectancy in most counties in the U.S. lags substantially behind those in the nations with the best life expectancy, according to a new report.
In some counties, the life expectancy is similar to that in much less developed countries, the researchers found.
''It is a wake-up call for all of us," says researcher Ali Mokdad, PhD, professor of global health at the University of Washington's Institute for Health Metrics and Evaluation in Seattle.
''Americans have higher risk factors and are paying for those in lower life expectancy than in similar countries," he tells WebMD. "We are left behind and everyone else is moving forward. For the U.S., it is alarming."
''Lots and lots of counties in the U.S. are not making as much progress as we think is possible as far as life expectancy," says Christopher Murray, MD, PhD, director of the Institute and the study's senior author.
The study is published today in the journal Population Health Metrics.
At the same time, the institute is releasing information on life expectancy in all U.S. counties from 1987 through 2007, the latest year for which data is available.
U.S. Life Expectancy: The Comparisons
The researchers looked at the years 2000 to 2007, using a statistical model to estimate life expectancy in the U.S. They compared it to that of the 10 nations with the best life expectancies.
In 2007, the life expectancy at birth was 75.6 years for men and 80.8 years for women in the U.S. Globally, that ranks U.S. men and women at 37th place.
The top 10 nations include:
- The Netherlands
U.S. Life Expectancy: County by County
The researchers found large differences in the U.S. county by county. For women, they found that life expectancies ranged from 16 calendar years ahead to more than 50 behind, when compared to the top 10 nations. For men, the life expectancy ranges from 15 years ahead to more than 50 behind.
Across all counties, the life expectancy in 2007 ranged from 65.9 to 81.1 years for men. For women, the range was 73.5 to 86 years.
Translated, the researchers say this means some counties' life expectancy was like that of the top 10 nations 50 years ago.
For women and men, Mississippi had the lowest life expectancies.
The best places to live, life span wise? For women, Collier, Fla., where the average life span was 86 years. That beats France, Switzerland, and Spain.
For men, it's Fairfax County, Va., where the average life expectancy is 81.1 years. That is better than Japan and Australia.
U.S. Life Expectancy Lag: Explaining It
Mokdad cites four reasons for the lag in life expectancy in the U.S.:
- Socioeconomic factors such as income and education. More education, he says, translates to a person being more likely to seek and follow medical advice.
- Access to health care. Some rural areas have shortages of doctors, he says, and many people lack health insurance.
- Quality of medical care. While some areas have superior care, many others do not, he says.
- Preventable risk factors such as obesity and smoking. Mokdad cites this as ''the main reason in this country we are behind."
However, Mokdad says the blame in not doing a better job in preventing obesity and stopping smoking lies in the system, more than in the people.
Behavior change, he says, requires a supportive community. "Many neighborhoods are not safe to walk in," he says, citing traffic hazards as well as crime.
The U.S. needs to take a page from those of other countries, he says, such as Australia, which promotes public health with community programs. "Australia invested in a lot of programs at the community level," he says. The country has a widespread skin cancer prevention campaign, for instance.
More public health programs that reach out to the community are needed in the U.S., he says.
U.S. Life Expectancy: Perspective
Jeffrey P. Koplan, MD, MPH, director of the Global Health Institute at Emory University, prefers to call the new report ''enlightening" rather than ''alarming." He reviewed the report for WebMD but was not involved in the research.
"Most of us, when it comes to being competitive, we think of other high-end, rich countries," Koplan says. The report shows that does not hold when it comes to life expectancy.
He agrees with Mokdad that strong environmental elements help explain the risk factors that lead to shortened lives. "If you live in a shady, green neighborhood with sidewalks and security, you are much more likely to go out for a walk," he says.
Environment and access play a role in healthy eating, too, he says. He notes that many people are unable to buy reasonably priced fresh produce.
Consumers should not just think about what they can do as individuals to improve, he says. "It's what can I do and my family do to make my community -- the county, the town, the city -- a healthy environment for all of us," Koplan says.
That could mean, for instance, voting for the bond issue for a neighborhood school that provides for safe playgrounds or voting in bike lanes to encourage more exercise, he says.
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SOURCES:Ali Mokdad, PhD, professor of global health, University of Washington Institute for Health Metrics and Evaluation, Seattle.Jeffrey P, Koplan, MD, MPH, vice president for global health and director, Global Health Institute, Emory University, Atlanta.Kulkarni K. Population Health Metrics, online June 15, 2011.Christopher Murray, MD, PHD, director, University of Washington Institute for Health Metrics and Evaluation, Seattle.
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