A new, long-term study of mortality trends in U.S. counties from 1960 to 2000 finds that an overall average life expectancy increase of 6.5 years for men and women is not reaching many parts of the country. Instead, the life expectancy of a significant segment of the population is actually declining or at best stagnating.Researchers at the Harvard School of Public Health (HSPH) and the University of Washington found that 4% of the male population and 19% of the female population experienced either decline or stagnation in mortality beginning in the 1980s.“There has always been a view in U.S. health policy that inequalities are more tolerable as long as everyone’s health is improving. There is now evidence that there are large parts of the population in the United States whose health has been getting worse for about two decades,” said Majid Ezzati, Associate Professor of International Health at HSPH and lead author of the study.The majority of the counties that had the worst downward swings in life expectancy were in the Deep South, along the Mississippi River, and in Appalachia, extending into the southern portion of the Midwest and into Texas.The study appears in the April 22, 2008, edition of the open-access journal PLoS Medicine. The researchers analyzed mortality data from the National Center for Health Statistics and population data from the U.S. Census Bureau between 1959 and 2001. The study is the first to look at mortality trends in the U.S. by county over such a long period of time. (County data is the smallest measurable unit for which mortality data is available.) The National Center for Health Statistics stopped providing data after 2001. The results showed that, between 1961 and 1999, average life expectancy in the U.S. increased from 66.9 to 74.1 years for men and from 73.5 to 79.6 for women. Looking at individual counties, however, the researchers found that beginning in the 1980s, the best-off counties continued to improve but there was a stagnation or worsening of life expectancy in the worst-off counties–what the researchers refer to as “the reversal of fortunes.” As a result, while men in the best-off counties lived 9.0 years longer than those in the worst-off counties in 1983, by 1999 that gap had increased to 11.0 years; for women the 1983 life expectancy gap of 6.7 years increased to 7.5 years by 1999. Over the past few decades, life expectancy in high-income countries around the world has gradually risen, with few exceptions. Given the consistent trend of declining mortality rates in high-income countries, the results of this study, which show large segments of the American population experiencing stagnating or worsening health conditions, are particularly troubling. Ezzati said, “The finding that 4% of the male population and 19% of the female population experienced either decline or stagnation in mortality is a major public health concern.” Christopher Murray, Director of the Institute for Health Metrics and Evaluation at the University of Washington and co-author of the study, added that “life expectancy decline is something that has traditionally been considered a sign that the health and social systems have failed, as has been the case in parts of Africa and Eastern Europe. The fact that is happening to a large number of Americans should be a sign that the U.S. health system needs serious rethinking.” The researchers also analyzed data on deaths from different diseases and showed that the stagnation and worsening mortality was primarily a result of an increase in diabetes, cancers and chronic obstructive pulmonary disease, combined with a slowdown or halt in improvements in cardiovascular mortality. An increase in HIV/AIDS and homicides also played a role for men, but not for women.The diseases that are responsible for this troubling trend seem to be most related to smoking, high blood pressure, and obesity. “Smoking and blood pressure have a long history of being controlled through both personal and population strategies. There is good evidence on relatively low-cost and effective ways of dealing with these issues if one of the health system’s imperatives becomes to close this widening life expectancy gap,” said Ezzati.
Since making his debut for Jamaica two years ago, Knight-Wisdom, who created history when he became the first Jamaican male to compete at the Olympic Games, when he did so at Rio 2016, believes he has progressed steadily and is looking to seal a second successive qualification to the Olympics Games at Japan 2020. “I hope to make Jamaica proud next season. I wanted to improve on the season before. Where I was last year to where I am now, I have a better understanding of what I need and how I need to train. I don’t have the same youthful energy I had four years ago, but I have definitely progressed. I am in a much better place than in 2016. I am looking forward to next year and trying to qualify for the next Olympics, and any support will be helpful,” he said. Knight-Wisdom is currently listed as the 24th best diver in the world, based on the latest FINA rankings. [email protected] OLYMPIC GAMES Jamaica’s lone diver on the international circuit, Yona Knight-Wisdom, says the next two years of his career will be very important and he is on the lookout for any possible sponsorship, that can help him achieve his ambitions. The England-born Jamaican representative, who just missed out on a historic medal at the Commonwealth Games in April, has his sights set on accomplishing great things in 2019, but says it will be tough without adequate funding. “I want to thank the Jamaican people who supported me through the ups and downs, the difficult times. It will come good soon,” Knight-Wisdom told The Gleaner via telephone yesterday. “I would like to show my thanks to the Jamaican people and I hope I can bring my best next year and make them proud every time I compete. “But I’m on the lookout for more sponsorship, more funding to continue for the next two years, minimum, and hopefully beyond. I want to continue representing this country as long as possible, so if there is any opportunity for that (sponsorship) or anything that can help me move forward, I am always open to that suggestion,” he said. The 23-year-old said more funding will help pay for physiotherapy, dietary, training and travel expenses. “To just reduce the unnecessary stresses finances cause. That would put me in a better physical and mental state,” added Knight-Wisdom.