Houston Chronicle, April 26, 2008: American canaries

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Whatever might be criticized in America’s rich, unfettered culture, our growing life spans suggested we were doing something right.

Now, a study has found that an alarming swathe of Americans is dying younger than before. The findings should prompt serious study of what’s going wrong. These shorter lives reflect inequities in health care, earnings and emotional health that are dangerous to all.

According to a study by the Harvard School of Public Health and the University of Washington, almost 20 percent of American women die at the same age or younger than women did in 1983. This contrasts bleakly with historic trends and with the still-growing life spans of most other Americans.

Since 1960, the first year the study considered, overall life expectancy has grown more than seven years for men and more than six years for women.

But the researchers also found that from 1983 to 1999 (the study’s last year), the life spans of 19 percent of American women stayed static or dropped.

Because the study looked at regions of the United States, it was clear who was dying younger: women in the deep South, along the Mississippi River and in Appalachia, as well as areas including the lower Midwest and parts of Texas.

These areas are among the country’s poorest and least populated. Meanwhile, in affluent areas, life spans in the same period continued to grow.

Causes of death for these women, researchers found, were mostly preventable: diseases linked to blood pressure, smoking and obesity.

There is some chance the trend is an anomaly. Some health analysts think it corresponds with the tail end of a 20th century cigarette-smoking boom for women.

Equally likely, however, is that the women in the study are cultural canaries most vulnerable to spreading lethal economic and social trends.

Why are women in some of the poorest, most isolated parts of the country unable to avoid lethal behaviors and thus dying earlier?

What is the role of substandard schools in these regions? Low insurance levels? Inequities in medical care for minorities and for women?

Despair, which is not interchangeable with poverty, also leads to bad habits and poor health. What saps the hope of so many Southern and Appalachian women, and what could restore it?

A particularly worrisome part of the study is the role of obesity. Obesity is a particularly worrying part of the findings. Once dismissed as a disorder of poverty, it has spread like a virus throughout social echelons.

At least a quarter of the population in almost two dozen states now is obese; the women reflected in the Harvard-University of Washington study might simply be the weight plague’s first mass casualties.

While the mortality researchers focused on county and region, their findings are in no way local problems. Until recently, Americans across the board steadily added years to their lives. When almost 20 percent of American women are now dying younger, it reflects social chasms in health care, education, even optimism that threaten the health of a society.

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