In many parts of the US, life expectancy for women today is declining and, in some parts of country, men and women are dying younger than people the same age in Syria, Panama and Vietnam. In a new study, Population Health Metrics, researchers describe a widening gulf between the healthiest and the least healthy due to wealth, cultural norms and public health efforts.
There are places in the US, including areas near Washington, the San Francisco Bay Area and elsewhere, where life expectancy is among the highest in the world, even topping that of Japan and Switzerland. But in poor, mostly rural parts of the South and in hard-hit urban centers like Philadelphia and St. Louis, people die the youngest; in Baltimore, where men live only 66.7 years on average, someone who lives in an affluent suburb has a life expectancy 20 years longer than someone in the city. (The Forbes blog does point out, one reason for the higher life expectancies for women in some parts of the US is simply that people move around, factors that the study’s data need to be adjusted for.)
What’s very troubling is that the US is falling behind other industrialized nations in life expectancy, with women in 737 US counties dying at younger ages between 1997 and 2007. Says Dr. Christopher Murray, director of the Institute for Health Metrics and Evaluation at the University of Washington, which carried out the research, in the Baltimore Sun: “There are just lots of places where things are getting worse. We’re not keeping up.”
Indeed, we are not. Women’s life expectancy at birth in the US was 81.3 years in 2007, placing the country 35th in the world — in 1987, the US was in the 20th place. Men’s life expectancy did increase to 76.7 years, or 24th best in the world, up from 32nd two decades earlier.
Population health experts cite smoking, high blood pressure and obesity as candidates for women dying younger. Notes the Baltimore Sun:
American women historically smoked more heavily than women in other countries, particularly after World War II, said Samuel Preston, a University of Pennsylvania demographer who co-chaired a 2011 National Academies panel that looked at life expectancies in high-income countries.
That had a delayed effect that drove up lung cancer rates among women as this generation aged. The trend may ease as that age group passes and the effects of more recent efforts to reduce smoking are felt, Preston said.
But Preston cautioned that the impact of other unhealthy lifestyles may undermine that progress. “In place of smoking, we have substituted obesity,” he said.
34 percent of Americans were classified as obese in 2010 — more than double the rate in 1980.
Worldwide, women’s life expectancy declined between 1987 and 1997, according to the study.
Again, researchers note that wealth is not the only factor in living long. Los Angeles county has one of the highest life expectancy rates in the country, even though its poverty rate is above the national average. Cultural factors play a significant role, it seems:
This may be evidence of what demographers and public health officials call the “Hispanic paradox,” a long recognized phenomenon in which Latino immigrants are generally healthier than non-Latinos of similar income.
Nearly half of Los Angeles County’s 10 million residents are Latino, and more than a third are foreign-born, according to census data. By contrast, less than a sixth of the population nationally is Latino, and less than an eighth is foreign-born.
One explanation of that phenomenon is that the people who become immigrants tend to be healthy. “These are not random people. They are the healthiest people who could get here,” said Carmen Nevarez, former president of the American Public Health Association.
But David Hayes-Bautista, who heads the Center for the Study of Latino Health and Culture at UCLA, said other factors, including social support networks, diet and even physical labor, may play a role as well, because not all immigrants have as good health outcomes as Latinos.
A 2006 Harvard University longevity study found that Asian women in New Jersey’s northern Bergen County have the highest life expectancy in the nation, typically reaching 91 years old. However, Bergen County is not among the top 25 counties in the US for life expectancy; 11.6 residents of Bergen County are Asian, while 82 percent are white and 6 percent are black. Howard Shih, manager of census information at the Asian American Federation of New York, suggested that cultural factors and wealth were key to the women’s long lives, with each Asian group offering a different explanation:
Raw tuna and green tea keep the Japanese alive, said Hiroyuki Gunji, a chef at Mitsuwa, a Japanese supermarket in Edgewater. East Indians depend on a diet heavy on vegetables and low on red meat , said Ravi Mehrotra, president of the Asian Indian Association of New Jersey. Prayer is the key for Filipinos, many of whom are Roman Catholic, said Nora Trivino, a member of the Filipino American Society of Teaneck. The Korean secret to long life is obvious, said Ji Yun Yoo of Fort Lee. “It has to be kimchi,” she quipped.
My own grandmother (on my father’s side), Ngin Ngin, died in October of 2009 at the age of 103 years. She had a number of ailments when she died including diabetes and high blood pressure, but, until her late 90s, was still doing pretty much everything I remember her doing her whole life, from cooking up a storm, to sewing clothes that ended up the racks of big department chains, to taking the bus to Reno, to babysitting her great-grandchildren, to walking to Oakland’s Chinatown, to calling my dad and talking up a storm. She didn’t smoke; she was never svelte. She emigrated from China to the US in the 1920s. She had no formal education to speak of (she was unable to read or write in Chinese or English). She was always surrounded by family members up to the moment she passed. She was the last of her generation to go; no one was nearly as old as her at her funeral.
What might we learn about longevity from studying cultural and social factors?
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