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Overall, the United States is falling further behind other industrialized nations, many of which have also made greater strides in cutting child mortality and reducing preventable deaths.
In 737 U.S. counties out of more than 3,000, life expectancies for women declined between 1997 and 2007. For life expectancy to decline in a developed nation is rare. Setbacks on this scale have not been seen in the U.S. since the Spanish influenza epidemic of 1918, according to demographers.
"There are just lots of places where things are getting worse," said Dr. Christopher Murray, director of the Institute for Health Metrics and Evaluation at the University of Washington, which conducted the research. "We’re not keeping up."

The backsliding for women began before 1997, but researchers found it had accelerated in the last decade. Only 227 counties saw women’s life expectancy decline between 1987 and 1997, according to the study.
The grim trend is fueled largely by smoking, high blood pressure and obesity, according to Murray and other population health experts.

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 those who were young adults in the 1950s 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 other unhealthful lifestyle choices may undermine that progress. "In place of smoking, we have substituted obesity," he said.
The number of Americans who are classified as obese hit 34 percent in 2010, more than double the rate in 1980.

The widening gulf between the healthiest and least healthy populations is partly due to wealth. A key finding of the data is that "inequality appears to be growing in the U.S.," said Eileen Crimmins, a gerontologist at the University of Southern California who also co-chaired the 2011 National Academies panel on life expectancies. "We are different than other countries."
Researchers found substantially fewer geographic disparities in Britain, Canada and Japan, for example.
An additional explanation appears to be cultural norms and differences in public health efforts, the researchers found.

Communities with large immigrant populations - Southern California, for example - fared considerably better than average despite relatively high poverty rates. The worst-performing counties were clustered primarily in Appalachia, the Deep South and the lower Midwest. In those places, women died as much as a year younger in 2007 than women did a decade earlier. Life expectancy for women slipped 2 { years in Madison County, Miss., which recorded the biggest regression.

The research is being published in the journal Population Health Metrics.........
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