But national data often masks disparities at the local level. For example, for the period between 1997 and 2001, the highest and lowest life expectancies in the United States by county were 18.2 and 12.7 years apart for males and females, respectively, compared to gaps of 6.7 and 4.9 years between whites and blacks. Counties are the smallest level for which death rates are available.
Using U.S. mortality statistics for every year between 1961 and 1999, the researchers found that overall life expectancy rose from 67 to 74 years for men and from 74 to 80 years for women. From 1961 to 1983, death rates for both men and women fell, largely because of gains in cardiovascular disease.
From 1961 to 1983, the differences in death rates across different counties also fell. But beginning in the early 1980s, the differences in county-level death rates began to increase while life expectancy decreased in many counties, especially among women. Not only did differences decrease, death rates actually increased in some areas.
Most of these were counties lining the Mississippi River in the Deep South and in Appalachia, along with parts of the Midwest and Texas. The increase in death rates came from an increase in cancer, diabetes, COPD (chronic obstructive pulmonary disease) and fewer gains in cardiovascular disease. For men, add HIV/AIDS and homicide.
And the increase in disparities primarily occurred in the worst-off segment of the population, with life expectancy for 4 percent of males and 19 percent of females either declining or stagnating.
"Over the past two decades, life expectancy has actually declined in dozens and dozens of counties throughout the U.S., mostly in poor, rural areas. Since life expectancy has continued to improve in more affluent areas, this trend has nothing to do with the limits of human survival, but rather with disparities in ed
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