Life Expectancy for Rural Women Declining

Two recent studies on life expectancies in the United States reveal troubling trends for many rural areas. As an advanced industrialized nation, you might assume life expectancies in the U.S. would increase and improve from generation to generation. But two studies show cracks in that assumption and neither is good news for rural communities.

Both of these reports have significant implications for services and policies in rural areas.

The Congressional Budget Office (CBO) report Growing Disparities in Life Expectancy published in April 2008, finds those at lower levels of income and educational attainment experiencing declining or stagnant life expectancies.

The CBO study did not examine differences between rural and urban life expectancies. Given that rural areas generally have lower income and educational attainment levels, we would expect rural areas to have more people experiencing declining or stagnant life expectancies.

A Harvard School of Public Health study – The Reversal of Fortunes: Trends in County Mortality and Cross-County Mortality Disparities in the United States, also published in April 2008 – is more striking. It finds that in nearly 1,000 mostly rural counties, life expectancies for women are now lower than or essentially the same as in the early 1980s. That means that life expectancies for women in nearly one-third of American counties did not increase for the first time since 1918.

Most of the rural counties experiencing decreases in life expectancy from 1983 to 1999 are concentrated in the South, the Southern Plains, and Appalachia. But counties not improving in life expectancy during the same time period are scattered throughout the nation, including large portions of the Midwest and Great Plains. By comparison, less than two dozen rural counties did not improve female life expectancies from 1961 to 1983. The phenomenon of declining life expectancies does not apply to rural men. Only seven rural counties experienced declining male life expectancies.

Both studies attribute much of their findings to heath outcomes and lifestyle choices. Both identify smoking and obesity – and their rates, especially among women – as primary causes. But both studies also point to a lack of access to health care services, the increase in the uninsured, and increasing income gaps as root causes that may make this a long-term issue for many portions of the American population.

Contact: Jon Bailey, jonb@cfra.org or 402.687.2103 x 1013 for more information.

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Another component is undoubtedly rising maternal mortality. As the nation's c-section rate is about 32% now, and any c-section which isn't performed solely to save the life of the mother (which is LESS THAN 5%) increases the risk of dying by at least 3% over vaginal delivery, it is extremely improbable that more women aren't dying from childbirth (read: c-sections). However, nobody, apparently, is tracking maternal death rates. (New York did for a couple of years, but then stopped when it got up to about 28 per 10,000, which was several years ago.)

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