Life getting shorter for women in hundreds of U.S. counties

Original Reporting | By Mike Alberti |

Instead, the public health department in Pike County has been focusing on young people, she said, by going into schools to educate children on the benefits of healthy habits and the dangers of unhealthy ones.

Nearby in McDowell County, West Virginia, Public Health Department administrator Jesse Rose echoed that sentiment. “We try to help everybody we can,” he said, “but mindset has a lot to do with it, and that’s hard to change.”

McDowell has one of the lowest life expectancies, for both men and women, in the country. Life expectancy has not changed at all for men since 1987, and has decreased for women by nearly 10 months.

“We’ve known about the disparities in the health care system for a long time,” David Kindig said, “but we’ve tolerated them because, on the whole, we were getting better. Until recently, we didn’t know that a lot of the country was actually getting worse.”

“It’s the women I don’t understand,” he said. “It seems like when we have clinics, it’s mostly women who come. I’m puzzled. I know we weren’t doing so great compared with the rest of the country, but I thought we would be doing better then we were.”



Judith Duncan, the director of physical activity and nutrition in the Oklahoma State Department of Public Health, was similarly puzzled when she heard that life expectancy had either declined or remained level in most counties in Oklahoma. In fact, Oklahoma is the only state in the country in which life expectancy for women decreased at the state level, from 78.5 years in 1987 to 77.9 in 2007. For men, it increased slightly during the same period, by a little more than one year.

“If I had the answer to why this is happening I would be a wealthy woman,” Duncan said.

Much of southern Oklahoma is rural, and the poverty rate in those counties is well above the national figures. Duncan also said that there are a relatively small number of primary care physicians in the state, which caused problems with access to care, especially in rural areas.

Sally Carter, another state public health official who concentrates primarily on tobacco use, said that smoking rates were particularly high in that part of the state, especially among women. In recent years, the state has been concentrating increasingly on that issue, starting a “quit line” that people who are quitting smoking can call for support and issuing free nicotine patches and gum to some residents.

But Duncan emphasized that there is only so much that Public Health Departments can do in Oklahoma, or anywhere else in the country. “Funding is obviously an issue, not just here but everywhere,” she said. “But there are some things we could do quickly that don’t cost a lot of money. There are policies that could be made at the state and federal level that would have enormous benefits at low costs.”

In Oklahoma, she said, there is no mandated requirement for health education classes in high school. She also mentioned banning smoking in restaurants and public places and setting aside property for community gardens to increase access to food.

Duncan acknowledged, however, that recent budget cuts have made it harder to do her work by reducing the staff available for the programs the Department runs. She said that, if the funding were available, she would be eager to invest in infrastructure such as sidewalks and green space to make it easier for residents to exercise. She would also like to introduce initiatives to increase the amount of fruits and vegetables available in grocery stores, and to run “counter-marketing” campaigns to highlight the dangers of tobacco use.

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