Study Points To Health Disparities Among U.S. Women
BLOCK: A new study on life expectancy in the U.S. is raising concerns about wide health disparities and about women in particular. The study compiled life expectancies in every county from 2000 to 2007 to assess how U.S. mortality compares with other wealthy countries. The simple answer, not well. Life expectancy here has not kept pace with those other countries and, in fact, it has fallen in many counties in Appalachia and the deep south and women fared worse than men. Now, the question is why.
Ali Mokdad is a professor of global health at the Institute for Health Metrics and Evaluation at the University of Washington. That's the institute that did the study. And Professor Mokdad, you're now looking at these numbers trying to understand what's going on. Were you surprised by these findings?
Professor ALI MOKDAD (Institute for Health Metrics and Evaluation): Yes, we were. We were very surprised with the finding, although we have seen finds from previous work that we have done. The scope of the disparity was in the United States and how we compared to the rest of world was very surprising for all of us here.
BLOCK: And let's look broadly at that disparity. If you look at the United States compared with other countries in life expectancy, where do we fall?
Dr. MOKDAD: We are number 37 compared to the world, unfortunately.
BLOCK: So, 37th among all countries in the world?
Dr. MOKDAD: True.
BLOCK: Professor Mokdad, let's lay out the situation for women in particular. The highest life expectancy for women in 2007 turned out to be in Collier County, Florida - that's the area around Naples - 86 years; the lowest for women, Holmes County, Mississippi, 73.5 years. About a 13 year difference there.
When you look at the reasons behind that disparity, what would some of the reasons be?
Dr. MOKDAD: What accounts for that gap, there are four factors - three are equally affecting men and women in this country. That will be socioeconomic factors and makeup and community; access to healthcare, insurance or no insurance. The third one is the quality of medical care. And in this country we have politicians, health officials. We have always said that we have the best medical care in the world, which is true. But unfortunately, that's not true for many Americans. It's true for certain pockets.
I am here at the University of Washington. We have a wonderful hospital. That's not true two-hour's drive away from here to the east of the state.
And the fourth one, which is really the most important, is our risk factors. These are preventable risk factors, such as smoking, obesity, poor diet, lack of physical activity. And unfortunately in this country, women are more likely to be obese. Women picked up smoking after men and they're paying for it right now. And we have found out from previous research that women, once diagnosed with blood pressure and cholesterol, they don't do as good as men in controlling these conditions.
BLOCK: You actually find that in more than 300 counties in the United States, life expectancy declined over 20 years for women. Are these problems getting worse?
Dr. MOKDAD: Yes, that's why we're sounding this alarm and saying it's time for all of us to maybe revisit what we're doing here, and figure out how we could work with these communities that are at a disparity when it comes to risk factors. And we all agree we need programs. But also policy will help you and we haven't seen a wave of policy in our communities.
Policies such as having roads that are safe for me to exercise. And I don't mean safety, crime; I mean not being hit by a car. Policies with the restaurants or the food outlets that I have should have a healthy option for me at a reasonable price, where I could go and buy fresh fruits and vegetables. Policy in place where smoking should be banned from public places.
BLOCK: You can look at these numbers, Professor Mokdad, and feel pretty gloomy about the health of this country and our mortality overall. Is that the message we should be taking from this?
Dr. MOKDAD: No. Actually I would like to take a message out of this that look at the success story in our country and our communities, and let's share the knowledge and work together. What has New York done so good, or Seattle so good to improve the health of their population that I could adopt in Missouri, or Alabama, or Atlanta, Georgia, or anywhere else in the country?
The paper should not be viewed as a stamp on our forehead that this is our life expectancy. The paper should be viewed as a wake-up call for all of us to work on prevention and improve our health and our life expectancy.
BLOCK: Professor Mokdad, thank you very much.
Dr. MOKDAD: You're quite welcome. Thank you.
BLOCK: Ali Mokdad is a professor of global health at the Institute for Health Metrics and Evaluation, that's at the University of Washington.
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