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TABLE 12-1 Life Expectancy at Birth and at Age 50 in States of the United States and Two Sets of Comparison Countries (in 2000)

Areas

Life Expectancy at Birth (in years)

Life Expectancy at Age 50 (in years)

Min

Max

Range

Min

Max

Range

States of the United States

72.3

79.7

7.4

28.0

32.4

4.4

All comparison countries

65.4

81.4

16.0

23.0

33.2

10.2

Selected high-income countries

76.7

81.4

4.7

29.1

33.2

4.1

NOTES: The full set of comparison countries includes Australia, Austria, Belarus, Belgium, Bulgaria, Canada, Chile, the Czech Republic, Denmark, Estonia, Finland, France, Germany, Hungary, Iceland, Ireland, Israel, Italy, Japan, Latvia, Lithuania, Luxembourg, the Netherlands, New Zealand, Norway, Poland, Portugal, Russia, Slovakia, Slovenia, Spain, Sweden, Switzerland, Taiwan, Ukraine, the United Kingdom, and the United States.

The selected set of countries includes all of the above except Chile, Israel, and Taiwan plus countries of Eastern Europe and the former Soviet Union (Belarus, Bulgaria, the Czech Republic, Estonia, Hungary, Latvia, Lithuania, Poland, Russia, Slovakia, Slovenia, and Ukraine).

SOURCE: Data from the Human Mortality Database (see http://www.mortality.org [accessed July 26, 2009]).

of the 20th century at all ages and for all states (plus the District of Columbia), the rankings of the various states or regions in this geographic hierarchy have changed rather little over this time period (National Center for Health Statistics, 1975, 1998). Moreover, in a recent investigation at the county level, Ezzati and colleagues uncovered an even greater range of disparities in life expectancy at birth in the United States, of around 13 years for women and 18 years for men in 1999 (Ezzati et al., 2008). The authors point out that, whereas geographic variability diminished during the 1960s and 1970s, the distribution of e0 by county in the United States started to diverge from the early 1980s onward. They demonstrated that this divergence—which was more pronounced for women than for men—was due to disparate trends affecting the more and the less advantaged areas of the country, as the former experienced a continuous rise in longevity while the latter experienced stagnation and, in the most extreme cases, a partial reversal of gains achieved in previous decades.

The divergence of the geographic distribution of mean longevity in the United States during the last two decades of the 20th century coincided with a rapid fall in the country’s position in international rankings with respect to various measures of mortality or longevity. The deterioration of the U.S. position is well documented with regard to infant mortality (for a recent discussion on this topic, see in particular MacDorman and Mathews, 2008) but appears to be less well known regarding mortality at older ages.



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