They found that nationwide, the rate of women dying younger than would be expected fell from 324 to 318 per 100,000. But in 1,344 counties, the average premature death rate rose, from 317 to about 333 per 100,000. Deaths rates rose for men in only about 100 counties.
“We were surprised” by how much worse women did in those counties, and by the geographic variations, Kindig said.
The study wasn’t the first to reach those conclusions. Two years ago, a study led by the University of Washington’s Dr. Christopher Murray also looked at county-level death rates. It too found that women were dying sooner, especially in the South.
Some other studies that focused on national data have highlighted steep declines in life expectancy for white women who never earned a high school diploma. Meanwhile, life expectancy seems to be growing for more educated and affluent women. Some experts also have suggested smokers or obese women are dragging down life expectancy.
The Murray and Kindig studies both spotlight regional differences. Some of the highest smoking rates are in Southern states, and the proportion of women who failed to finish high school is also highest in the South.
“I think the most likely explanation for why mortality is getting worse is those factors are just stronger in those counties,” Murray said, adding that abuse of Oxycontin and other drugs also may add to the problem.
Some also think the statistics could reflect a migration of healthier women out of rural areas, leaving behind others who are too poor and unhealthy to relocate. That would change the rate, and make life expectancy in a county look worse, explained Bob Anderson of the CDC’s National Center for Health Statistics
“We shouldn’t jump to the conclusion that more people are getting sicker in these geographic areas than previously,” he said.
But that is open to debate. Migration didn’t seem to affect male death rates. Murray disagrees with the theory, saying he has tracked a great deal of movement from urban areas to less-populated counties.