Living Longer, but Gender Gap Narrows

The gender gap in life expectancy between men and women in the United States has narrowed to six years--the lowest in a generation--largely because women are posting stubbornly high rates of such smoking-related illnesses as heart disease and cancer.

The finding is a key part of the federal government’s annual study of the health of Americans being issued today.

The report also shows that the longevity difference between blacks and whites has narrowed to 6.6 years, the smallest gap in a decade, reflecting significant declines in death rates among African Americans from heart disease, homicide and AIDS.

The overall tone of the report is encouraging, with life expectancy at a record high--76.1 years for a baby born in 1996--the infant mortality rate at a record low point, and falling death rates from heart disease, cancer and firearms.

“Health is improving in America along many fronts, and our challenge is to share that progress as widely as possible,” Donna Shalala, secretary of health and human services, said in a statement accompanying the report.

Among the study’s noteworthy findings:

* The number of AIDS cases dropped 6% and AIDS is no longer the leading cause of death for men between the ages of 25 and 44. It now ranks third, behind accidents and cancer. “We are doing better at keeping AIDS patients alive longer,” said Elsie Pamuk, a statistician with the National Center for Health Statistics, which prepared the study.

* The birth rate for teenagers dropped for the fifth consecutive year.

* Deaths from firearms-related injuries have declined for four years straight.

* A quarter of the U.S. population now receives medical care from health maintenance organizations. Enrollment in HMOs climbed to 67 million and has doubled since 1991.

The statistics contained in the 460-page report reflect steady progress toward longer, healthier lives for the majority of the population. The life expectancy of 76.1 years is a dramatic change from 1900, when it was 46 years, and from as recently as 1970, when life expectancy was 70 years.

The life expectancy was 73.1 for men in 1996 and 79.1 for women.

“Smoking has not subsided among women the way it has in men,” said Kate Prager, a demographer for the statistics center. “Smoking among women climbed to a certain level and stayed there.”

Because of persistently high smoking rates among women, death rates for heart disease and cancer--although dropping overall--have not declined as rapidly among women as among men.

“Everybody is improving, but men are improving more rapidly than women,” according to Pamuk.

Life expectancy was 76.8 years for whites and 70.2 for blacks, according to the report, called “Health, United States, 1998.”

It was 73.9 for white men and 66.1 for black men, 79.7 for white women and 74.2 for black women.

Death rates among blacks fell 4% for heart disease. African American deaths from HIV infection, which had risen 15% a year for a five-year period, reversed course and plunged 20%, while deaths from homicide dropped 8%.

The sharp drops in several categories “had a substantial effect on life expectancy among blacks,” according to Prager.

The country is making some modest progress in its battle against cancer, the report noted. The death rate for cancer dropped 5% between 1990 and 1996, after rising during the previous two decades.

The report included special studies on income and health, showing that “each increase in either income or education increased the likelihood of being in good health.”

“Persons with lower income or education also had a higher prevalence of health risk factors, such as sedentary lifestyle and cigarette smoking, were less likely to have health insurance coverage or receive preventive care, and were more likely to report unmet heath care needs,” the report said.

For example, poor women are less likely to have health insurance, more likely to smoke and to give birth to low-weight babies who are at greater risk of dying. Children in poor families are more likely to have high levels of lead in their blood, because they live in old houses or apartments where the walls are covered with lead-based paints.

There is a “strong relationship between socioeconomic status and health in the United States for every race and ethnic group studied,” Shalala said.