Life expectancy for women in The T&D Region was stagnant between 1983 and 1999, pointing to the nation's continuing problems with chronic disease and health disparities, a study revealed.

The Harvard School of Public Health study, titled "The Reversal of Fortunes," showed that in 18 counties in South Carolina, life expectancy for women either declined or remained stagnant between 1983 and 1999, the last year for which data was provided.

"It is clearly unacceptable that in 39 percent of South Carolina counties, life expectancy, especially for women, did not keep pace with increases seen in most of the nation or, worse yet, actually declined," District 66 Rep. Gilda Cobb-Hunter said.

Cobb-Hunter was the featured speaker in May at the one-year anniversary celebration of the Columbia-based Partnership to Fight Chronic Disease, where the study was mentioned as an indicator of the need for health policy changes.

Researchers found a clear correlation in the U.S. between socioeconomic status and life expectancy: Poorer counties did worse while wealthier counties did better.

They concluded that "female mortality increased ... primarily because of chronic diseases related to smoking, overweight and obesity and high blood pressure."

"It is important to connect chronic disease and health disparities since a number of chronic diseases are a direct result of the disparities in health," Cobb-Hunter said. "Poor counties did worse, especially in South Carolina, which often means counties with a higher population of people of color. People of color are nearly twice as likely as whites to be diagnosed with diabetes and three times as likely to die from complications."

She said reducing health disparities are among the changes in public policy that will not happen overnight, but progress is being made.

"I am very pleased that headway is being made in the training of the whole health care workforce from two points: cultural competency and increasing the number of people of color who are involved in the health care delivery system," Cobb-Hunter said. "We have made progress here with our two medical schools in addressing those two issues, but there is a lot of work that is still left to be done in that area."

"Clearly, we're not doing enough to erase the health disparities that are documented in the Harvard study," she said, touting the importance of the Partnership to Prevent Chronic Disease in making chronic disease prevention "a top health priority goal."

Men and women in Orangeburg, Bamberg and Calhoun counties did not see a reduction in life expectancy but remained largely out of step with the national average. The national change in life expectancy for men was 3.1 years for men and 1.3 years for women between 1983 to 1999.

Orangeburg County men and women experienced nominal increases in life expectancy between 1983 and 1999. Men had a 2 percent increase in life expectancy, from 67.01 to 68.61, while women had a one percent increase, from 75.78 to 76.76.

Bamberg County fared slightly better, with men having a 3 percent increase in their life expectancy rate, from 67.01 to 68.86. Women in the county only had a 1 percent increase, from 75.52 to 76.49.

At 4 percent, Calhoun County had the largest percentage increase in its life expectancy rate among men, from 67.87 to 70.48. Women only had a one percent increase it the rate, from 76.86 to 77.98.

Barnwell County, however, was above the national average in the life expectancy rates of both men and women between 1983 and 1988. Men had a 4 percent increase in their rates, from 68.61 to 71.67. Women had a three percent increase, from 75.95 to 77.92.

John Robitscher, executive director of the National Association of Chronic Disease Directors and a member of the advisory board of the national Partnership to Fight Chronic Disease, said the study points to the need for prevention and "really should be a wake up call."

"The top leading causes of death in the U.S. are heart disease, cancer, stroke, chronic respiratory disease, Alzheimer's disease and kidney disease. The ... leading causes of death are all largely preventable," Robitscher said. "Eighty-three cents of every health care dollar is spent on treating chronic conditions. We can save by preventing the conditions in the first place."

He said Medicare and Medicaid struggle with rising health costs, making it necessary for communities and policy makers to boost resources to promote, for example, healthier workplaces.

"We are now about to leave a really tragic legacy for our children," Robitscher said. "For the first time in the U.S., our generation is likely to live longer than our children. Studies point out that black women are at risk for living significantly shorter lives than their parents. A lot of this is just attributed to the obesity epidemic," he said, noting the need for better access to fresh fruits and vegetables in all communities and "less focus on TV."

The creation of walking trails, safe playgrounds and "social networks" of individuals focused on promoting healthier activities -- if only among families themselves -- is key to creating change that will hopefully spawn federal policy changes, Robitscher said.

"Personal responsibility is important, but we also have to know that there are some policy changes that need to take place," he said.

As a member of the House Ways and Means Committee, Cobb-Hunter said she recognizes the need for a healthy balance between the two.

"I recognize an ounce of prevention is worth a pound of cure," she said. "We don't need to be penny-wise and pound-foolish. We've got to focus on prevention and education about chronic disease.

"We can't keep pouring money into this black hole without people taking responsibility for changing lifestyles and their behavior because otherwise, we'll never had enough resources to take care of the problem."

To access the Harvard School of Public Health study online, visit http://medicine.plosjournals.org/perlserv/?requestget-document&doi10.1371/journal.pmed.0050066. Scroll down to data set S-2 to view county-level data.

T&D Staff Writer Dionne Gleaton can be reached by e-mail at dgleaton@timesanddemocrat.com or by telephone at 803-533-5534. Discuss this and other stories online at TheTandD.com.

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