Life expectancy ranks near the bottom nationwide

City comes up short on longevity

September 12, 2006|By Frank D. Roylance and Chris Emery | Frank D. Roylance and Chris Emery,Sun reporters

Baltimoreans face the lowest life expectancy of almost any jurisdiction in America, according to a new study by the Harvard School of Public Health.

City residents can expect to live 68.6 years on average, the study found. That is worse than in all but a handful of counties in South Dakota that include impoverished Indian reservations, and there has been little improvement since a study published in 1997.

Longevity in Baltimore is much lower than in affluent Montgomery County, where it was 81.3 years, eighth-highest in the nation and trailing seven Colorado counties only fractionally.

Similar disparities persist in many of the nation's high-risk urban settings even when the effects of high rates of homicide and HIV/AIDS are removed, the study found. And the problem does not appear to lie among the very young or the very old.

Instead, the researchers say, the disparities are best explained by chronic health problems among those ages 15 to 59, including cardiovascular and lung disease, diabetes, the effects of smoking and alcohol use, and injuries, all of which are well- understood and preventable.

That would not come as news to John Adams, 57, a longtime security guard at Johns Hopkins Bayview Medical Center who was forced to retire three years ago because of arthritis.

"City life is tough," he said during lunch yesterday at Northeast Market. "Here in the city, truth be told, black men don't live very long."

His eldest brother, 61, recently had a stroke. Drugs, violence and AIDS, he said, threaten black men from their teens into their 30s. "If you can make it past then," he said, "you can live to be real old."

Norma Jackson, who said only that she was in her 70s, observed that older people seemed to be living longer but that young people seem to die more often.

"It's the times," she said. "They don't take care of themselves. They drink too much. They're doing drugs. There are gangs."

Joshua M. Sharfstein, Baltimore's health commissioner, said the city "is not where we want it to be." Despite recent gains against HIV, venereal disease and homicides, he said, the city has "very serious health needs."

"The intermediate ages face special risk in Baltimore, and the safety net systems to care for them need to be strengthened," he said. "It's an age group that traditionally gets less support from both government and the nonprofit world, which is naturally inclined to look at kids and the elderly."

The Harvard study "does sharpen the focus on the need to look at the great number of people in the middle," Sharfstein said. "It's a pretty interesting finding."

When the first Harvard study appeared in 1997, Dr. Peter Beilenson, then the city health commissioner, acknowledged serious public health problems. He also said the city was being compared unfairly with cities such as Detroit, Cleveland, Atlanta and Newark, N.J., that, unlike Baltimore, are part of larger counties with more affluent suburbs.

The new peer-reviewed study was published today in the online journal PLoS Medicine. (PloS stands for Public Library of Science.)

The lead author is Christopher J.L. Murray of the Harvard School of Public Health. Others are from Harvard and the University of California, San Francisco. Their work was sponsored by the federal Centers for Disease Control and Prevention, the Association of Schools of Public Health and the National Institute on Aging.

The researchers gathered and derived population, age, race and gender data from the 1980 and 1990 censuses. More recent data through 2001 were acquired from the National Center for Health Statistics. The reports' longevity averages are from 1999, the most recent available. Other data came from surveys by the CDC and the World Health Organization.

The study is a follow-up to a similar one in 1997, and the Baltimore statistics show few gains. Life expectancy for Baltimore men, which fell from 64.6 years to 63.2 years between 1980 and 1990, recovered only part of that loss by 1999, rising to 63.8 years.

For women in the city, life expectancy was essentially unchanged at 73.4 years.

In Montgomery County, women live an average of 83 years, almost four years longer than men.

"I think it's lifestyle," said Fred Shapiro, 74, a resident of Leisure World retirement community in Rockville. Shapiro ate breakfast at the Panera restaurant in nearby Aspen Hill Shopping Center yesterday with several of his tennis partners after rain washed out their usual Monday matches.

He credits the county's greater longevity to better education, economic status and community resources.

"There is an availability of a lot of different facilities, both intellectual and physical," he said.

Richard Helfrich, the county's deputy health officer, said in a statement that "despite the good news, we remain committed to improving the long-term health of our residents."

"This includes addressing disparities that still exist among different ethnic groups in such areas such as infant mortality, cancer and access to health care services," he said.

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