Overall life expectancy for women in the U.S. rose by more than six years between 1959 and 2001, but remained flat or fell in many poor and rural areas.

The AFP reported April 23 that researchers from the Harvard School of Public Health and the University of Washington said that in 1,000 mostly rural and poor counties, life expectancy began declining in the 1980s "primarily because of chronic diseases related to smoking, overweight and obesity, and high blood pressure."

About one-fifth of U.S. women saw their life expectancy decline or hold steady during the study period, largely in the south, Appalachia, and parts of the Midwest and Texas. "There is now evidence that there are large parts of the population in the United States whose health has been getting worse for about two decades," said lead author Majid Ezzati of the Harvard School of Public Health.

"Life expectancy decline is something that has traditionally been considered a sign that the health and social systems have failed, as has been the case in parts of Africa and Eastern Europe," said co-author Christopher Murray of the Institute for Health Metrics and Evaluation at the University of Washington. "The fact that this is happening to a large number of Americans should be a sign that the U.S. health system needs serious rethinking."

The study was published in the journal PLoS Medicine.