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Americans living healthier lives, report suggests

WASHINGTON—Americans are living more prudently when it comes to their health, suggest new government numbers on what killed people in 2003.

The figures, released this week by the Centers for Disease Control, predict a record-high life expectancy of 77.6 years for Americans born in 2003. That's nearly four months longer than the life expectancy for Americans born in 2002 and more than health demographers had expected.

But the big surprise was an almost across-the-board decline in mortality from the causes of death over which people have the greatest personal control. For example, while the overall U.S. death rate declined 1.7 percent:

_ Alcohol-induced deaths declined 4.3 percent.

_ Drug-induced deaths dropped 3.3 percent.

_ Homicides dropped 4.9 percent.

_ Deaths due to firearm injuries dropped 2.9 percent.

_ Suicides dropped 3.7 percent.

In addition, accidental deaths of all kinds were down 2.2 percent.

The figures are age-adjusted to offset distortions caused by the U.S. population as it ages. They're also just preliminary numbers for one year that could be revised, not evidence of a trend. But the range and depth of the declines impressed Richard Rogers, a health sociologist at the University of Colorado at Boulder.

"As a country, we can pat ourselves on the back for engaging in more positive health behaviors," Rogers said. "We're making some progress."

While U.S. longevity is increasing, it still ranks below Japan, Australia, France, Sweden and about 20 other countries. The U.S. improvements for 2003 also could be overtaken by the consequences of rising obesity and a resumption of risky sexual behavior, or by an avian flu epidemic or an especially deadly flu season.

For now, less smoking is the most important behavior change, several analysts said. Smoking dropped from 42 percent of all adults in 1965 to 22.5 percent in 2002, according to the latest CDC figures. The decline is cutting death rates from the three leading U.S. killers, whose lethality can be affected by behavior as well as the victim's genes and the quality of available drugs and medical care:

_ Heart disease, down 3.6 percent in 2003.

_ Cancer, down 2.2 percent.

_ Stroke, down 4.6 percent.

Richard Suzman, the chief demographer at the National Institute on Aging in Bethesda, Md., gave better public health awareness and prudence some of the credit, along with medical advances such as statins to curb heart disease.

"There's much more good information out there on what to do and what not to do, especially when it comes to diet and exercise," Suzman said. "We're getting better at that," he added, "although we're not very good at the moment."

Of the two leading U.S. causes of death that are surging, one can be influenced by diet, drinking and exercise. That's hypertension, up 5.7 percent between 2002 and 2003. The other—Alzheimer's disease, up 5.9 percent—isn't something victims can do much to prevent.

Another leading preventable killer, HIV disease, declined 4.1 percent in 2003. But that's a disappointing number compared with the late `90s, when a combination of better drugs and safer sex produced declines greater than 25 percent a year.

Overall, however, "this is actually quite a hopeful list," Suzman said of the 2003 figures.

His worry is that the latest numbers reflect the gains from reduced smoking but not the increased mortality from obesity that he fears is coming due.

Kenneth Manton, the research director at the Center for Demographic Studies at Duke University in Durham, N.C., is more optimistic, especially when it comes to how well Americans follow medical advice.

Manton notes that the U.S. educational level is rising and will continue to rise through the next decade. With more education, he said, comes less tolerance of risky behavior. That means a present and future U.S. population that, according to Manton, is "more compliant in accepting medical care and medical intervention ... people who communicate better with their physicians and are more likely to take their meds with more discipline."

He believes that 2003's declines in suicides and deaths induced by alcohol and narcotics may already reflect education-linked progress.

"There's less of a stigma to acknowledging psychological depression and taking anti-depressants," Manton said. Anti-depressants may be over-prescribed, he added, "but it's better than killing a bottle of scotch every day; and, if they're taking a prescription drug, at least they're talking to a doctor."

John Haaga, Suzman's deputy at the National Institute on Aging, attributed the declines in mortality from heart disease to a similar combination of better medicine, better care and behavior changes.

The regimen of an aspirin a day, exercise and diet, plus beta blockers if needed, is making an especially big difference for one growing population, said Haaga: "We're doing better at prolonging the lives of people who've had one heart scare. They're motivated and there's something we can do for them."

Haaga also is impressed by evidence of declines in risky behavior among young people.

Alcohol-related traffic fatalities among youth under 21, for example, dropped 2.9 percent in 2003. Homicides, which tend to involve males in the 18-to-26 range, fell. Reported teen smoking and drug abuse fell, too, according to other recent government-funded nationwide surveys.

"When you save a 17-year-old, that adds a lot of years of life-expectancy," Haaga said.

Prudent teens mean more prudent adults, added Manton, because "behaviors at a young age predict future behaviors."

The 2003 figures are preliminary and may be less remarkable once the final numbers are in, cautioned Donna Hoyert of the CDC's National Center for Health Statistics, the lead author of the analysis.

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To read the CDC's report, go to www.cdc.gov/nchs and click on "Deaths: Preliminary Data for 2003."

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(c) 2005, Knight Ridder/Tribune Information Services.

GRAPHIC (from KRT Graphics, 202-383-6064): 20050303 DEATH causes

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