PBS高端访谈:美国妇女寿命落后于其他高收入国家

 　　GWEN IFILL:And we close about with new findings about declining life spans for some women. Those come from a pair of new studies.

　　The first reported that, in 43 percent of the nation's counties, many of them in the South and the West, women—more women 75 and younger are dying sooner. The second study found mortality for all Americans under 50, but particularly women, is more pronounced in the U.S. than other high-income countries. Both were published in the journal "Health Affairs."

　　Editor in chief and a NewsHour regular Susan Dentzer joins me now.

　　Susan, hello.

　　SUSAN DENTZER, “Health Affairs”: Nice to be with you, Gwen.

　　GWEN IFILL:So, the first question is why. Why are we seeing these increased mortality rates at younger ages?

　　SUSAN DENTZER:This is an unfortunate stew¹ of unpleasant circumstances.

　　Chronic² disease is driving a lot of this early death in women. A lot of this is death before the age of 50, believe it or not. So it's issues like obesity³, correlated with heart disease, diabetes⁴, smoking. We know that one in five U.S. adults are still smoking. A lot of that smoking is going on in this population.

　　Unintentional injuries, traffic accidents, and drug overdoses, particularly prescription⁵ drug abuse emerging now in the data as another big cause of mortality in this population.

　　GWEN IFILL:But, at least in one of these studies—one was from the University of Wisconsin, one was from the University of Washington—at least in one, they said that male mortality figures were holding steady. Why aren't men more affected⁶?

　　SUSAN DENTZER:Well, it's been true over time that female life expectancy⁷ is generally longer than male life expectancy anyway.

　　So it's not as if the situation is completely rosy⁸ for men. It is true, in the David Kindig study from the University of Wisconsin, that in three percent of U.S. counties, male mortality also is rising. So the men aren't held harmless here.

　　But the big effect has been I'm women, and particularly since we have been—we have been expecting women's life expectancy to be longer. What we now see is that, for women in particular with less than 12 years of education, so women who didn't make it out of high school, their life expectancy has actually fallen by four years since 1990.

　　And that means, overall, it's part of the equation that now has U.S. life expectancy looking so poor relative to all our other rich countries, all peer countries.

　　GWEN IFILL:Is there a regional way of pinpointing¹⁰ this, or demographics?

　　SUSAN DENTZER:Yes.

　　If you look at a map, it's concentrated in, say, Kentucky, Tennessee, West Virginia, down to what's known as the "Stroke Belt," Louisiana, Texas, over to the West—not so much California, interestingly.

　　And one interesting aspect of the story is that this is not a situation that is driven—it's not cropping up in the Hispanic population, for example. It's really more white lower-income populations in the Southern part of the country in particular.

　　GWEN IFILL:And we say 43—that number, 43 percent of counties, what number? Is there a way to say how many women are actually affected?

　　SUSAN DENTZER:Well, not necessarily from this study.

　　But if you think about it, we have about 3,000—3,100 U.S. counties or parishes or the equivalent. And so it's a hefty portion. It's not the most populous¹¹ counties. The more populous counties tend to be, say, in the Northeast or in California. These are less populous areas of the country that still are very, very hard-hit by these phenomena¹².

　　GWEN IFILL:And are there trend lines that we should be watching, whether it's comparing what is happening here to what's happening in other countries, to just what's happening domestically?

　　SUSAN DENTZER:Well, what we know is our situation continues to worsen relative to all the other rich countries.

　　The Institute of Medicine published a study in January, "U.S. Health and International Perspective," that shows that our life expectancy is worse, that our mortality before age 50 is particularly driving the problem. That was emphasized also by Jessica Ho's study.

　　Again, we're—if you look—if you compare the years of life that Americans lose before the age of 50 relative to the average of all the other rich countries, we're double. We lose double the amount of life before age 50 of these other countries.

　　GWEN IFILL:Is there a way to pinpoint⁹ when this slide began? Is this something that is brand-new, or is this something that we have been able to document over time?

　　SUSAN DENTZER:We have been seeing this crop up in the data starting in the late '80s and early 1990s.

　　And one of the interesting factors that David Kindig, one of the authors, suggested is we really need to go back now and look at these data and see if they're correlated with any of our economic cataclysms¹³ that we have had.

　　GWEN IFILL:Right.

　　SUSAN DENTZER:Has that been driving any of this? Or it this just independent of economic forces, independent of unemployment rates, for example? That could be a driver.

　　We also know, of course, these are areas of the country where there's barely been any wage growth to speak of for many years. And we need to start to tease it across all of these economic and social factors that are driving this.

　　GWEN IFILL:So, your—there's an assumption somewhere in this that if you dig deep enough, you may find that the reason why it happens in certain counties and not in others is that these people who maybe don't have the resources may be eating a worse diet, may be more likely to smoke, may engage in behaviors that you might not do if you were more prosperous.

　　SUSAN DENTZER:And we know that the social and economic determinants of health, as they are called, are extremely powerful, and usually are driving differences in health status. And it's most likely that that's the case here.

　　What that means is that to tackle this is much more complicated than, for example, giving people access to health care.

　　GWEN IFILL:Right.

　　SUSAN DENTZER:That really isn't going to be the fix. It will be efforts to raise educational levels, create more economic growth in communities, secure access to high-wage jobs, create a healthy food environment, more activity for individuals, all of those things, a much, much broader agenda.

　　GWEN IFILL:How to turn it all around.

　　Susan Dentzer of "Health Affairs," thank you so much.

　　SUSAN DENTZER:Great to be with you, Gwen.

1 stew   

n.炖汤，焖，烦恼；v.炖汤，焖，忧虑

参考例句：

• The stew must be boiled up before serving.炖肉必须煮熟才能上桌。
• There's no need to get in a stew.没有必要烦恼。

2 chronic   

adj.(疾病)长期未愈的，慢性的；极坏的

参考例句：

• Famine differs from chronic malnutrition.饥荒不同于慢性营养不良。
• Chronic poisoning may lead to death from inanition.慢性中毒也可能由虚弱导致死亡。

3 obesity   

n.肥胖，肥大

参考例句：

• One effect of overeating may be obesity.吃得过多能导致肥胖。
• Sugar and fat can more easily lead to obesity than some other foods.糖和脂肪比其他食物更容易导致肥胖。

4 diabetes   

n.糖尿病

参考例句：

• In case of diabetes, physicians advise against the use of sugar.对于糖尿病患者，医生告诫他们不要吃糖。
• Diabetes is caused by a fault in the insulin production of the body.糖尿病是由体內胰岛素分泌失调引起的。

5 prescription   

n.处方，开药；指示，规定

参考例句：

• The physician made a prescription against sea- sickness for him.医生给他开了个治晕船的药方。
• The drug is available on prescription only.这种药只能凭处方购买。

6 affected   

adj.不自然的，假装的

参考例句：

• She showed an affected interest in our subject.她假装对我们的课题感到兴趣。
• His manners are affected.他的态度不自然。

7 expectancy   

n.期望，预期，（根据概率统计求得）预期数额

参考例句：

• Japanese people have a very high life expectancy.日本人的平均寿命非常长。
• The atomosphere of tense expectancy sobered everyone.这种期望的紧张气氛使每个人变得严肃起来。

8 rosy   

adj.美好的，乐观的，玫瑰色的

参考例句：

• She got a new job and her life looks rosy.她找到一份新工作，生活看上去很美好。
• She always takes a rosy view of life.她总是对生活持乐观态度。

9 pinpoint   

vt.准确地确定；用针标出…的精确位置

参考例句：

• It is difficult to pinpoint when water problems of the modern age began.很难准确地指出，现代用水的问题是什么时候出现的。
• I could pinpoint his precise location on a map.我能在地图上指明他的准确位置。

10 pinpointing   

准确地找出或描述( pinpoint的现在分词 )； 为…准确定位

参考例句：

• The difficulty of pinpointing primitive and derived characters remains. 要正确地指出原始性状和次生性状仍然感到困难。
• Pinpointing the true source of power in Japan is a notoriously slippery task. 要准确指出日本真正的权力来源，是一项非常困难的任务。

11 populous   

adj.人口稠密的，人口众多的

参考例句：

• London is the most populous area of Britain.伦敦是英国人口最稠密的地区。
• China is the most populous developing country in the world.中国是世界上人口最多的发展中国家。

12 phenomena   

n.现象

参考例句：

• Ade couldn't relate the phenomena with any theory he knew.艾德无法用他所知道的任何理论来解释这种现象。
• The object of these experiments was to find the connection,if any,between the two phenomena.这些实验的目的就是探索这两种现象之间的联系，如果存在着任何联系的话。

13 cataclysms   

n.（突然降临的）大灾难( cataclysm的名词复数 )

参考例句：