One of the most disturbing trends in American public health is that women's life expectancy is shrinking in many parts of the U.S. Women's longevity took an unprecedented nosedive during the past decade, researchers recently discovered, with their life expectancy tumbling or stagnating in one of every five counties in the country. In Connecticut, for example, New London County saw a drop in longevity, while Fairfield and Hartford counties saw significant jumps. The last time life expectancy fell for a large number of American women was 1918, due to Spanish influenza.
While many scientists believe that smoking and obesity are driving the downward spiral, a growing chorus of experts contends that chronic stress may be a key culprit, too — especially the stress of juggling work and family.
"It's a hypothesis at this point, but a reasonable and plausible one," said James S. House, a professor at the University of Michigan's Institute for Social Research. Women may have gained work opportunities over the last four decades, he said, but society has done relatively little to help them support their increased responsibilities.
"Clearly, obesity and smoking are things that contribute to chronic disease and reduced life span," said Carolyn Mazure, director of Women's Health Research at Yale, which funds interdisciplinary research on gender differences in health. "There is really no question in my mind that stress plays a role in that algorithm, especially for women."
Life expectancy studies show that women's projected longevity declined or stagnated in 662 counties in the United States — more than 20 percent of the 3,198 counties in the nation — between 1999 and 2009. The largest declines are in parts of the South, Appalachia and the southern portion of the Midwest.
Even in counties where women are living longer, their extra years are often marred by chronic diseases or disabilities, said Chloe Bird, a senior sociologist at the Rand Corp.
The projections for women are in stark contrast to changes in American men's life expectancy, which had downturns in only 167, or five percent, of the nation's counties, according to a study by the Institute for Health Metrics and Evaluation (IHME) at the University of Washington in Seattle.
In terms of change over the last decade, Fairfield and Hartford counties saw the largest jumps in female longevity, with increases of 2.2 years since 1999. At the other end of the spectrum, women in New London lost 0.1 year over the last decade, while women in New Haven, Litchfield and Windham saw gains lower than the U.S. average.
Ridged Schedules and No Childcare
At Harvard University, Lisa Berkman, director of the Center for Population and Development Studies, said challenging social conditions in the U.S. have created a "perfect storm" that can damage women's health.
Not only did women flood into the job market over the past few decades, she notes, but the number of single parents skyrocketed. Despite these major changes, the U.S. has created few policies to help women handle childcare. As a result, there are "extreme stresses even on the relatively advantaged," Berkman said.
Job stress can be particularly damaging for employees who hold jobs with rigid hours and high demands, such as clerical, administrative or production work, researchers have found.
When Berkman studied women stressed by work and family conflict, she found they had more medical issues than other working women. She looked at women who worked in elder care facilities, comparing those who had rigid and flexible job schedules.
Women with rigid schedules were twice as likely as women with more flexibility to have at least two risk factors for cardiovascular disease, such as high blood pressure, high cholesterol, being overweight or smoking, Berkman found.
Food, Exercise, Smoking, Family Care
Some studies suggest that women are more likely than men to soothe themselves by eating, the Rand Corporation's Bird said. They may also be more likely to reduce exercising so they can fulfill their work and family obligations, she said.
Work and family demands also can increase the amount of stress hormones surging through women's bodies, Bird said. Women do not experience the same decline in stress hormones as men during lunch breaks or after work, since they often use those hours to deal with family issues.
Stress can affect health in two distinct ways. There may be physiological changes, due to excess stress hormones, like cortisol. But it also may cause women to change their behaviors, cutting out such healthy activities as exercise, or indulging in smoking or overeating.
Mazure, of the Yale School of Medicine's center on Women's Health Research, was among a cadre of researchers who began studying the impact of stress on women's health in the 1990s. Even as studies have shown that stress is closely tied to depression, cardiac disease and other chronic illnesses in women, "we know a fraction of what there is to know" about gender differences, she said.