State and local public health officials should pay close attention to new statistics that show the life expectancy of a significant number of women in the United States has started to decline.

Without more aggressive prevention and treatment programs, the latest research suggests, the obesity epidemic in the Deep South and other poorer regions of the country will shorten the lives of women even more.

Throughout the 1960s and '70s, life expectancy showed a steady increase among both men and women, but that progress began to level off in the 1980s and even decline among a small subgroup of men and a larger subgroup of women, researchers in the online medical journal PLoS reported Monday.

The researchers looked at death rates at the local level and found significant declines in life expectancy over the last two decades for women in nearly 1,000 counties in Appalachia, the Southeast, Texas, the Mississippi River delta area and the lower Midwest. Income and race played a role in counties where the steepest declines in life expectancy among women took place.

Researchers also noted increased death rates among women from lung cancer and emphysema, which probably reflects the fact that American women did not take up smoking in large numbers until tobacco companies started marketing cigarette brands for them in the 1970s.

"This is a story about smoking, blood pressure and obesity," said Majid Ezzati of the Harvard Initiative for Global Health, a co-author of the study.

But if marketing has contributed to this problem, it may also be part of the solution. Public health officials and health care activists need to target a message of lifestyle change at women who need to hear that story.

— Mike King, for the editorial board