Americans were shocked on Tuesday to read the results of a study by four scientists affiliated to the Initiative for Global Health at Harvard University.* Since 1983 life expectancy has declined for women in hundreds of US counties, most of them in the south, and for men in a dozen counties.

Two troubling explanations arise. The first is that, for reasons that are not yet clear, health is deteriorating in the US. Such things happen. In alcohol-soaked post-communist Russia men die at about the age of 59. In Aids-ravaged Namibia the lifespan has dropped 10 years since independence in 1990. One of the doctors who wrote the paper, Christopher Murray, is pessimistic. “I think this is a harbinger,” he told The Washington Post. “This is not going to be isolated to this set of counties, is my guess.”