The average life expectancy for Missourians hit a record high last year, according to data released by the Missouri Department of Health. The average life expectancy in 1998 was 75.7, compared with 75.6 years in 1997 and 75.2 in 1988.

However, the increased life expectancy has been concentrated primarily among men. In 1998 the male life expectancy increased 0.3 years to 72.9 years. The rate for women did not change, remaining at 78.6. This difference of 5.7 years between the sexes is the smallest life expectancy differential since the early 1950s.

Much of this change by gender can be attributed to changes in smoking-related deaths. From 1988 to 1998, deaths from lung cancer, chronic obstructive lung disease and heart disease increased by 9 percent for women while they decreased by 2 percent for men. Changes in smoking patterns by gender 20 to 30 years ago affected these changes.

"Unfortunately, we are seeing the effects today of women taking up smoking in large numbers in the 1960s and 1970s," said Dr. Maureen Dempsey, director of the Missouri Department of Health.

Overall, a record 54,849 Missourians died in 1998 compared with 54,203 in 1997. This increased mortality primarily was due to an aging of the population.

Heart disease, the number one killer in the state and nation, decreased in 1998. A total of 17,841 Missourians died from heart disease in 1998, about two percent less than the 18,228 heart disease deaths in 1997. This is the lowest since 1992 and the death rate of 328.0 per 100,000 population is the lowest heart disease death rate in 50 years.

Dempsey said heart disease mortality has been reduced as a result of awareness, physician counseling, and community-based programs that reduce smoking, physical inactivity, poor nutrition and obesity. Additionally, better medical treatment and emergency care for heart attack victims are factors.

The next five leading causes of death: cancer, stroke, chronic lung disease, pneumonia and influenza, and accidents (unintentional injuries) all increased in 1998. Pneumonia and influenza deaths showed the largest percentage increase, 12.2 percent. Pneumonia and influenza may have been a contributor to other causes of death, as flu epidemics frequently lead to increases in chronic diseases and other causes of death.

A subcategory of accidents, non-motor vehicle unintentional injuries, also increased sharply in 1998, from 1,079 to 1,222 deaths or a 13.3 percent increase. The increase primarily reflected increases in falls among the elderly.

According to Dempsey, deaths from falls among people 75 years and older increased from 286 in 1997 to 378 in 1998, or 32 percent. She said most of these falls occur in homes.

"As Missouri's population continues to age, falls will increasingly become a concern," Dempsey said. She said recommendations for prevention include safety devices such grab bars and nonskid mats in tubs and showers, handrails alongside stairs and good lighting in all rooms.

Dempsey said osteoporosis may also play a role, and dietary supplements of vitamin D, and calcium may help, along with exercise.

In other statistics released, AIDS deaths continued to decrease, but at a much slower pace in 1998. Deaths due to AIDS decreased by 12 percent from 163 in 1997 to 145 in 1998. This follows decreases by one-third and one-half for the two previous years. With no new treatments in the past year this slower decrease was expected.

Infant mortality has stabilized in recent years as the 1998 infant death rate of 7.6 per 1,000 live births is the same as the rates in 1996 and 1997. Nationally, the infant death rate is also stabilizing, but at a slightly lower level of 7.0 per 1,000 live births in 1997 and 1998. However, the disparity between African-American and white infant mortality remains high. In 1998 the African-American infant death rate of 16.7 per 1,000 live births was more than 2.7 times the white rate of 6.1. The white rate has decreased by almost one third in the past decade while the African-American rate is almost the same as it was ten years ago.

"I am very concerned about the high infant mortality rate among African-Americans in the state," Dempsey said. "It is clear that we are going to have to find new approaches that will focus on helping African-Americans have healthy babies and providing support in the babies' early years," she added.

Other maternal and child health rates show a continuation of trends over the past few years. The low birth weight (less than 5.5 pounds) increased from 7.7 percent in 1997 to 7.8 percent in 1998, the highest level in 30 years. The rate of inadequate prenatal care continued to decrease, reaching a record low 11.0 percent compared with 11.4 percent in 1997 and 17.4 percent in 1988.

Total live births increased by about two percent in 1998 to 75,242 from 73,940 in 1997. This is the highest Missouri birth count since 1992. Both white and African-American births increased in 1998.

Other maternal and child health indicators showed the following:

Other vital statistics data show a continued decrease in marriages as well as a decrease in dissolutions of marriage. The 1998 marriage count of 43,685 marriages is the lowest in 32 years. Divorces have been fairly stable in recent years.

Live births increased in March as 6,785 Missouri babies were born compared to 6,670 one year earlier. Cumulative births show a decrease for the first quarter of 1999 and an increase for the 12 months ending with March.

Deaths increased in March, but decreased for the cumulative 3- and 12-month periods ending with March. For the first quarter, deaths decreased from 15,683 to 15,420, or 1.7 percent.

The Natural increase for Missouri in March was 1,136 (6,785 births minus 5,649 deaths). The natural increase rate in March was 2.4 per 1,000 population, the same as the previous March.

Marriages increased in March, but were down for the 3- and 12-month periods ending with March.

Dissolutions of marriage also increased in March, but decreased for the 3- and 12-month periods ending with March.

Infant deaths decreased in March as 42 Missouri infants died compared with 59 in March 1998. Infant deaths also decreased for the first quarter and 12 months ending with March.