declining life expectancy

MADISON, W.Va. (AP) — If you want to understand why U.S. life expectancy is declining, West Virginia is a good place to start.
The state is a bellwether of bad health, portending major problems years before they became severe nationally.
“It seems that the worst outcomes happen here first,” said Dr. Michael Brumage, a West Virginia University public health expert who formerly ran the health department in Charleston. “We’re the canary in the coal mine.”