© The Southern Sociological Society 2014. For the first time in modern history, the life expectancy of a particular segment of the American population—namely non-Hispanic white women with low levels of education and income living in certain rural counties—is declining. The exact causes are currently unknown, although smoking and obesity are likely important. In this article, I highlight this pattern and also compare it with the decline of male longevity in Russia. More broadly, I call on health and epidemiological researchers to undertake more in-depth research on this relatively new and emerging health crisis in the United States and suggest that Health Lifestyles Theory offers a valuable springboard for doing so.