Barbara Gentry slowly shifts her heavy frame out of a chair and uses a walker to move the dozen feet to a chair not far from the pool table at the Buford Senior Center. Her hair is white and a cough sometimes interrupts her speech, but she says she enjoys coming to the center for bingo. It beats staying home alone, the 64-year-old says.
"I don't work," she said. "I don't do anything but come here. I've got friends here."
Gentry is among an estimated 340,000 white Georgia women who never finished high school, a group whose members have paid a price not just in lost opportunities but also poorer health and reduced lifespans, according to a new study.
Nationwide, the life expectancy of white women without high school diplomas fell from 78.5 in 1990 to 73.5 in 2008, according to the study. Lifespans for white men with no diplomas fell from 70.5 to 67.5 over the same period.
"It is as if Americans with the least education are living in a time warp," said S. Jay Olshansky, professor in the school of public health at the University of Illinois at Chicago and lead researcher on the study. "The declines were more rapid and larger than anything we've seen in history."
Life expectancy in the United States has risen steadily overall, across genders and ethnicities, according to studies by the Centers for Disease Control and Prevention and other agencies. Olshansky's study is unusual in that it focuses on the correlation between lifespan and education level.
White men without a high school education still live about a year longer than black men in the same category, though the latter group's longevity has risen. Lifespans for black women with no high school diploma also are up and slightly exceed those for white women, according to the university's study.
Longevity among Hispanics of either gender without high school diplomas also has climbed, and they outlive both blacks and whites, the research found.
Most other categories of education level - high school, some college, college degree - showed gains for both genders and all three ethnicities.
Why the sharpest decline among undereducated white women?
"We are not entirely sure about why it happened," Olshansky said.
Less-educated white women in general are less healthy in part because of choices, starting with not finishing school and sometimes continuing with smoking or drug or alcohol abuse.
Other factors - not necessarily unique to undereducated women - can add stress and degrade health, such as less access to health care, early pregnancies, fewer job options and strained family situations.
Yet the starkest factor may be economic: the shrinking of opportunity.
A generation ago, manufacturing provided jobs for people with relatively little education.
"Manufacturing traditionally had somewhat higher pay, but also more stability - the dependability of steady employment," said Joan Entmacher, vice president for family economic security at the National Women's Law Center.
In early 1990, manufacturing represented 17 percent of the jobs in Georgia. At the start of this year, it accounted for 8 percent. Those job losses ratchet up pressure and stress among working-class families, even as choices shrink.
In 1990, there were roughly 168,500 women in Georgia manufacturing and fewer than 97,000 now, when the state's population is more than twice as large.
Now, unskilled women are more likely to be hired in retail or restaurants, where the pay is lower, jobs are insecure and hours often are irregular, Entmacher said.
Since the economy started slowly to improve in 2009, manufacturing nationally has added 442,000 jobs for men, but the number of women employed in manufacturing has dropped by 89,000, she said.
Financial struggles make family life harder, yet people can handle hardship if they see an escape route, said Wanda Taft, director of aging services in the south Georgia city of Waycross. "Being poor is not so bad if you have hope. But in the last 25 years, it has become a lot harder for poor people to survive."
People without hope for the future often look for things that make them feel better now - like drink, drugs and binge eating, she said.
"Some of these things are a way to feel better for a little while, even if the long-term consequences are disastrous."
Why is education such a crucial dividing line?
Experts start with the obvious: people learn - schooling itself has value. Education is also a credential that opens some economic doors. Without it, some opportunities are simply out of reach.
Penny Thomason, 48, of Lawrenceville, Ga., graduated from Milton High School, got married at 20 and became a mother at 21. She never expected to have to work outside the home. Then she found herself divorced, living in a trailer with her son and working three jobs.
She feels lucky to have been hired at a big company a dozen years ago. "Without a high school degree, I wouldn't have gotten hired even in the mail room."
Kristen Beene, 20, of Hiram, left school at 16.
"I've been looking for a job in child care or retail, but it's hard to find one," she said. "I apply and they say, 'You didn't finish high school? Oh, so you can't commit to things.' It makes me feel like a failure."
She thinks she made a mistake and plans to get a GED.
"It's one thing when you're 18, but when you get to be 20, they say, 'Why don't you have your life together? What is your problem?' "
Laura Nicholson, 28, of Hall County, left high school after 10th grade. Though she later earned a GED, she repeatedly bumped into a glass ceiling.
"Whenever I looked for jobs, you always needed a college degree or a high school diploma - even for clerical jobs," she said. "I think a lot of people look down on someone who drops out of high school. They think 'This person gives up easily.' "
After some waitressing, warehouse and office jobs, she decided she'd do better to start her own business. She's now a Web designer, doing contract work mainly for small companies. "I am making more now than I ever could without going back to college."
Some experts are wary that the Olshansky study, which sifted through information on millions of death certificates, exaggerates the problem. The data is still incomplete, said Robert Hummer, a demographer at the University of Texas.
"We should be a little skeptical," he said.
Hummer has conducted parallel research that also showed uneducated white women doing poorly, but not as badly as Olshansky found. That makes him cautious about conclusions, though still concerned.
Lack of schooling, of course, doesn't always lead to health problems. But it has been a correlation too often seen in people like Gentry, the Buford Senior Center regular.
Instead of going to high school, Gentry worked on the family farm. Five decades later, she battles high blood pressure "and other things," fights a quiver in her left hand and moves with difficulty - all at an age when many people are still working.
"I take my medicine morning and night," she said.
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