Maggie Hill, 67, watches Charity play in Madison, W.Va., on Thursday, Nov. 29, 2018. Hill adopted the 10-year-old girl about five years ago. Hill's son had been raising her but lost custody during his ongoing struggle with drug addiction, Hill said. (AP Photo/Tyler Evert)

Maggie Hill, 67, watches Charity play in Madison, W.Va., on Thursday, Nov. 29, 2018. Hill adopted the 10-year-old girl about five years ago. Hill's son had been raising her but lost custody during his ongoing struggle with drug addiction, Hill said. (AP Photo/Tyler Evert)

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 theexpectancy.

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Ten years ago, The Associated Press described Huntington, West Virginia, and its environs as the unhealthiest place in America , based on health survey data from the Centers for Disease Control and Prevention that put it at the bottom of the charts in more than a half-dozen measures, including the highest proportions of people who were obese, had diabetes and had heart disease.

The AP report, and others like it, drew widespread attention that peaked in 2010, when celebrity chef Jamie Oliver staged a reality TV show in Huntington to teach people how to eat better.

The attention was not entirely welcomed. It felt like outsiders coming in to criticize and perpetuate “hillbilly” stereotypes, said Steve Williams, who was elected Huntington’s mayor in 2012.

But Williams said it also was