Despite all of the advances in medicine in recent years, one key indicator of health in America is not looking good: Life expectancy has fallen for the second straight year.

For men, that is. Women’s life expectancy remained the same, and they now live on average five years longer than men — 81 years versus 76 years.

This is the first time since the early 1960s that average life expectancy has fallen in consecutive years, the Centers for Disease Control and Prevention reported. It also comes three years after a record high average of 78.8 years.

Life expectancy assumes death rates for various age groups will apply throughout the lives of babies born in a given year. It is influenced by death rates at younger ages, including infant mortality.

The 10 leading causes of death remained unchanged from 2015 to 2016, with heart disease and cancer topping the list. Unintentional injuries, which include drug overdoses, moved up a notch to third, reflecting the rising impact of the opioid epidemic. Rounding out the top 10 are chronic lower respiratory disease, stroke, Alzheimer’s disease, diabetes, influenza and pneumonia, kidney disease and suicide.

While life expectancy has been rising worldwide, it is going the opposite way here. British researchers writing in The Lancet predict it will get worse, noting the U.S. has the highest child and maternal mortality, homicide rate, and body-mass index of any high-income country. They also cited high and rising health inequalities as factors.

As gloomy as all of that may be, consider that simple lifestyle changes — such as a better diet, more exercise and kicking bad habits like smoking and drinking — could help turn the tide.