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Life expectancy in the US by state: Where do people live the longest?

The United States has been falling behind other countries when it comes to life expectancy over the past forty years but certain states are worse off.

US states whose life expectancy is falling behind

A new study published in the American Journal of Public Health documents “the evolution of the US life expectancy disadvantage and regional variation across the US states.” Looking at life expectancy estimates over the past 80 years from a series of databases, the author Steven Woolf calculated the changes in life expectancy growth rates around the world and where the US ranks globally. Furthermore he was able to extract state-level trends.

The report titled Falling Behind: The Growing Gap in Life Expectancy Between the United States and Other Countries, 1933–2021″ shows that the US has been lagging behind other nations since 1950 in all periods studied expect for one. While the starting point of 1933 had the US ranked eighth out of sixteen most populous countries, on an expanded list of countries it is now 46th. Woolf, director emeritus of the Center on Society and Health at Virginia Commonwealth University, notes that the disadvantage has accelerated over the past forty years being outperformed by dozens of globally diverse countries on every inhabited continent.

Life expectancy in the US by state: Where do people live the longest?

The underperformance in life expectancy growth has not been uniform across the US, Woolf found that the disadvantage has been concentrated in the Midwest and South. While in the North and West, life expectancy improvements have been in some cases on par with some of the healthiest countries in the world. Such has been the case of Hawaii and New York.

Hawaii has the highest life expectancy in the US and 22nd in the world, if it were a nation, of 80.9 years according to data from 2019. For comparison, on the same measure Mississippi, the state with the lowest life expectancy at 74.4 years that same year, would have ranked 79th. The covid-19 pandemic took a toll on all nations and has helped knock the average life expectancy down in both states to 80.7 years and 71.9 years, respectively.

The CDC reported in December that average life expectancy in the US was 76.4 years at the end of 2021 with heart disease, cancer and covid-19 the top three causes of death.

Why is the US life expectancy falling behind other nations?

It’s not just wealthy countries that are surpassing the US in health outcomes that are helping their citizens live longer. “We found that countries with different cultures, forms of governance, societies and economies have all found a way to outperform the United States in terms of health outcomes and life expectancy,” said Woolf.

Countries in Northern and Western Europe made up the majority of nations that outperformed the US prior to 1950. However, the following decade saw Southern and Eastern European countries surpass the US. Then in the 1960s, a number of Asian countries began to overtake the US and in the 1990s, Middle Eastern countries which continued over the next two decades.

The lagging of the US in life expectancy growth could be the result of health declines stemming from relaxed regulations that protect public health and safety according to the author. Likewise, redistribution of wealth from the middle class to the upper class along with reduced access to education, health care and human services.

“The upside is that many countries have found a way to consistently ensure that their populations live longer, healthier lives,” said Woolf. “That’s hopeful, because it means that there are policy solutions that could help Americans live longer.”

“This issue is not a lack of solutions, but rather a lack of political will.”

Rolling back healthcare and well-being programs resulting in higher mortality

Previous research found that states that have adopted more conservative policies had a greater chance of experiencing stagnant or decreasing life expectancy and higher mortality. One of the driving factors for the lower life expectancy in the US results from higher mortality among those under 65. Among men it was due mainly to drugs, suicide, and homicide, while for women cardiovascular and respiratory disease according to an international analysis of 2014–2015.

“State governments play a large role in promoting the health and well-being of their constituents,” said Woolf. But the disparities between states has been growing over time. The study’s author says that there is encouragement in this “as it shows that states are capable of adopting policies that improve health.” However, the flip side of the coin causes concern “because many other states that fared poorly in this study are now actively weakening or rolling back such policies.”

The US states with the longest and shortest life expectancy

Here are the top ten states for life expectancy and the bottom ten. You can check out the full list and see how your state ranks at NiceRx.

US states will longest life expectancy

RankingStateLife expectancy
4New Hampshire79.0

US states will lowest life expectancy

RankStateLife expectancy
49West Virginia72.8
43New Mexico74.5
42South Carolina74.8

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