Recent research reveals that the United States ranks last in life expectancy among English-speaking countries. However, this average masks significant disparities between states, with some experiencing notably lower life expectancy rates than others.
A study published in BMJ Open this month by Ho and colleagues analyzed life expectancy data from both the Human Mortality Database and the World Health Organization’s Mortality Database, covering the years from 1990 to 2018 across various countries, including Canada, Ireland, the UK, Australia, and New Zealand.
Not only did the U.S. have the lowest overall life expectancy, but it also exhibited marked geographical variations, highlighting deep regional inequalities.
“Within the U.S., there’s a long-standing divide, with the West and Northeast showing much better outcomes while the South and Appalachia often struggle,” said Ho.
One factor contributing to this issue is the difference between urban and rural life expectancies observed over the past three decades.
“Central cities and their suburbs have made significant improvements in life expectancy, whereas smaller cities and rural areas have seen much less progress,” Ho explained.
Several elements might influence these disparities, such as health behaviors (e.g., smoking, sedentary lifestyles, poor diet, substance abuse) and selective migration patterns that see healthier individuals moving to urban and coastal regions, leaving behind less healthy populations.
Additionally, Ho noted, “The South and Midwest, which are home to many rural residents, often have more permissive gun laws and consequently higher rates of gun-related deaths.”
According to data from 2018, the five states with the lowest life expectancies were:
- West Virginia—74.5 years
- Mississippi—74.6 years
- Alabama—75.1 years
- Kentucky—75.3 years
- Tennessee—75.6 years
Conversely, the five states with the highest life expectancy for the same year included:
- Hawaii—81 years
- California—80.8 years
- Minnesota—80.5 years
- New York—80.5 years
- Connecticut—80.4 years
To tackle these inequalities and boost the overall life expectancy in America, it’s crucial to address preventable deaths, particularly among younger individuals.
Ho suggests implementing policies that enhance treatment access for drug addiction, reduce traffic fatalities, invest in public transportation, decrease gun violence, and combat cardiovascular diseases.
References
Wilkie, R. Z., & Ho, J. Y. (2024). Life expectancy and geographic variation in mortality: an observational comparison study of six high-income Anglophone countries. BMJ Open, 14(9), e079365. https://doi.org/10.1136/bmjopen-2023-079365