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There are many clues why life expectancy and well-being vary significantly by state.
Why are there significant differences in U.S. life expectancies by state? Answers to this question can potentially be found by digging into the underlying influences on life expectancies, which are a basic measurement of well-being in a broad population.
The life expectancies discussed in this post were published by the CDC in January 2023 and collected by Assurance, an insurance technology platform. Below are the top 10 and bottom 10 states by life expectancy according to this ranking:
Top 10 states by life expectancy
1. Hawaii (80.7 years)
2. Washington (79.2 years)
3. Minnesota (79.1 years)
4. California (79.0 years)
5. Massachusetts (79.0 years)
6. New Hampshire (79.0 years)
7. Vermont (78.8 years)
8. Oregon (78.8 years)
9. Utah (78.6 years)
10. Connecticut (78.4 years)
Bottom 10 states by life expectancy
41. South Carolina (74.8 years)
42. New Mexico (74.5 years)
43. Oklahoma (74.1 years)
44. Tennessee (73.8 years)
45. Arkansas (73.8 years)
46. Kentucky (73.5 years)
47. Alabama (73.2 years)
48. Louisiana (73.1 years)
49. West Virginia (72.8 years)
50. Mississippi (71.9 years)
The above life expectancies were calculated by applying current rates of death as measured in a specified population at each future age starting from birth. Leading causes of death in the United States are heart disease, cancer, and accidents, in that order. These immediate causes are significantly influenced by factors such as poverty rates, educational attainment, rates of obesity and smoking, and access to health care.
When you think about it, all these factors have the potential to influence a person’s quality of life. The measured life expectancy rolls up all these factors into one objective measure of well-being based on population data.
Let’s look at how the states with the highest and lowest life expectancies rate for each of the above factors that influence life expectancies.
Poverty rate is a strong predictor of shortened lifespans
People living in poverty often have limited access to health care and healthy food and are subject to financial stress. Each of these factors has the potential to negatively impact life expectancies.
According to the World Population Review, of the 10 states ranked in the bottom for life expectancy, there was an exact match with poverty levels: These 10 states had the highest levels of poverty in the U.S.
Interested in learning more about this topic? NPR recently published an insightful article that describes how the stresses of poverty have the potential to “weather” a body and shorten lifespans.
On the other hand, of the states ranked in the top 10 by life expectancy, six were at the bottom of the list of states that had the lowest percentage of population with incomes below the poverty level (New Hampshire, Utah, Hawaii, Minnesota, Massachusetts, and Connecticut).
Educational attainment positively influences life expectancies
Educational attainment helps individuals learn and distinguish healthy from unhealthy behaviors. It also indicates a basic degree of opportunity and discipline, which is needed to help avoid unhealthy behaviors. Educational attainment is significantly correlated with income and wealth, another strong influence on life expectancy.
According to the World Population Review, of the states ranked in the top 10 for life expectancy, four were also in the top 10 of the states with the highest percentage of the population who graduated from high school (Vermont, Minnesota, New Hampshire, and Utah). Four of these states also had the highest prevalence of its population earning a bachelor’s degree or higher (Massachusetts, Connecticut, Vermont, and New Hampshire).
Of the states ranked in the bottom 10 for life expectancy, six were also in the bottom 10 of the states with the lower percentage of the population who graduated from high school (Mississippi, Louisiana, New Mexico, Alabama, Kentucky, and Arkansas). Eight were also in the bottom 10 regarding whether residents had earned a bachelor’s degree or higher (West Virginia, Mississippi, Arkansas, Louisiana, Kentucky, Oklahoma, Alabama, and New Mexico).
No surprise: smoking and obesity negatively impact lifespan
It’s widely known that smoking and obesity can have a negative impact on health and longevity.
The state-by-state data provides support for this conclusion:
- Of the top 10 states ranked by longevity, six have the lowest rates of smoking and five have the lowest rates of obesity, according to the World Population Review.
- Of the bottom 10 states ranked by longevity, seven have the highest rates of smoking and nine have the highest rates of obesity.
Access to health care is correlated with life expectancies
Access to health care is determined by a variety of factors, including affordability, access to health care professionals, and spending by state and local governments. According to a recent analysis by MoneyGeek:
- Of the top 10 states ranked by access to health care, six are also in the top 10 states ranked by life expectancy (Hawaii, Minnesota, New Hampshire, Massachusetts, Utah, and Washington).
- Of the bottom 10 states ranked by access to health care, seven are also in the bottom 10 states ranked by life expectancy (West Virginia, Mississippi, Tennessee, Louisiana, Oklahoma, New Mexico, and Kentucky).
Causation between life expectancies and environmental factors not proved
It should be noted that the relationships between life expectancies and some of the factors described in this post don’t necessarily prove causation. However, they strongly point to potential reasons for longer or shorter life expectancies that can be further explored by research.
Causation between life expectancies and lifestyle and environmental factors can be demonstrated by longitudinal studies that follow people over time and medical studies that identify the damage to your body that lifestyle and environmental factors can cause. For example, such studies have provided respected evidence that smoking and obesity can cause shortened lifespans.
There are also other influences on peoples’ expected lifespans, including the level of support by federal, state, and local governments, the level of social interactions, and the overall health of the local environment.
The factors described in this post can be used as a list for policymakers to address if they want to improve the measurement of well-being of their constituents. In the meantime, pre-retirees and retirees can take these factors into account when deciding where to live for the rest of their lives.
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