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America has the lowest life expectancy of all English-speaking countries, new research has found. However, this varies significantly across the nation, with some states seeing much lower life expectancies than others.
“It’s well-known that American life expectancy performs very poorly compared to other high-income countries,” Jessica Ho, associate professor of sociology and demography at Penn State and senior author on the new paper, told Newsweek via email. “[However,] even compared to this subset of countries with shared characteristics, the U.S. has very low life expectancy, which is quite alarming.”
In their study, published in the peer-reviewed journal BMJ Open earlier this month, Ho and colleagues compared life expectancy data from the Human Mortality Database (HMD) and World Health Organization (WHO) Mortality Database between 1990 and 2018 for the United States, Canada, Ireland, the United Kingdom, Australia and New Zealand.
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Not only did the U.S. come bottom in terms of life expectancy, but it also showed significant geographical variations, indicating stark inequalities between regions.
“Looking within the United States, there are longstanding disparities between regions, with parts of the West and Northeast performing very well and the South and Appalachia typically lagging behind,” Ho said.
One potential reason for this could be the divergence in urban and rural life expectancies seen across the U.S. since the 1990s.
“Over the past three decades, large central cities and their suburbs have experienced strong gains in life expectancy, while medium/small cities and particularly nonmetros have much lower life expectancy levels and experienced small or no gains in life expectancy,” Ho said.
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Factors that may contribute to these disparities include differences in health behaviors like smoking, sedentary lifestyle, poor diet, and illicit drug use and alcohol abuse, according to Ho.
“Patterns of selective migration where the healthiest and best off tend to move to cities and coastal states, leaving behind the less healthy and less well-off; and differences in distance to hospitals and access to care,” she said.
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Ho added: “The South and the Midwest, which contain a large portion of our rural population, tend to have more lax gun laws and also happen to have higher rates of gun-related fatalities.”
With this in mind, taking the data from 2018, the following five states experienced the lowest life expectancies:
At the other end of the spectrum, these five states saw the highest average life expectancy for that same year:
In order to improve these inequalities, and America’s lagging life expectancy more broadly, the U.S. needs to address these avoidable deaths, especially among its younger citizens.
“These include policies that would improve access to treatment for drug addiction and overdose, reduce road traffic fatalities and invest in public transportation, decrease gun deaths, and reduce cardiovascular disease,” Ho said.
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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