After pointed declines during the pandemic, life expectancy in the United States is expected to rebound to 2019 levels nationwide and in 26 states this year – but not as quickly as it should compared to similar countries, a modern study finds.
Bad habits like junk food, smoking and illicit drug exploit prevent longer life expectancy, even as technology brings major advances in diseases like cancer and heart disease, according to a modern study from the University of Washington’s Institute for Health Metrics and Evaluation.
By 2050, the life expectancy of babies born that year in the U.S. is expected to rise from 79.1 to 80.4 years, a modest improvement that would drop the United States behind almost all other high-income countriessays the study.
Poverty and inadequate health insurance are slowing progress in some states. Wealthier, more urban, and more educated states perform better and are more likely to take action that saves lives, from restricting access to guns to providing income support to modern mothers. Nine of the 10 states (all but North Dakota) with the longest life expectancies for babies born this year are dominated by Democrats, and all 10 have expanded Medicaid as part of the Affordable Care Act. All ten states with the shortest life expectancies are controlled by Republicans (although Kentucky has a Democratic governor), and this includes five of the ten states that have not expanded Medicaid.
A Stateline analysis of data from the study shows that life expectancy has increased in some states and decreased in others.
In 1990, for example, New York and West Virginia were nearly tied at 39th and 41st in life expectancy state rankings. But since then, the two have taken completely different paths – New York rose to No. 3 in 2024 and is expected to be the third by 2050 have the highest life expectancy of any state, surpassing Hawaii and Massachusetts.
West Virginia is ahead of only Mississippi in 2024 and is expected to be the last state in 2050.
New York has benefited from good health care in New York hospitals as well as state policies such as strict gun laws that have curbed suicides and harm reduction efforts to curb overdose deaths with supervised exploit sites and other controversial programs, Brett Harris said. President of the New York State Public Health Association and Associate Professor in the Department of Health Policy at the University at Albany.
Harris said she wasn’t surprised that despite its escalate in life expectancy among states by 2050, New York state would still fall from 33rd to 41st if ranked as a nation. according to the analysis.
“I think that’s partly because of how individualistic we are in this country, the idea of always moving forward, as opposed to a more community-based environment in other countries,” Harris said. “Their social policies tend to be better for health outcomes. If you live in a family environment rather than an individualistic one, that means more support.”
West Virginia’s low population density and rural poverty make access to health care complex. It’s also complex to overcome social and political skepticism about health measures, said Brian Huggins, health officer for Monongalia County, West Virginia. Huggins has worked with other county health departments to advocate for stricter anti-smoking laws and maintain school vaccination requirements despite opposition.
“It hurts to see West Virginia at the bottom. We are a proud state,” Huggins said, adding that life expectancy there is also hurt by a lack of economic opportunities that is driving newborn, fit residents to move away. Among the many concerns are the lack of sidewalks, which makes fit walking more hazardous, and a diet culture that does not include vegetables. both promote obesity.
Huggins has also seen conditions abroad. When he was stationed in Germany with the U.S. Army, he experienced generous health offerings for the Germans, such as two-week retreats with massages and saunas for those who felt stressed or burned out at work.
“Their goal in Germany is that they want you back at work. Prevention and maintaining a healthy workforce are their priorities because that contributes to the economy,” Huggins said. “On the other hand, they have built a tax system to support this. You pay about 18% tax on everything you buy there – that’s not something Americans would necessarily accept.” German VAT is now 19%. applies to most goods and services.
Life expectancy has fallen for two consecutive years during the COVID-19 pandemic, including a nationwide decline of more than 1.8 years between 2019 and 2020, from 79.1 to 77.3 years. The recovery is not forecast to be complete until this year, with tardy progress predicted until 2050 – when national life expectancy will be around 80.4 years.
States that recovered fastest from the pandemic included North Dakota, Rhode Island and Massachusetts, where life expectancy increased by about a year between 2019 and 2024. 24 states have still not returned to their 2019 life expectancy.
The District of Columbia, which is not a state, had a lower life expectancy than all 50 states in 1990, but ranks 23rd this year. Ali Mokdad, author of the study and chief strategy officer for population health at the University of Washington, said the improvement in DC is at least partly due to the influx of wealthier and better educated people since 1990.
Most of the states that were in the top 10 in 1990 have dropped out: Colorado (from No. 7 to 11), Iowa (from No. 4 to 17), Kansas (from No. 8 to 36), Nebraska (from No. 9). at No. 19), South Dakota (falling from No. 10 to 21) and Utah (falling from No. 2 to 12).
New in the top 10 in 2024 compared to 1990 are: Massachusetts (from 13th to 2nd), New York (as mentioned from 39th to 3rd), California (from 24th to 4th), New Jersey (from no. 26 to 6), Rhode Island (from Nos. 19 to 8) and Washington State (from Nos. 14 to 10).
Because of the availability of world-class care, urban concentrations are critical for longevity, Mokdad said.
“I’m very close to the hospital [in Seattle] and I have health insurance. But does this apply to everyone in Washington state? They live maybe two or three hours from Seattle, so even for people of my income and education level, it’s not the same,” Mokdad said.
Quality care and insurance are also critical, Mokdad said, to ensure problems such as obesity and high blood pressure are identified and controlled.
“You see that obesity has increased tremendously in many areas, particularly in the southern states, and while smoking has declined in wealthy areas, it persists in other communities. This explains a lot of it [state differences] – what we call preventable risk factors,” Mokdad said.
“Life expectancy is increasing, but many people are still left behind,” Mokdad said.
Even in urban areas, ethnic minority groups and women can find themselves in needy circumstances that can shorten both their lives and those of their children. A report The same issue of the Lancet this month featured a program in majority-black Flint, Michigan, where doctors prescribe money to women from delayed pregnancy through a child’s first year of life.
Families cannot make it to the doctor because they do not have transportation. They have difficulty eating fit because it is too pricey.
– Dr. Mona Hanna, a pediatrician in Flint, Michigan
The program, launched this year, is the first in the nation to replicate that of 140 other countries that offer cash grants for child health, the article said. The success of similar, momentary child tax credits early in the pandemic has prompted other states to do so introduce or expand your own tax credits for newborn mothers.
“We increasingly know that what happens in early childhood can influence life expectancy,” said Dr. Mona Hanna, a Flint pediatrician who founded the program called Rx Kids. It relies on government aid in the form of permission to exploit federal funds as well as private donations.
Michigan included $20 million in the state budget for next year to expand the program to other cities as well as predominantly white, rural counties in the state’s Upper Peninsula. The program provides $1,500 to expectant mothers and $500 per month for the baby’s first year of life.
“This is a concrete solution to overcome these place-based disparities and inequalities,” Hanna said. “The stress of being born into poverty can lead to premature births and low birth weight. Mothers are more likely to suffer from stress and may smoke. I see it every day. Families cannot make it to the doctor because they do not have transportation. They struggle to eat healthy because it’s too expensive.”
Rural areas in West Virginia could benefit from similar programs to address the state’s problems with poverty, aging and dependence on sinking industries such as coal, said Darren Liu, a health policy professor at West Virginia University’s School of Public Health.
To improve access to health care for rural residents, the state should expand telemedicine, set up more mobile clinics and offer student loan forgiveness to health care workers in rural areas, Liu said in an email to Stateline.
Huggins, the county health officer in West Virginia, said money is still an issue modern federal guidelines which require many health examinations that are free for insured patients. Often, low-income patients receive preventive care but cannot afford to treat disabling conditions such as knee and back pain that come from physical work.
“Because of the hurdles that insurance companies put in place because they have to be profitable, I think that’s another reason why West Virginia is ranked low,” Huggins said. “That’s an obstacle we have to try to figure out. Almost every insurance policy now has a deductible of well over $1,000.”
