A study led by Yale shows significant disparities in life expectancies across U.S. states. Life expectancy in the United States varies greatly depending on the location. Researchers at the Yale School of Public Health analyzed over 179 million deaths from 1969 to 2020, exposing wide discrepancies in lifespan among states and demonstrating how local health policies impact longevity.
Americans have seen improvements in lifespan over the years due to advancements in sanitation, tobacco control, medical care, and prevention of chronic diseases like heart disease and cancer. However, these gains have not been uniform across the country. While some states have made progress, others have fallen behind.
The study, published in JAMA Network Open, took a unique approach by examining groups of people born around the same time, known as birth cohorts, instead of analyzing individual years. This method provides a clearer view of how different generations experience health throughout their lives.
According to Theodore R. Holford, the lead author of the study and a professor at YSPH, observing mortality trends by cohort offers a more precise insight into the experiences of populations and highlights the long-term impact of policies and social conditions on life expectancy.
From 1900 to 2000, life expectancy notably increased in the Northeast and West, particularly in states like New York, California, and Washington, D.C. For example, women in New York and California experienced lifespan gains of over 20 years. In contrast, Southern states such as Mississippi, Alabama, and Kentucky saw minimal improvements, especially among women, with increases of less than three years over the same period.
The researchers attribute these disparities to the influence of state policies. Progressive states that implemented measures early, like tobacco control laws and improved healthcare access, contributed to longer and healthier lives for their residents. For instance, California’s early smoking ban in 1995 led to significant improvements in life expectancy over the years, as generations grew up without second-hand smoke exposure and many adults quit smoking.
Conversely, states like Kentucky, West Virginia, Oklahoma, Arkansas, Tennessee, Louisiana, Mississippi, and Alabama, which lacked aggressive health measures, experienced higher smoking rates and increased mortality rates. Poverty and limited healthcare access were identified as key factors contributing to shorter lifespans in these states.
The study also highlighted how early life experiences influence health outcomes as individuals age.
Exposure to sanitation, vaccinations, or tobacco control has a significant impact on health in later years. Researchers studied the rate at which mortality increases after age 35, with longer intervals indicating better aging outcomes. Regional disparities were evident, with New York and Florida showing healthier aging trends compared to Oklahoma and Iowa.
According to Holford, public health interventions influence individuals from an early age and continue to affect them as they grow older. Measures such as raising the legal smoking age and enhancing childhood vaccinations have enduring health benefits over a person’s lifetime.
The study emphasizes that today’s health inequalities are the result of cumulative effects over decades, including tobacco use, healthcare disparities, and environmental factors. Without proactive policy changes, these disparities are likely to persist or worsen.
The research advocates for targeted interventions like tobacco control, improved healthcare access, and environmental safeguards. The hope is that these findings will prompt policy adjustments to ensure better health outcomes for future generations.
Tam highlights the importance of considering health from a generational perspective, noting that the benefits of health interventions have long-lasting effects. Despite this, as Holford points out, one’s place of birth should not dictate their lifespan, although current circumstances in the U.S. often suggest otherwise.
