The United States has a health problem. Across the country, life expectancies routinely fail to meet the standards set by other developed nations. Differences in life expectancy between the United States and other developed nations, such as Switzerland and Japan, are dramatic.
However, some states have closed the gap with these nations. In both Hawaii and Minnesota, a resident born in 2010 could expect to live 81 years on average. In 12 states, the life expectancy at birth was 80 years or more.
The states with the longest life expectancies have concurrently low mortality rates, according to data from the Centers for Disease Control and Prevention (CDC). Across the United States, the age-adjusted mortality rate was 732.8 deaths per 100,000 people in 2012. However, in eight of the states with the highest life expectancies the mortality rate was less than 700 deaths for every 100,000 residents. In Hawaii, the age-adjusted mortality rate was just 586.5 per 100,000, the lowest in the country.
Access to health coverage is among the important factors that promotes good health -- and as a result leads to longer lives. In most of the states with the longest life expectancies a far lower percentage of the population was uninsured relative to the nation as a whole. While 14.5% of Americans did not have health care coverage last year, only 3.7% of Massachusetts residents did not. In Hawaii and Vermont the uninsured rates was also less than half the national rate.
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However, not all the research is conclusive on the effects of health care coverage on mortality. One 2009 study in the American Journal of Public Health stated that a lack of coverage led to nearly 45,000 deaths in the United States a year. However, another 2009 study appearing in Health Services Research argued that “there is little evidence to suggest that extending insurance coverage to all adults would have a large effect on the number of deaths in the United States.”
Poverty, too, can contribute to poor health outcomes. In fact, many states that have relatively high life expectancies also have relatively low poverty rates. New Hampshire, Connecticut, and Hawaii were all among the states with the longest life expectancies, as well as among the five states with the lowest poverty rates.
Some contributors to poor health and the resulting low life expectancies are preventable.
Smoking, for instance, was far more prevalent in the states with the lowest life expectancies, as was physical inactivity. By contrast, in many of the healthiest states, people were far more likely to have healthy habits, such as not smoking and being more active.
In order to identify the states with the highest life expectancies at birth in 2010, 24/7 Wall St. reviewed figures from the OECD’s 2014 study on regional well-being. Data on age-adjusted mortality rates are from the CDC for 2012. Figures on poverty and health insurance coverage are from the Census Bureau’s 2013 American Community Survey. Other figures cited are from the 2014 edition of America’s Health Rankings, an annual study from the United Health Foundation.
These are the states where people live longest.
10. Utah
> Life expectancy: 80.2 years
> Obesity rate: 24.1% (4th lowest)
> Poverty rate: 12.7% (14th lowest)
Utah has one of the highest life expectancies in the United States, at just over 80 years. No state had a lower percentage of adults who smoke. Utah is also the only top state for life expectancy that has not yet committed to expanding Medicaid under the Affordable Care Act. Utah Governor Gary Herbert has instead pushed an alternative plan, called Healthy Utah, to provide coverage to disadvantaged residents.
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9. New Jersey
> Life expectancy: 80.3 years (tied-8th highest)
> Obesity rate: 26.3% (12th lowest)
> Poverty rate: 11.4% (8th lowest)
New Jersey has especially high number of medical professionals. There were more than 143 general practitioners as well as 83 dentists for every 100,000 residents as of the most recently available data. In addition to high numbers of medical professionals, residents were among the least likely Americans to smoke. The effects of a high life expectancy at birth are also reflected in a low age-adjusted death rate, at just 677.6 deaths for every 100,000 people. By comparison, the death rate for all Americans was 732.8 per 100,00 people.
8. New Hampshire
> Life expectancy: 80.3 years (tied-8th highest)
> Obesity rate: 26.7% (16th lowest)
> Poverty rate: 8.7% (the lowest)
Limiting poverty can also improve health outcomes, and no state had a lower poverty rate than New Hampshire. Just 8.7% of the New Hampshire population lived below the poverty line in 2013, versus 15.8% of all Americans. Residents were more likely than most Americans to exercise regularly, and were likely than almost all states to be a victim of a violent crime. Violence has become increasingly recognized as a public health matter in recent decades.
7. Vermont
> Life expectancy: 80.5 years (tied-5th highest)
> Obesity rate: 24.7% (7th lowest)
> Poverty rate: 12.3% (13th lowest)
Few states have a higher rate of insurance coverage than Vermont, where only 7.2% of the population was uninsured in 2013. Vermont’s governor considered instituting single-payer health care, in which the government serves as the sole provider of coverage, but he abandoned the idea in the face of high costs. In addition to its commitment to high levels of coverage, the state residents are also among the most physically active -- less than 19% of residents were not regularly active in 2013, among the lowest rates in the nation.
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6. New York
> Life expectancy: 80.5 years (tied-5th highest)
> Obesity rate: 25.4% (9th lowest)
> Poverty rate: 16.0% (20th highest)
New York’s high life expectancy appears to the result of a number of factors. For one, the state's smoking and obesity rates were substantially below national levels. So, too, were drug deaths. New York’s age-adjusted mortality rate was among the best in the nation, at just 652.1 deaths for every 100,000 people in 2012. The state spent nearly $150 dollars per person in health funding in 2012 and 2013, among the highest amounts in the nation.
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5. Massachusetts
> Life expectancy: 80.5 years (tied-5th highest)
> Obesity rate: 23.6% (3rd lowest)
> Poverty rate: 11.9% (11th lowest)
Just 3.7% of the Massachusetts population did not have health insurance in 2013, the lowest in the United States. The availability of health insurance may play a role in lowering mortality rates in the state. Massachusetts also had the highest concentration of general practitioners and dentists of any state, with 200.8 generalists and 85.6 dentists for every 100,000 people. As of 2012, Massachusetts led the nation with the fewest years of life lost due to premature death -- deaths occurring at ages under 75.
4. Connecticut
> Life expectancy: 80.8 years (tied-3rd highest)
> Obesity rate: 24.9% (8th lowest)
> Poverty rate: 10.7% (4th lowest)
Connecticut had some of the nation’s best immunization rates in 2012, with more than 78% of children aged 19 to 35 months and 73.8% of adolescents between 13 and 17 years received recommended vaccinations. As in many other states with high life expectancies, Connecticut residents were more likely than most Americans to abstain from smoking and less likely than most to be obese. The state’s poverty rate of 10.7% in 2013 was also quite low, which likely helped achieve the better health outcomes, as poverty can contribute to poor health.
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3. California
> Life expectancy: 80.8 years (tied-3rd highest)
> Obesity rate: 24.1% (4th lowest)
> Poverty rate: 16.8% (16th highest)
Californians are among the least likely Americans to be obese or to smoke. Just 12.5% of adults in the state were smokers last year, the sand just 24.1% were considered to be obese. By comparison, the national smoking and obesity rates were 19% and 29.4%, respectively. Californians were also among the most physically active Americans. The combination of these healthy behaviors may have offset, at least somewhat, the high percentage of uninsured Californians last year.
2. Minnesota
> Life expectancy: 81.1 years
> Obesity rate: 25.5% (10th lowest)
> Poverty rate: 11.2% (7th lowest)
Only Minnesota and Hawaii had a life expectancy at birth of more than 81 years as of 2010. Low levels of obesity and drug-related deaths, combined with a high rate of health insurance, all likely contributed to the extended life expectancies in the state. However, Minnesotans were more likely than people in other states to binge drink. Last year, 21% of adults consumed alcohol at an unhealthy level, among the highest rates in the country.
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1. Hawaii
> Life expectancy: 81.3 years
> Obesity rate: 21.8% (2nd lowest)
> Poverty rate: 10.8% (5th lowest)
Hawaii had the highest life expectancy at birth in the nation, at 81.3 years as of 2010. The state’s age-adjusted death rate was just 586.5 deaths for every 100,000 residents in 2012, the lowest in the country. Like other states with a high life expectancy, Hawaii had both low obesity and smoking rates, as well as a high rate of health insurance coverage. Likely related to the high coverage rate, the state also had the lowest rate of preventable hospitalizations, at just 28.2 per 1,000 Medicare enrollees -- less than half the national rate of 62.9 per 1,000.
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