Life expectancy is one of the most important and commonly cited indicators of population health — and in the United States, life expectancy is falling at a historic rate. According to the Centers for Disease Control and Prevention, life expectancy at birth declined by 1.5 years in 2020, the largest one-year drop since World War II.
The CDC attributes the decline to the COVID-19 pandemic and 93,000 drug overdose deaths — an all-time one-year high. Homicide, diabetes, and liver disease were also contributing factors. Here is a look at the states with the most drug overdose deaths in 2020.
While the national trend is alarming, there are parts of the country where life expectancy is far higher than the national average. Using data from County Health Rankings & Roadmaps, a Robert Wood Johnson Foundation and University of Wisconsin Population Health Institute joint program, 24/7 Tempo identified the county with the longest life expectancy at birth in every state. It is important to note that life expectancy figures are averages for the years 2017 through 2019 — the most recent period for which county-level data is available — so they are pre-pandemic.
Though each county or county equivalent on this list has the longest life expectancy at birth in its state, average life expectancies vary considerably — from as low as 78.7 years up to well over 90. The comparable national average life expectancy stands at 79.2 years.
Variations in life expectancy are tied to a number of both economic and behavioral factors. For example, tobacco use is the leading cause of preventable death in the U.S., and in a majority of counties and county equivalents on this list, the share of adults who smoke is below the corresponding statewide average. Here is a look at the American cities where the most people smoke.
Income levels are also linked to life expectancy. Poverty, for example, presents challenges and stressors that can take a cumulative toll on both physical and mental health. Additionally, lower-income Americans are less able to afford adequate health care or a range of healthy options related to diet and lifestyle. Recent studies have shown that life expectancy among the wealthiest 1% of Americans exceeds that of the poorest 1% by well over a decade. In most counties on this list, the poverty rate is below the statewide poverty rate.