Average life expectancy declined in every state in the country between 2019 and 2020, falling by nearly two years.
For all 50 states and the District of Columbia, life expectancy at birth fell from 78.8. years in 2019 to 77 years in 2020, according to new federal data from the Centers for Disease Control and Prevention’s (CDC) National Center for Health Statistics (NCHS). The new average life expectancy may well be the lowest average in nearly two decades.
The same report found that states with the highest life expectancy are mainly in the West and Northeast—including Washington, Minnesota, California, and Massachusetts. States with the lowest life expectancy were predominantly in the South, counting Kentucky, Alabama, Louisiana, West Virginia and Mississippi.
Medical experts say it's shocking and unsettling to see such a decrease in life expectancy, particularly because the U.S. has historically experienced a gradual increase over time.
“Over the last century, we’ve gained 30 years in life expectancy, which is phenomenal and unprecedented in human history. We’ve continued to increase life expectancy year after year, so to see a decrease in life expectancy is deeply upsetting,” Scott Kaiser, MD, geriatrician and director of geriatric cognitive health for the Pacific Neuroscience Institute at Providence Saint John’s Health Center, told Health.
The decline in life expectancy isn't something the country has experienced since such major events as the 1918 flu pandemic or World War II, Dr. Kaiser added.
"There have been some dips like the 1918 influenza pandemic, but otherwise, life expectancy typically has been increasing," Dr. Kaiser said. "Now, to see a decrease two years in a row is concerning. It should be a real wake-up call."
Here's a closer look at some of the reasons why life expectancy has recently reversed course and what you can do in response.
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Hawaii Tops the List and Southern States Rank Lowest
The new report from NCHS was compiled based on data from 2020. And while there was a life expectancy decrease in every single state across the nation and the District of Columbia, the exact amount of that decrease varies based on the state in which you happen to live—ranging from a decline of just 0.2 years to as much as 3 years.
The states that came out at the top of the heap, with the highest life expectancy, were mostly in the West and Northeast. States in the South on the other hand, had the lowest life expectancy, according to the data.
Hawaii, for instance topped the list with an average life expectancy of 80.7 years. Males in Hawaii were found to have an average lifespan of 77.6 and females 83.8 years. Washington state ranked second, with an average lifespan of 79.2 years. Broken down by males and females, the averages in Washington were 76.9 and 81.6 respectively. Minnesota, California and Massachusetts rounded out the top five longest life expectancies on the ranking, where the averages were nearly the same at 79.1 years to 79 years.
On the other end of the list, the bottom five states with the shortest life expectancy were Mississippi, West Virginia (72.8 years), Louisiana (73.1 years), Alabama (73.2 years) and Kentucky (73.5 years). Mississippi fared the worst in the nation with an average life expectancy of 71.9 years in 2020. For men however, that number was even lower at 68.6 years, while for females it was 75.2 years.
It's also worth noting that the difference in longevity between the highest ranked state and the lowest rank state also increased between 2019 and 2020, according to the the data. In 2019, there was a 6.5 year difference in lifespan between the top ranked and bottom ranked state, which has since widened to an 8.8 year gap.
Nationwide Declines Linked to Pandemic, Unintentional Injuries and More
Experts attribute the nationwide life expectancy decline primarily to two factors—the COVID-19 pandemic and increases in "unintentional injuries," such as drug overdoses.
Both factors have a significant impact for different reasons, according to Jeff Gladd, MD, chief medical officer for Fullscript medical advisory board and an integrative medicine physician. For its part, COVID-19 created a record number of deaths. Unintentional injuries meanwhile, have had a significant impact on younger ages.
"COVID-19 was obviously a novel cause that did not exist in previous years," Dr. Gladd, told Health. "With drug overdose deaths, they mainly occur in a younger population and will have a more dramatic effect on lowering the average age of death."
Even though COVID-19 was the major contributor, there’s a multitude of other reasons—related and not related—to the pandemic that could be contributing factors to the decrease in life expectancy among Americans, said both Dr. Gladd and Dr. Kaiser. Additional factors may include vaccination rates, masking practices, local public health response to the pandemic and other social determinants of health.
"Certainly deaths directly attributed to COVID-19 infection were significant, but indirectly many patients were impacted in terms of their access to medical preventive screenings and check-ups, activity and exercise, as well as their nutrition," Dr. Gladd said.
Additional factors such as education levels and health behaviors like avoiding smoking also have an impact, Dr. Kaiser said. The health systems in place across the country may also play a role.
"Our systems aren't necessarily set up to promote healthy behaviors to help people achieve their best health and well-being," Dr. Kaiser explained. "We invest a lot more heavily in acute and rescue care as opposed to prevention. And so I think that's reflected in our lower life expectancy."
Additional issues contributing to the decline in life expectancy include environmental factors, genetic factors, obesity, diabetes, and heart disease, as well as many unknown contributing factors, Scott Lauter, MD, chief medical officer at Atlantic Medical Group, told Health.
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Tips To Improve Life Expectancy
Regardless of where you live, or the presence of chronic diseases, adopting a healthy lifestyle and healthy behaviors has been shown to improve life expectancy, medical experts say.
"Many of the states with a higher life expectancy directly correlate with obesity rates. [The healthier states] have often been associated with places that cater to more active lifestyles," Dr. Gladd said. "That just means exercise like hiking and walking are more common, but everyone has opportunities to increase their exercises regardless of their locale."
Beyond exercise there are many other big and small changes that can be made, which will have a significant impact on life expectancy—even if you live in one of the states that ranked the lowest on the CDC report.
"Moving to a different state seems unrealistic and may not resolve health concerns," Dr. Lauter said. "Instead, individuals should focus on controllable lifestyle measures and practice good healthy habits."
Here are some actionable steps to improve health and lifespan, recommended by all three physicians.
Consume a balanced and healthy diet
Consuming a balanced diet with a variety of foods like leafy greens, fruits, protein, and whole grains frequently can increase life expectancy because they contain vitamins, fibers and minerals. For example, one study found a diet rich in legumes and whole grains could increase a person’s life by as much as 10 years.
Exercise or get physical activity regularly/maintain a healthy weight
Experts recommend getting at least 150 minutes of moderate activity each week, which is equivalent to about 30 minutes a day. Studies have shown physical activity can reduce several major mortality risk factors including Type 2 diabetes, certain cancers, and heart disease. In some cases, those who were active decreased their risk of these fatal diseases by about 30%.
Get enough sleep
It’s also suggested that people get adequate sleep each night to improve life expectancy. National guidelines recommend that on average, adults get 7 to 9 hours of sleep each night. Studies show that people with better sleep patterns have improved longevity.
Manage stress and mental health
People can also improve their overall health by managing stress, having a positive support system and focusing on their mental health.
Nearly 52 million people in the U.S. are impacted by mental illness, which can have an impact on life span. One study found serious mental illness can reduce life expectancy by 10 to 20 years. Still other reports indicate that social isolation can have negative impacts on overall health and can increase a person’s risk of premature death.
Additional ways people can improve overall health and life expectancy are to limit their alcohol consumption, avoid smoking, vaping, or using illegal drugs, and schedule routine health screenings for things like heart attack, stroke, colon cancer, and other health conditions.
"Getting started somewhere is the hardest and most important. Even single action lifestyle changes, such as increasing vegetable consumption or avoiding smoking, can improve life expectancy significantly," Dr. Gladd said. "Adhering to additional healthy lifestyle habits can have an even greater impact on life expectancy, regardless of geographical location."
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