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 decline 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 50 U.S. metro areas with the longest average life expectancy at birth. It is important to note that life expectancy figures are averages for the years 2017 through 2019 — the most recent period for which metro-level data is available — so they are pre-pandemic.

Among the metro areas on this list, average life expectancy at birth ranges from 81 years to over 86 years — compared to the national average of 79.2 years. Half of the metro areas on this list are located in Western states, including a dozen in California alone. 

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 the majority of metro areas on this list, the share of adults who smoke is below the 16.6% national 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 metro areas on this list, the poverty rate is below the 12.3% national average.

Click here to see the metros with the longest life expectancy
Click here to read our detailed methodology