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.
Even before the pandemic, there were parts of the country where life expectancy at birth was far lower than the national average — in some cases by 10 years or more.
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 shortest life expectancy at birth in every state. Life expectancy figures are averages for the years 2017 through 2019, the most recent period for which county-level data is available.
Though each county and county equivalent on this list has the shortest life expectancy at birth in its state, average life expectancies vary considerably — from more than 80 years to less than 65. The comparable national average life expectancy stands at 79.2 years.
Variations in life expectancy are tied to a number of factors. Tobacco use, for example, is the leading cause of preventable death in the U.S., and in nearly every county on this list, the share of adults who smoke is above 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 exceeds the statewide poverty rate.