Life expectancy in southern states changed little for Americans born from 1900 to 2000, study finds

In the United States, how long a person lives can vary substantially depending on where in the country they reside. 

Comparing the life expectancy of people born from 1900 to 2000, a study published Monday found that in many southern states, life expectancy changed very little, especially for women. But in several states in the Northeast and West, as well as in Washington, D.C., it improved significantly.

Ranked among the worst states for longevity improvements over the last century, West Virginia’s life expectancy for women born in 2000 rose to just 75.3 years, one year longer than its life expectancy for women born in 1900, according to the study. The state’s life expectancy for men born in 2000 increased by about 9 years compared to those born in 1900.

By comparison, the study showed the life expectancy for women born in New York in 2000 is about 92 years, roughly two decades longer than for those born in 1900. And men born in New York in 2000 have a life expectancy of about 88 years, almost 28 years longer than those born in 1900. 

Life expectancy nationwide increased far more for men from 1900 to 2000 than it did for women, a pattern that held true in a number of individual states. Overall, women’s life expectancy by birth cohort grew from 73.8 to 84.1 years, while men’s rose from 62.8 to 80.3 years.

The study also found that longevity for men typically plateaued around 1950. Researchers said life expectancy increased by less than 2 years for men in many states since 1950.

Researchers at the Yale School of Public Health conducted the study, and their findings were published in the journal JAMA Network Open. The results analyzed 179 million deaths around the U.S., including the deaths of 77 million women and 102 million men. 

The study differs from previous ones by looking at life expectancy by birth cohort, rather than by just calendar years, the authors say. 

“Prior studies have considered mortality and disease from the perspective of calendar year or period but have not provided summaries for individuals by birth cohorts,” they wrote. “The cohort trends can assess the outcomes of policy changes that have more impact on individuals of a particular age and impact health thereafter.”

Best and worst states for life expectancy

For women, the study found that life expectancy changed very little for those born in 1900 and those born in 2000 in five states: West Virginia, up from 74.3 to 75.3; Oklahoma, which saw a decrease from 76.7 to 76; Kentucky, up from 74.9 to 76.5; Mississippi, up from 73.2 to 76.6; and Arkansas, where it rose from 75.7 to 76.6. 

Ted Holford, a research scientist in biostatistics who co-authored the study, told CBS News the minimal changes in women’s longevity found in certain regions were unexpected. 

“For some of those states in the Northeast and the West, there’s been quite a lot of change, which one would expect, given all of the changes in medical practices and health care over the 20th century,” Holford said. “But what was surprising to me is how little it changed, especially for women, in some of those southern states. Some of them basically didn’t change at all.”

For men, Mississippi, West Virginia, Alabama, Louisiana and Tennessee saw the lowest changes in life expectancy compared with the rest of the country. In each, men born in 1900 had a life expectancy of between 61.5 and 63.7 years, while those born in 2000 have a life expectancy between 71.8 and 73.4 years. Much of the longevity increases for men in those states happened before 1950, with little improvement from then onward, Holford said. 

Like the lowest-ranking states, those with the highest life expectancy, and the most significant jumps in longevity over the last century, overlapped between women and men. 

For women, the study found life expectancy rates were highest and most improved for those born in Washington, D.C., New York, California, Massachusetts and Hawaii. New York, California, Washington, D.C., Massachusetts and Washington state topped the list for men.

Why do people live longer in some states and not others?

Authors of the study attributed the country’s overall decrease in mortality rates to national improvements in sanitation, tobacco policies and health care, specifically calling out the progress made in terms of preventing cardiovascular disease, cancer and other illnesses since 1900. They cited variations in state public health policies between individual states to potentially explain the regional discrepancies indicated in the study, which also mentioned widening longevity gaps from the 1980s onward.

“These are undoubtedly shaped by state-level policies: states with progressive public health policies were more likely to experience increases in life expectancy than states without such policies,” the authors wrote, adding that “differences in mortality rates are also observed even at more granular levels by county.”

Holford acknowledged that “a complex array of things” has contributed to the ways in which life expectancy has changed in some states and not others, with variations in statewide tobacco regulations, vaccine policies and wealth to support better health care being a few of them. As this study grew out of a larger project that Holford worked on, developing population models for lung cancer, he used the evolving laws in some states to clamp down on cigarette smoking in some states versus others as one example of discrepancies that could feed into state-by-state differences in life expectancy.

“Some of the states have been more aggressive bout trying to control tobacco use, introducing things like taxes on cigarettes and having clean air laws,” Holford told CBS News. “But some of these southern states, they’ve done very little. Some of them haven’t instituted any efforts [to curb tobacco use].”

Socioeconomic factors play a significant role in the differences between health environments by state, Holford and his co-authors noted, echoing findings of other reports on longevity in the U.S. Last year, a study that examined death records from 2000 to 2021 pinpointed large disparities in life expectancy based on location, as well as race and ethnicity. 

Accounting for the effects of the COVID-19 pandemic, the authors of that study found that historically marginalized populations, including Black and Indigenous Americans, experienced disproportionately high mortality rates and “horrific losses in life expectancy” compared with other groups.