Californians live longer than people in all but three states, but not all counties are equal.
Though life expectancy has declined in recent years, Californians still live longer than most Americans. Rudy Anderson / Pixabay Pixabay License
Despite the prevalence of news reports claiming that people are abandoning California, reflected at least somewhat in the reality of the state’s declining population over the past few years, California still remains the promised land for a sizable portion of the American population. According to a 2023 survey by the real estate analysis site HomeBay, about one in every five Americans (19 percent) say that in an ideal world, they would rather live in Los Angeles than any other United States city.
That’s more than any other U.S. city. The survey also found that California is the state where more Americans dream about moving than any other. More than one in four Americans (27 percent) according to the HomeBay study said that if money were not a factor, they would move to California. Only Florida (25 percent) and Hawaii (22 percent) even came close to California in desirability.
What makes California so attractive? The survey found that the top reason Americans move is simple and perhaps not too surprising: quality of life. But even the study noted that the phrase can be “a little vague.”
One statistic cannot be disputed, however, and that is how long a person can expect to live. Life expectancy stats are often used to gauge the overall health of a population and, according to the Organisation for Economic Co-operation and Development (OECD), generally reflect “rising living standards, improved lifestyle and better education, as well as greater access to quality health services.” All are important quality-of-life factors.
Perhaps, then, it should come as no surprise that people living in California, statistically speaking, can expect to live longer than in all but three other U.S. states, according to stats compiled by the Centers for Disease Control (CDC). And yet, even in California, the life-expectancy picture is not all positive. There is a significant disparity in expected life span between California’s urban and suburban coastal counties, and the rural northern counties as well as some inland largely agricultural counties.
Why can people in California’s biggest cities and coastal areas expect to live longer than rural Californians? The reasons are, unsurprisingly, complex but can be reduced with a high degree of accuracy to two factors—money and politics.
What is ‘Life Expectancy’ Anyway?
Before trying to understand why different regions of California, and the U.S., have different life expectancies, it would help to know what is meant, exactly, by the term. On its face, it seems straightforward. How many years can you expect to live? But there are different ways of arriving at this number, and the term itself can be used in different ways. The most frequently used numbers come from data on life expectancy at birth. That is, in any given year, how long can an infant born in that year be expected to live? Life expectancy, however, changes as a person ages. In general, the longer you live, the longer you can expect to live.
According to tables compiled by the U.S. Social Security Administration, a newborn American male can currently expect to live just over 76 years (76.04 to be exact). A male who is currently 30 years old, however, can expect to live to the age of 77 years and nine months. And a man who has already survived to be 65 can expect to live to be just shy of 83.
Life expectancy also varies by gender and race. Men have shorter life expectancies than women. A newborn female child, per the Social Security Administration figures, has a life expectancy of 81 years. A 65-year-old woman can expect to live to be 85 years and six months old. White people in the U.S. have a life expectancy of 76.4 years, compared to 70.8 years for Black Americans, as of 2021.
But those numbers come with an important caveat. Life expectancy at birth, or at any age along the way, assumes that “mortality patterns”—the varying ages at which people die—will remain the same throughout a person’s entire life. Numbers that make that assumption are called “period life expectancy” figures because they take ages of death during a specific period—the year 2022, for example—average them out, and then use the result to determine the life expectancy of any person born or alive in the same period.
A second type of figure is known as “cohort life expectancy,” in which a cohort is any specific group of people—for example, “people born in 2022.” This type of calculation takes past mortality data and projections of future mortality into account. Cohort-based calculations are usually used to determine age-specific life expectancy projections.
California and the Life Expectancy Gap
American life expectancy is falling. The COVID-19 pandemic as well as other factors such as increased rates of drug overdoses, suicide, and alcohol-related diseases brought the life expectancy of the average American down from 78.8 in 2019 to 76.4 in 2022. Americans can now expect less life than at any time since 1996, when Americans born in that year could expect to live 76.1 years.
Californians continue to enjoy among the highest life expectancies anywhere in the country, but the state has not been immune to the national drop in expected life. As of 2018, California ranked second only to Hawaii with an overall life expectancy of 80.9 years. By the end of 2022, Californian life expectancy at birth was down to an even 79 years, still good enough for fourth place among all 50 states and the District of Columbia, but a worrying trend nonetheless.
But how long you can expect to live depends on where you live. A map by former Federal Reserve policy strategist Jeremy Ney—creator of the American Inequality website—breaks down life expectancy by county, showing that within California the disparity reaches as much as seven years depending on where you live.
According to the figures on Ney’s map, Marin County residents enjoy an at-birth life expectancy of 83.8 years, the highest in the state. But up in the rural north, residents of Del Norte County can expect a statewide low of just 76.4 years alive, the same as the national average. Other coastal counties also see life expectancies topping 80 years, such as San Diego and Los Angeles Counties at 81.4 years, and Orange County at 82.3 years.
Across the country, the disparities are even more stark. The southeastern U.S. is a particularly dismal place to live, for people who actually want to live. In some Georgia counties—such as Bacon County—life expectancy has dropped below 73 years. In Polk County, Georgia, which is represented in the U.S. House of Representatives by right-wing Republican Marjorie Taylor Greene, residents can expect just 73.5 years and in Chattooga County, also in Greene’s district, life expectancy stands at 74.5 years.
The same pattern holds through most of the southeast, with a low of 72.7 years in Marion County, Mississippi, and 72.8 in Washington Parish, Louisiana.
Looking at the map, one correlation jumps out. Generally speaking, regions with the lowest life expectancies are the most politically conservative areas, while more liberal, “blue” regions see longer lives for their residents, on average. But why? Is there something about voting Democratic that leads to a lengthier time alive?
Liberal Policies Lead To Longer Lives, Data Shows
Southern states, which have voted uniformly Republican in recent elections and mostly have Republican governors and legislative majorities, also have the lowest life expectancies in the country. Mississippi brings up the rear at a dismal 72 years. Men in Mississippi can expect to live only 69 years, based on the 2022 CDC at-birth averages.
A study released in January 2023 by the Population Reference Bureau—a Washington, D.C., nonpartisan research group—offered an explanation for the wide gap between “red” and “blue” areas.
“The chances that an individual can live a long and healthy life appear to be increasingly tied to their state of residence and the policy choices made by governors and state legislators,” Syracuse University’s Jennifer Karas Montez—who led the study first published in The Milbank Quarterly—said in a report by the nonpartisan think tank.
The team used data from 1970 to 2014 to correlate life expectancies with state policies which were scored by their liberalism or conservatism—defining “liberal” policy as “expanding state power for economic regulation and redistribution or for protecting marginalized groups, or restricting state power for punishing deviant social behavior.” Conservative policies were defined as the opposite.
“Changes in US state policies since the 1970s, particularly after 2010, have played an important role in the stagnation and recent decline in US life expectancy,” the study found. “Some US state policies appear to be key levers for improving life expectancy, such as policies on tobacco, labor, immigration, civil rights, and the environment.”
The growing polarization of state policies, between highly conservative “red” states and more progressive “blue” ones, has driven the disparity in life expectancies, the study’s authors say. One striking example from the PRB report showed the difference between the steadfastly conservative Oklahoma and increasingly liberal Connecticut, which in 1950 had the same life expectancy of 71.1 years.
Over the next 69 years, as Connecticut adopted more and more liberal policies but Oklahoma remained firmly conservative, the two states developed a wide life expectancy gap. By 2019, Connecticut residents could expect to live 80.8 years. Their Oklahoman counterparts saw a much smaller gain, with life expectancy there rising to just 76.1 years—a 4.7-year advantage for the more liberal state.
If all states adopted the liberal policies found in most “blue” states, average U.S. life expectancies would be 2.8 years longer for women and 2.1 years longer for men, the study found.
More Money Means More Life. So Does More Gun Regulation
Want to live longer? There’s one simple way to do it. Get rich. Or better still, be born rich. According to a 2016 study in the Journal of the American Medical Association, “the gap in life expectancy between the richest 1 percent and poorest 1 percent of individuals was 14.6 years for men and 10.1 years for women.”
Wealth was also a determining factor in the amount that life expectancy increased over time, according to the study conducted by researchers at Stanford University and Massachusetts Institute of Technology. From 2001 to 2014, men in the top 5 percent of income earners added 2.34 years to their expected time alive, and women gained 2.91 years. But the bottom 5 percent saw barely any gains at all—just 0.32 years for men and 0.04 years for women.
The Ney map of life expectancy by county shows very similar results. The county with the lowest life expectancy in the country, Oglala Lakota County in South Dakota, at just 66.8 years, has a median household income of $30,347. That's less than half the national median of $78,813. Compare that with Summit County in Colorado, where the median income is $93,505 and life expectancy is the highest in the country—86.9 years.
Why would the amount of money you have correlate with how long you can statistically expect to live? The answer is not just money alone, but the conditions in which having plenty of cash, or not having it, allows you to live.
According to an essay by Ney published on April 12, 2023, people who live in low-income communities generally have less access to affordable health care. As of 2023, 10 states still refused to adopt the expansion of Medicaid, the government-run insurance program for low-income individuals and families, that was authorized by the 2012 Affordable Care Act. All of those states were politically controlled by Republicans.
In addition, Ney wrote, low-income communities are more likely to be located near environmentally contaminated toxic sites, and in food deserts where the nearest supermarket is at least one mile away in an urban area, or 10 miles away in a rural area. More than 2.1 million Americans live in food deserts and do not have access to transportation to get them the distance they need to travel to find a grocery store.
High food prices also make it difficult or near impossible for low-income Americans to obtain food. Inflation is a cause of those high prices, but perhaps an even more important factor is gentrification. As neighborhoods gentrify, discount grocers are replaced by high-end supermarkets such as the Amazon-owned Whole Foods and similar upscale stores. The dominance of high-priced supermarkets effectively creates food deserts for the lower-income residents who remain in those neighborhoods.
And something else is also shaving years off American lives. That something else is gun violence. A 2005 study published in the Journal of Risk and Insurance calculated that the average American’s life would be 103.6 days longer if not for the prevalence of guns in the United States. The South, where gun laws tend to be most lax, is hit the hardest. From 2009 to 2018 the South lost an aggregate total of 5.7 million years of potential life for its residents due to gun violence, according to a study by surgeons at Westchester Medical Center in New York.
Stricter gun regulations lead to increases in life expectancy. For children, who are now killed by guns more than by any other single cause, if gun deaths could somehow be eliminated, all five-year-old children in the South would immediately see three years added to their life expectancy.
One in 25 American five-year-olds will not live to the age of 40, a rate four times as high as in other “wealthy” nations, according to a New York Times report. Death rates among young people have spiked since the start of the COVID-19 pandemic in 2020 but COVID itself is the cause of only 2 percent of those deaths. About half of the increase in death among America’s young, the Times reported, is due to guns.
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