Life expectancy in the U.S. varies drastically depending on where Americans live, with those in the South having the lowest rate. Mississippi and West Virginia both have a life expectancy rate of about 74 years, while California and Hawaii are at almost 81 years. 

That’s according to a report by The Commonwealth Fund, which analyzed life expectancy data from the Centers for Disease Control and Prevention (CDC) against those of countries part of the Organization for Economic Co-operation and Development (OCED). Researchers found that even compared to the states that have higher life expectancy, like California and Hawaii, the U.S. was still below other large, developed nations. 

For example, in Japan average life expectancy is 84.4 years, in Spain and Switzerland it’s 84 years and in neighboring Canada its 82.3 years. 

However, researchers stressed that regardless of where Americans live, they are “more likely to die earlier than people in many other countries. And they’re more likely to die from factors that could have been prevented with the right care provided at the right time.” 

Researchers explained that life expectancy is driven by multiple factors, including socioeconomic circumstances, public health care systems and policy choices. Healthcare is a major factor and an issue the U.S. struggles with, ranking last on access to care, administrative efficiency, equity and health care outcomes — despite spending the most.  

From 1980 to 2019, Commonwealth Fund found that the U.S. spent nearly 17 percent on helth care as a percentage of its gross domestic product (GDP). Other countries spent well below that, but still earned higher health care performance scores, like Switzerland, the U.K., Australia, Norway and more. 

One issue researchers identified was avoidable mortality, defined as death before the age of 75 from conditions that are either preventable through effective public health and primary prevention or treatable when detected early and effective care management is provided.  

Deaths from diabetes, certain infections, breast and colon cancer, appendicitis are some examples of avoidable mortality.  

In the U.S. avoidable mortality rates were found to be much higher, with 272 per 100,000 people, than other OCED countries. In Mississippi and West Virginia, there were more than 400 deaths per 100,000 people, which is higher than all other OCED countries, including Mexico, Lithuania, Latvia and Hungary. 

From 2019 to 2020, the CDC said that a decline in U.S. life expectancy could primarily be attributed to deaths from the pandemic, accidents/unintentional injuries, and drug overdose deaths.  

Commonwealth researchers outlined multiple actions the U.S. can take in order to address its alarming life expectancy rates, starting by offering universal insurance coverage to all Americans with minimal cost barriers. 

They also suggested committing to stronger community-based primary care, addressing administrative burdens that can hinder access to care and developing well-sourced social services that can support healthier populations and reduce stress on the health care delivery system.  

One major difference highlighted, most other middle- and high-income countries in OCED offer some form of guaranteed health care access through universal health care programs.