Life expectancy data underscore the importance of state policies.

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Research indicates that state laws and approaches have a bearing on average life expectancy.
Image credit: BAY ISMOYO/AFP via Getty Images.

“Americans die younger than people in other high-income countries,” says Prof. Jennifer Karas Montez, a sociologist at Syracuse University, in New York, and the lead author of a new study investigating life expectancy across the United States.

“This gap in life expectancy between the U.S. and other countries emerged in the 1980s and has grown ever since. Since that time, gaps in life expectancy between U.S. states also expanded,” she adds.

The study that Prof. Montez helmed has found that people who live in “blue states” live longer than those in “red states,” due to differences in state policies.

In blue states, voters primarily opt for Democratic Party candidates, while red states are mainly home to Republican Party voters.

During the 1980s and after 2010, changes to state policies have had a negative impact on life expectancy in the U.S., the study authors report, and these changes have had the most profound effect on women.

The researchers estimate that since 2010, there would have been a 25% greater gain in life expectancy for women and a 13% gain for men, had certain states not become more conservative.

The study has been published in The Milbank Quarterly.

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“The difference between the highest and lowest life expectancy states has grown to 7 years — the largest ever recorded,” says Prof. Montez. Those states are Connecticut and Oklahoma, respectively.

In Connecticut, life expectancy rose by 5.8 years between 1980 and 2017. During the same period, Oklahoma residents saw an increase of just 2.2 years.

Life expectancy in Connecticut ranks between that in Denmark and Costa Rica, while the life expectancy in Oklahoma places the state between Serbia and Brazil.

The study also observes that as political polarization across the country has accelerated, Connecticut has become one of America’s most liberal states, while Oklahoma has become one of its most conservative.

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The authors of the study looked at 18 topics of state policy, 10 of which strongly predict life expectancy.

Overall, liberal policies were associated with longer lives and conservative policies with shorter lives.

The difference was especially striking in terms of policy concerning tobacco use, immigration, civil rights, the environment, and labor issues — such as right-to-work laws and the minimum wage.

Minimum wage levels, earned income tax credits, abortion laws, and Medicaid availability particularly affect the life expectancy of women, the researchers found.

They controlled for factors specific to each state and its residents, and they also considered the effects of gun control policy.

“If all states enacted liberal policies across the 18 domains, our study estimated that U.S. life expectancy would increase by 2.8 years for women and 2.1 years for men. However, if all states enacted conservative policies, U.S. life expectancy would decline by 2.0 years for women and 1.9 years for men. If all states followed current national policy trends, there would continue to be little improvement in life expectancy.”

– Prof. Jennifer Karas Montez, lead author of the study

The authors report that changing current conservative policies could improve health and longevity in the U.S. Simply changing state labor laws, for example, from conservative to liberal could result in a life expectancy gain of 1 year.

“In particular,” says Prof. Montez, “it is essential to enact policies that protect the environment, regulate tobacco and firearms, and ensure labor, reproductive, and civil rights.”

However, the authors caution that prioritizing longevity may not be simple. In many states, policymakers also consider the interests of corporations and their lobbyists — particularly those of the American Legislative Exchange Council (ALEC).

Pro-corporation and politically conservative lobbying groups, such as ALEC, are highly active in places like Oklahoma but far less influential in places like Connecticut.

Prof. Montez concludes, “Policymakers and the public must recognize that putting profits over people cuts lives short.”

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