Why Are Americans in One Region Dying Years Earlier Than Rest of Country?

Same country. Shorter lives. What’s going on?

This article originally appeared on the Daily Caller News Foundation and was republished with permission.

Guest post by Ireland Owens

Southerners have a lower life expectancy than people living in other U.S. states, which experts attribute to several possible factors.

Several studies have shown that Americans in some areas of the Southern U.S. often have lower life expectancy and poorer overall health than those who live in other regions of the country. Analysts told the Daily Caller News Foundation that factors such as a lack of quality healthcare, lower medical insurance access and unhealthy habits may be contributing to poor health among some Southern Americans.

Lower life expectancy in some Southern parts of the country may result from higher chronic disease rates and rural hospital closures, according to a spokesperson for the Lifespan Research Institute (LRI), a nonprofit group which focuses on “strategically driving forward science to extend healthy human lifespan.”

“There is no single explanation,” the LRI spokesperson told the DCNF. “In many Southern states, lower life expectancy appears to reflect a combination of higher chronic disease rates, including heart disease, diabetes, obesity, kidney disease, and certain cancers, along with lower access to preventive care, higher uninsured or underinsured populations in some areas, rural hospital closures, transportation barriers, and persistent poverty.”

“It is also important to view this in the broader national context,” they added. “U.S. life expectancy has also been pressured by alcohol-related disease, opioid addiction, suicide, and other deaths of despair. While these trends are national rather than uniquely Southern, they have added strain in many communities already facing economic stress, chronic illness, and limited healthcare access.”

In Southern states such as Mississippi, Louisiana, Alabama, South Carolina, Kentucky, Arkansas and Tennessee, life expectancy tends to be between five to ten years shorter than in other regions of the nation, according to a January 2024 report from The Cornell Healthcare Review, which notes that the exact reason for lower life expectancy in these states is not currently known.

In 2024, life expectancy for the U.S. population was 79.0 years, marking an increase of 0.6 years from 2023, according to estimates from the National Center for Health Statistics (NCHS) published in January. Meanwhile, the age-adjusted death rate dropped 3.8% from 750.5 deaths per 100,000 U.S. standard population in 2023 to 722.1 in 2024, the NCHS reported.

The LRI spokesperson also told the DCNF that the “key point is that many of these outcomes are preventable,” adding “earlier detection, better risk-factor management, stronger primary care access, and healthier aging strategies could significantly improve both lifespan and quality of life [in these states].”

From 2022 to 2023, most of the U.S. states with shorter life expectancies were concentrated in the South, while those with longer-life expectancies were largely located in the West and Northeast, USAFacts reported in March 2025, citing data from the Centers for Disease Control and Prevention.

A study released in April 2025 showed that life expectancy saw minimal change for Americans born between 1900 and 2000 in many Southern states, particularly among women, CBS News reported. However, several Northeastern and Western states, along with Washington, D.C., saw life expectancy dramatically improve during the same period.

Moreover, living in walkable communities can also help to improve some people’s health, according to The Cornell Healthcare Review. Many residents of certain Southern U.S. cities are often car-dependent.

As of 2025, some of the least walkable cities across the nation included Arlington, Texas, Charlotte, North Carolina and Jacksonville, Florida, Radical Storage reported.

“The most important answer here is that no one really knows,” Michael Cannon, director of health policy studies at the CATO Institute, told the DCNF. “These issues are extremely complex. We can observe disparities in life expectancies and other measures of health. We can observe correlations between those disparities and disparities in factors that influence health, [such as] income [and] employment, housing, nutrition, education, access to health insurance [or] medical care, crime, stress, etc.”

“Lots of these factors influence each other, often in both directions,” he continued. “Low income can cause poor health, but poor health can cause low income. Lots of people offer theories with great confidence. Many of those theories are probably correct. But these issues are so complex.”

Cannon went on to say that some Southerners are facing several major barriers to improving their overall health, like less access to medical care as well as financial hurdles from having low incomes.

“Having said that, the safest thing to say is that southern states likely exhibit poorer health measures due to a combination of factors like low incomes, unhealthy behaviors, over-regulation, less access to healthcare, etc.,” Cannon said.

Residents of Southern U.S. states tend to die earlier from a range of chronic illnesses compared to those in other parts of the country, according to a February 2018 report from Texas A&M University. Meanwhile, infectious diseases such as whooping cough, salmonella and chlamydia are also more prevalent across the region, especially in Louisiana and the Carolinas, per the report.

A Journal of the American Heart Association report published in July 2018 found that people with a history of heart disease who ate a traditional “Southern” diet — which includes added fats, fried food and egg dishes — had a higher risk of death compared to those who stuck to a Mediterranean-style diet.

Additionally, there were 1.63 million excess deaths among black Americans relative to white Americans over the past two decades, KFF reported in October 2024. As of 2023, 56% of the U.S.’ black population were living in the South, while another 17% lived in the Midwest and Northeast and 10% lived in the West, according to a Pew Research Center fact sheet released in January 2025.

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