Policy polarization is rewriting the American geography of longevity
“Figure 2 shows how Black and White life expectancy has changed between 1990 and 2019 across these state policy clusters. Across all race-sex groups, more liberal states achieved far larger gains in life expectancy between 1990 and 2019 than their conservative counterparts. In the most liberal states, life expectancy rose by 3.4 years for White women and an extraordinary 10.7 years for Black men. Meanwhile, the most conservative states registered modest improvements at best, and for White women, there was essentially no progress at all.”
Cost of healthcare also causing many to delay pursuing milestones and life-enhancing goals
Amid a landscape of elevated prices and a rising cost of living, Americans are feeling financial strain from both a range of daily expenses, such as groceries and utilities, and healthcare expenses.
The West Health-Gallup Affordability Index indicates that Americans’ ability to afford healthcare has deteriorated in recent years. In 2026, millions are expected to face higher insurance premiums and rising out-of-pocket costs as the expiration of some Affordable Care Act subsidies and upcoming cuts to Medicaid enrollment threaten coverage. Collectively, these shifts could leave millions of Americans without health insurance at a time when financial stress is already running high.
New findings from the West Health-Gallup Center on Healthcare in America reveal that some Americans are cutting back on a wide range of other expenses, including utilities, driving less to save gas money to pay for healthcare, and stretching out doses of prescription drugs or borrowing money.
Americans also report that healthcare expenses are influencing long-term planning and major life decisions. Even middle-income households are feeling the strain.
Healthcare Costs Impact Daily Life
In a nationally and state-representative survey of nearly 20,000 U.S. adults conducted from June through August 2025, roughly one-third of respondents — the equivalent of more than 82 million Americans — said they have made at least one trade-off with daily living expenses to afford healthcare.
One problem with these statistics is that deaths from drug addition and shootings are not separated from those such as aging diseases. The main improvement in life expectancy came from a reduction in infant mortality. Hence it is hard to read things into this.
I think you can read that conservative states have higher infant mortality, shootings and durg overdoses.
Conservative states tend to have more poverty which contributes to the above. There is also smoking, obesity and typical lifestyle drivers.
But there is also education and government programs and that is very effected by politics.
The infant mortality rates and the variations around the US are shocking. They correlate very well to political affiliation. Utah as a relatively rich red state has low infant mortality but quite high black infant mortality. Also has relatively high life expectancy so it is hard to make generalizations.
But overall, being poor in the US is pretty bad all around relative to more advanced countries.
This makes sense as many countries have strong safety nets such as socialized healthcare for all, whereas the US does not. Believe it or not, but free healthcare positively impacts lifespan. 
A new study using better data and more rigorous methods finds that every US state saw cohort life expectancy gains of at least 5 years between the generations born in 1941 and 2000 — directly contradicting previous estimates that showed losses in some states. The real story of American longevity may be far more optimistic than the headlines suggest. Full text
Pifarré i Arolas H, Andrade J, Fletcher J
Life expectancy gains across US states between 1941 and 2000: a cohort study
BMJ Open Access 2026;16:e109623. doi: 10.1136/bmjopen-2025-109623
The obesity of high income nations is also interesting. Puerto Rick, of course is a US protectorate.
High-Income Country Rankings (Approx. 2024-2025)
| Rank | Country | Obesity Rate (%) | Region |
|---|---|---|---|
| 1 | Kuwait | 45.0 | Middle East |
| 2 | Qatar | 44.0 | Middle East |
| 3 | United States | 43.0 | North America |
| 4 | Saudi Arabia | 43.0 | Middle East |
| 5 | Puerto Rico | 42.0 | Caribbean |
| 6 | Chile | 40.0 | South America |
| 7 | Bahrain | 38.0 | Middle East |
| 8 | Panama | 37.0 | Central America |
| 9 | Romania | 35.0 | Europe |
| 10 | New Zealand | 34.0 | Asia-Pacific |
Partisans can hack away to find what they want but the unimpeachable evidence is a massive wealth gap, due largely to current US tax structure and related policy. A 20 year span between the haves and the have nots. Embarrassing that this is OK so so many here in the US.
U.S. Counties With A Life Expectancy Above 80 Years
Can you guess the two counties with Life Expectancy above 90?
The rhythm of aging: Stability and drift in the individual rate of senescence
I hate to say it, but capitalism is failing most Americans.
Of course, not rich Americans.
Socialized medicine provides a basic floor and standard of care that helps people live healthier and longer.
The number of years people in the UK spend in good health is falling, according to a new report.
Over the past decade healthy life expectancy (HLE) has dropped by around two years to just under 61 for both men and women.
The UK is one of only five of the richest 21 countries to see HLE decline and its fall was the second steepest.
The Health Foundation, which produced the analysis, said there was a significant economic cost to this trend and the findings should act as a watershed moment.
I found this to be an interesting graph:
Source: https://x.com/mboudry/status/2060694769890635887?s=20
Interesting, but not surprising, right? These are countries which were recently fairly poor, and now have a massive influx of abundant (tasty) food, high calories etc. Certainly in Kuwai, Qatar, Saudi, Bahrain etc, you probably aren’t having much of an outdoor active lifestyle or much routine daily activity. Those places have some of the lowest daily activity levels in the world. (I remember Fitbit publishing the data and the average steps per day in Saudi was like 3,000, lol).
One “funny” aspect is that the overtly Muslim countries have such high obesity rates, while excessive consumption and gluttony is expressly forbidden in their religion, and they even practice fasting.
