Newsweek has created a map that highlights a sobering reality for parts of the United States: in dozens of U.S. counties, average life expectancy is now lower than that of North Korea.
Life expectancy in North Korea—a country often cited for its economic hardship and limited healthcare access—stood at 72.6 years in 2021, according to the World Health Organization.
Yet in parts of the United States—particularly in Southern states including Mississippi, Kentucky and West Virginia—county-level data shows average life expectancies below that threshold, according to the County Health Rankings project, an annual analysis conducted by the University of Wisconsin Population Health Institute.
It comes as new research carried out by the Yale School of Public Health (YSPH), published in JAMA Network Open, found that certain states’ life expectancy is far worse than others—particularly in parts of the Deep South and Appalachia—underscoring the severity of health inequities within the United States.
Why It Matters
The U.S. spends more on health care per capita than any other country, yet significant health disparities persist, particularly in rural and low-income areas.
Many of the counties falling below North Korea’s life expectancy benchmark are in regions with high poverty rates, limited access to medical care, and a high burden of chronic diseases, including obesity and diabetes.
What To Know
U.S. counties where life expectancy falls below North Korea’s average of 72.9 years include:
- Oglala Lakota County, South Dakota: 56.9 years
- McDowell County, West Virginia: 65.1 years
- Union County, Florida: 67.9 years
- Monroe County, Arkansas: 68.8 years
- Kusilvak Census Area, Alaska: 65 years
The Yale School of Public Health study, published last month, looked at mortality trends by cohort, rather than standard life expectancy calculations, which estimate how long a newborn today is expected to live.
While states in the West and Northeast saw continuous improvements, parts of the South have stagnated.
For instance, female life expectancy in some Southern states increased by fewer than three years between the 1900 and 2000 birth cohorts. For males in the same region, life expectancy increased by less than two years since the 1950 cohort.
Washington, D.C., had the lowest life expectancy in the 1900 birth cohort at 61.1 years, but it achieved one of the most significant gains over the century, reaching 72.8 years.
The Yale study examined the rate at which mortality increased after age 35, which is summarized by the number of years it takes for an individual’s risk of death to double. Longer doubling times indicate healthier aging. Regional differences were clear: New York and Florida showed slower mortality increases, while Oklahoma and Iowa saw faster mortality escalations.
After 35 years of age, the highest rate-doubling time in a state was 9.39 years in New York for females and 11.47 years for males in Florida.
Conversely, Oklahoma and Iowa exhibited the fastest doubling of death rates after age 35—a sign of more rapid health deterioration among their populations.
The study concluded: “From 1969 to 2020, period life expectancy increased, although there was greater improvement for some states in the West and Northeast and less for some states in the South.
“Some states in the West and Northeast showed increases in the cohort life expectancy greater than 30 years for those born in 2000 compared with 1900. However, in parts of the South, female cohort life expectancy increased by less than 2 years.
“For male cohorts in parts of the South, life expectancy increased from 1900 to 1950 but by less than 2 years after 1950.”
What People Are Saying
County Health Rankings and Roadmaps says: “Safe housing, jobs that pay a living wage and well-resourced schools are among the factors, often called the social determinants of health, that make up a healthy community.
“How these conditions are created, distributed and maintained determines the opportunity for everyone to thrive. Written and unwritten societal rules—and how they are applied—shape conditions for healthy communities.
“Rules may be written in the form of policies and laws, or unwritten, in the form of worldviews and norms. Together, power and rules are the structural determinants of health.”
What Happens Next
Yale researchers have called for policy changes to address the gaps in life expectancy across the country.
“The disparities we see today are the result of decades of cumulative effects—on smoking rates, health care access, environmental exposures, and public health investments,” the study’s lead author, Theodore R. Holford, said. “Without conscious policy changes, these gaps will likely persist or even widen.”
Newsweek has contacted the Department of Health and Human Services, via email, for comment.