It generated headlines in 2015 when the average life expectancy in the U.S. finally began to fall after decades of meager or no growth. It has declined by a tenth of a percentage point every year since, down to an average 78.6 years in 2017.
But it didn’t have to be that way, a team of researchers suggests in a new, peer-reviewed study Tuesday. And, in fact, states like California, which have implemented a broad slate of liberal policies, have kept pace with their Western European counterparts.
The study, co-authored by researchers at six North American universities and published in the Milbank Quarterly Journal, found that if all 50 states had all followed the lead of California and other liberal-leaning states on policies ranging from labor, immigration and civil rights to tobacco, gun control and the environment, it could have added between two and three years to the average American life expectancy.
“We can take away from the study that state policies and state politics have damaged U.S. life expectancy since the ’80s,” said Jennifer Karas Montez, a Syracuse University sociologist and the study’s lead author. “Some policies are going in a direction that extend life expectancy. Some are going in a direction that shorten it. But on the whole, that the net result is that it’s damaging U.S. life expectancy.”
Montez and her team saw the alarming numbers in 2015 and wanted to understand the root cause. What they found dated back to the 1980s, when state policies began to splinter down partisan lines.
They examined 135 different policies, spanning over a dozen different fields, enacted by states between 1970 and 2014, and assigned states “liberalism” scores from zero — the most conservative — to one, the most liberal. When they compared it against state mortality data from the same timespan, the correlation was undeniable.
For example, researchers found positive correlation between California’s car emission standards and its high minimum wage, to name a couple, with its longer lifespan, which at an average of 81.3 years, is among the highest in the country.
From 1970 to 2014, California transformed into the most liberal state in the country by the 135 policy markers studied by the researchers. It’s followed closely by Connecticut, which moved the furthest leftward from where it was 50 years ago, and a cluster of other states in the northeastern U.S., then Oregon and Washington.
In the same time, Oklahoma moved furthest to the right, but Mississippi, Georgia, South Carolina and a host of other southern states still ranked as more conservative, according to the researchers.
It’s those states that moved in a conservative direction, researchers concluded, that held back the overall life expectancy in the U.S.
“When we’re looking for explanations, we need to be looking back historically, to see what are the roots of these troubles that have just been percolating now for 40 years,” Montez said.
West Virginia ranked last in 2017, with an average life expectancy of about 74.6 years, which would put it 93rd in the world, right between Lithuania and Mauritius, and behind Honduras, Morocco, Tunisia and Vietnam. Mississippi, Oklahoma and South Carolina rank only slightly better.
Meanwhile, the life expectancy in states like California and Hawaii, which has the highest in the nation at 81.6 years, is on par with countries described by researchers as “world leaders:” Canada, Iceland and Sweden.
Liberal policies on tobacco (indoor smoking bans, cigarette taxes), the environment (solar tax credit, emissions standards, limits on greenhouse gases, endangered species laws), labor (high minimum wage, paid leave, no “right to work”), gun control (assault weapons ban, background check and registration requirements), civil rights (ratification of the Equal Rights Amendment, equal pay laws, bans on discrimination and the death penalty) and access to health care (expansion of Medicaid under the Affordable Care Act, legal abortion) all resulted in better health outcomes, according to the study.
Simply shifting from the most conservative labor laws to the most liberal ones, Montez said, would by itself increase the life expectancy in a state by a whole year.
But there were some liberal policies that had negative downstream health effects: primarily marijuana legalization, while other policy areas, like access to voting (voter ID laws, early voting), campaign finance reform (limits or bans on donations from PACs or corporations) and education (K-12, higher-ed funding), didn’t appear to correlate in either direction.
If every state implemented the most liberal policies in all 16 areas, researchers said, the average American woman would live 2.8 years longer, while the average American man would add 2.1 years to his life. Whereas, if every state were to move to the most conservative end of the spectrum, it would decrease Americans’ average life expectancies by two years.
On the country’s current policy trajectory, researchers estimate the U.S. will add about 0.4 years to its average life expectancy.
