The Growing Influence of State Governments on Population Health in the United States

JAMA Network March 11, 2022
Steven H. Woolf, MD, MPH

For decades, the population of the US has experienced shorter life expectancy and higher disease rates than populations in other high-income countries. The gap in life expectancy between the US and 16 peer countries increased from 1.9 years in 2010 to 3.1 years in 2018 and 4.7 years in 2020.¹ The US health disadvantage is even worse in certain states, with states such as Alabama and Mississippi having the same life expectancy as Latvia (75 years).^2,3

Disparities in health across the 50 states are growing, a trend that began in the 1990s.⁴ For example, in 1990, life expectancy in New York was lower than in Oklahoma, but the trajectories separated sharply in the 1990s and, by 2016, New York ranked...

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