Healthy older couple engaged in art project

Top US States to Live a Long, Healthy Life

For the first time in a generation, Americans born today can expect to die sooner than their parents.

U.S. life expectancy has declined two years in a row, which marks the biggest decrease since 1923—exactly one century ago. Thorny issues like drug overdoses—not to mention our recent international health catastrophe—were among the key factors for the decline. However, even prior to 2020, the U.S. ranked No. 40 for life expectancy, lagging behind many wealthy nations and even countries such as Kuwait, Estonia, and Panama. In 2019, Americans could expect to live to 78.5, while our northern neighbors in Canada could expect to live until 82.2, according to the World Health Organization.

American life expectancy lags behind, despite the U.S. spending a higher portion of its GDP on healthcare than any other developed nation. This illustrates that lifestyle choices are responsible for our lower longevity and highlights the importance of taking care of your personal well-being.

The secrets to a longer, healthier life aren't really so secret. Scientific research indicates that regular exercise is associated with a lower risk of chronic diseases, lower stress and better sleep quality, while diets that are rich in fruits, vegetables, whole grains, lean proteins and healthy fats can help support overall health. Spending time outdoors and nurturing personal relationships are also tied to longevity, with one meta-analysis finding a 50% increased likelihood of survival for people with stronger social ties.

Lifestyle decisions aren't the only determinant of how long someone lives, though. Keep in mind that other factors—like genetics, environmental concerns and access to health care—also play a role in life expectancy.

Life Expectancy Over Time

Source: Centers for Disease Control and Prevention

Even so, taking steps to live a healthier lifestyle can help increase the chances of living a longer life. But how closely do the country's longest-living people stick to exercise routines, healthy diets, sound sleep and other habits?

We analyzed federal data for eight measures to determine which states have the healthiest lifestyles, and compared states' overall lifestyle scores to their actual life expectancies, in order to rank states based on healthy habits and longevity.

In doing so, we offer insight into which states are likely going to trend upward and live longer in the years to come. Of course, healthy choices boil down to each individual—but in the era of remote work, people have more choice where to live and work and may seek states that align with their health and wellness goals.

The findings show that people in states with healthier habits do tend to live longer—but that the relationship isn't always as clear-cut as you might expect.

Key Findings

  • The best states tend to have scenic outdoor areas and active populations evidenced by Hawaii, Vermont, Utah and Colorado all landing among the top 10 overall.
  • Seven of the 10 states with the longest life expectancies also rank in the top 10 for living a healthy lifestyle. D.C. is a notable exception as our nation's capital ranks No. 23 for life expectancy despite having the No. 6 most healthy lifestyle.
  • The 10 states with the unhealthiest lifestyles also have the lowest life expectancies, and are mainly concentrated in the Southeast.

Best and Worst States

Hawaii is the best state for longevity, with a life expectancy of 80.7 years —higher than any other state—and among the healthiest lifestyles in America. Minnesota, Vermont, Washington and New Hampshire round out the top five, perhaps no surprise given the ample opportunities to get active and spend time outdoors in those states.

State Rankings

Source: Centers for Disease Control and Prevention, Bureau of Economic Analysis, U.S. Census Bureau

A whopping 4.8% of Hawaii's GDP is spent on outdoor recreation, while 83.5% of Vermonters exercise regularly and 75.6% eat fruit and vegetables every day, a higher rate than any other state. All of the activity must be tiring them out, given roughly 70% of adults in Vermont, Minnesota and Colorado say they get enough sleep.

On the other end of the spectrum, West Virginia, Mississippi, Alabama, Louisiana and Kentucky rank last overall. That's partly because adults in these states are more likely to report anxiety symptoms—that rate is 1 in 3 in West Virginia—and they are also generally less likely to say they exercise regularly and get enough sleep.

While states with higher lifestyle scores tend to have higher life expectancies, healthy habits aren't a perfect predictor of longevity. For example, Washington, D.C., scores No. 6 for healthy lifestyle, but residents have a life expectancy of 75.3 years, below most states.

The D.C. paradox is because we're measuring life expectancy at birth versus health behaviors taken over time—so if a population is changing its behaviors, it takes time for life expectancy changes to catch up.

In general, DC's life expectancy is lower due to racial disparities in life expectancy, which are long-standing and due largely to heart disease, cancer and homicide. The city also saw a more pronounced decline in life expectancy since 2020. Also, keep in mind that it's a city, not a state, so its data is always a little abnormal in state-level rankings.

Connecticut and New York are other notable exceptions, given they have higher life expectancies despite scoring in the middle of the pack for healthy lifestyles.

Montana, Alaska and North Carolina, meanwhile, have generally good health habits but only average life expectancies. The findings emphasize the benefits of a healthy lifestyle for longevity—but also serve as a reminder that other factors play a major role, too.

The Big Picture

Strong relationships, quality sleep and stress management are key to well-being and longevity. Social connections and support can help people cope with stress by providing them a sense of belonging, security and validation.

While it's not a perfect measure, we looked at the share of single-person households as an indicator of social isolation and loneliness, and found that across the states, a median 29.1% of homes are made up of just one person. Meanwhile, a median 34.8% of adults regularly don't get enough sleep, and 28.2% had anxiety symptoms in early February, indicating they may be struggling with chronic stress.

U.S Life Expectancy Indicators

Source: Centers for Disease Control and Prevention, Bureau of Economic Analysis, U.S. Census Bureau

Physical health also plays a role. Fortunately, most Americans exercise every month, eat fruit and vegetables daily and live near a park, even though only 30.2% of Americans are at a healthy weight.

Looking toward the broader environment, state GDP spending on outdoor recreation tracks how much a state invests in parks and other green spaces, offering insight into the availability of these areas for residents and visitors. Across the states, the median rate was 2.1% in 2021.

America Ranks No. 40 for Life Expectancy Globally

According to the World Health Organization's latest figures, countries such as Kuwait, Estonia and Panama outlive the people of America. When you consider how much money America spends on healthcare, America's lower life expectancy has a lot to do with lifestyle choices. And a few standout communities around the globe, dubbed "Blue Zones," help show how healthy living and life expectancy go hand in hand.

They range from Okinawa, Japan, where women live the longest in the world, to Nicoya, Costa Rica, where residents are more than twice as likely as Americans to reach their 90th birthday. Researchers identified nine core healthy principles that they believe are key to longevity in the Blue Zones, including moving regularly throughout the day, eating a mostly plant-based diet, having a sense of purpose and putting family first.

Rank Country Life Expectancy
1 Japan 84.3
2 Switzerland 83.4
3 Republic of Korea 83.3
4 Spain 83.2
5 Singapore 83.2
6 Cyprus 83.1
7 Italy 83
8 Australia 83
9 Norway 82.6
10 Israel 82.6
11 France 82.5
12 Sweden 82.4
13 Luxembourg 82.4
14 Iceland 82.3
15 Canada 82.2
16 New Zealand 82
17 Malta 81.9
18 Netherlands 81.8
19 Ireland 81.8
20 Germany 81.7
21 Portugal 81.6
22 Finland 81.6
23 Austria 81.6
24 United Kingdom 81.4
25 Belgium 81.4
26 Slovenia 81.3
27 Denmark 81.3
28 Greece 81.1
29 Kuwait 81
30 Costa Rica 80.8
31 Chile 80.7
32 Peru 79.9
33 Maldives 79.6
34 Panama 79.3
35 Colombia 79.3
36 Czechia 79.1
37 Estonia 78.9
38 Turkey 78.6
39 Croatia 78.6
40 United States of America 78.5

5 Tips to Improve Life Expectancy

  1. Spend time outside

    . Not only is it important to stay active and maintain a healthy weight, but time in the sun triggers your body to produce vitamin D, which is essential to support bone health, a strong immune system and even mental health. If you live in a cloudier, darker area, or have especially long winters, consider adding vitamin D to your wellness routine.
  2. Maintain a healthy diet

    . Add more fruits, vegetables and lean proteins to your daily diet, and moderate your alcohol intake. If you smoke cigarettes, now is the time to quit. In addition to a healthy diet, vitamins and other nutrients can support whole-body health.
  3. Prioritize family and friends

    . Strong social relationships are key to a longer, happier life, so make sure to spend time with loved ones. Try making it a point to sit down together for family meals, or start up a weekly recreational sports league with friends.
  4. Sleep well

    . Try turning off screens at least 30 minutes before bed to make sure you get a full night's sleep. Melatonin can help ensure you get quality rest.
  5. Reduce your stress

    . Different stressors in life can make it difficult to maintain your peace of mind. If you find yourself constantly stressed out, try adopting techniques like meditation, yoga or deep breathing.


There are many factors that contribute to life expectancy, including diet, exercise, access to health care and socioeconomic status. But by understanding the relationship between healthy living and longevity, you can make informed decisions and take steps to improve your quality of life.


We used federal data to identify the relationship between life expectancy at birth and eight key metrics from the Centers for Disease Control and Prevention, the Bureau of Economic Analysis and the Census Bureau. We used a Z-score distribution to scale each data point relative to the mean across all 50 states and Washington, D.C., and multiplied these scores by -1 if they were negatively associated with being above the national average, including metrics related to insufficient sleep, stress and living alone.

Z-scores were capped so extreme outliers didn't skew the results, and a state's overall lifestyle score was calculated using its average Z-score across the eight metrics. We then compared that score to a state's life expectancy ranking, averaging the two to come up with the overall 1-51 ranking.

We used the most recently available data for the analysis. Here's a closer look at the metrics:

  • Longevity

    : Life expectancy at birth, 2020 (CDC)
  • Exercise

    : Share of adults who say they exercise, 2021 (CDC)
  • Healthy diet

    : Average of the shares of adults who say they eat fruit and vegetables at least once per day, 2021 (CDC)
  • Healthy weight

    : Share of adults at a healthy weight, 2021 (CDC)
  • Park proximity

    : Share of the population living within a half-mile of a park or school, 2020 (CDC)
  • Outdoor recreation spending

    : Share of state gross domestic product for outdoor recreation, 2021 (BEA)
  • Sleep quality

    : Share of adults with insufficient sleep time, pegged at less than seven hours per night, 2020 (CDC)
  • Stress

    : Share of adults with anxiety symptoms, Feb. 2023 (CDC)
  • Social isolation

    : Share of households with only one person, 2021 (Census)

About the Author: Dr. Michael A. Smith received his medical doctorate from the University of Texas, Southwestern Medical Center, and he practiced Internal Medicine and Radiology in Dallas, Texas in the early 2000s. Dr. Smith is the author of The Supplement Pyramid: How to Build your Personalized Nutritional Regimen. He is also the host of the Live Foreverish podcast and Facebook Live show for Life Extension.