In the western United States, Native Americans’ life expectancy has fallen below 64 years, which is comparable to life expectancies in Haiti and the Democratic Republic of the Congo. The life expectancy for many Asian Americans is approximately 84, which is comparable to that of Japan and Switzerland.
Although there has long been inequality in American health, a recent study reveals that since 2000, the difference in life expectancies across various communities has almost doubled. Tom Bollyky, a research author and head of the Council on Foreign Relations’ global health program, compared this to comparing extremely different nations.
According to an investigation titled “Ten Americas,” which was published in The Lancet late last year, a person’s life expectancy varies significantly according on their racial and ethnic identity, where they reside, and the economic conditions in their community. The country’s overall life expectancy, which is the lowest among wealthy nations at 75 years for men and 80 years for women, is largely due to the declining health of particular communities.
Policymakers will need to address issues compromising life expectancy for all groups if they are to fulfill promises made by the new Trump administration to restore America’s health.
According to Kathleen Harris, a sociologist at the University of North Carolina, we will have a very low life expectancy as long as there are these quite significant discrepancies. For a wealthy nation like the United States, it shouldn’t be that way.
For many American Indians and Alaska Natives, the average life expectancy has been progressively declining since 2000. For Black residents of low-income counties in the Southeast United States, this has been the case since 2014.
According to Bollyky, there are certain populations in the US that are experiencing a health crisis, and since it is becoming worse, we must address it.
The immediate cause includes heart disease, auto accidents, diabetes, COVID-19, and other prevalent causes of mortality. However, studies reveal that a person’s life circumstances, actions, and surroundings have a significant impact on why some groups are more vulnerable than others.
Living in counties where the average annual income is less than $20,000, Native Americans in the West—defined in the Ten Americas study as more than a dozen states excluding California, Washington, and Oregon—were among the lowest in the survey. People with poor wages typically have shorter lives, according to economists.
Research has also connected harmful coping mechanisms like smoking and substance use disorders to the stress of poverty, trauma, and discrimination.Additionally, grocery stores and clean, piped water are sometimes absent from reserves, making it challenging to purchase and prepare wholesome food.
According to a KFF investigation, approximately one in five Native Americans in the Southwest lack health insurance. Despite offering coverage, the Indian Health Service is deemed inadequate by the report because of ongoing underfunding. This implies that people might put off or forego chronic sickness treatments. The high rate of COVID-19 among Native Americans was caused by delayed medical care; at the height of the pandemic, around 1 in 188 Navajo people perished from the illness.
According to Bollyky, the combination of greater health risks and restricted access to care has been disastrous.
On the other end of the scale, Asian Americans in the research group continued to have the highest life expectancies since 2000. It was eighty-four years in 2021.
Some groups may have longer lifespans due in part to education. According to Ali Mokdad, an epidemiologist at the University of Washington’s Institute for Health Metrics and Evaluation and one of the paper’s authors, people who have greater education are more inclined to seek out and follow health advice. Additionally, education increases the likelihood of finding full-time employment with health insurance. According to Mokdad, having money enables you to take care of yourself.
White individuals made up the largest income category in the majority of the analysis’s years, followed by Asian individuals. However, the latter continued to have by far the highest rates of college graduation. Compared to less than a third of other groups, about half completed college.
According to the study, white residents of low-income counties, where the average individual income was less than $32,363, differ from one another in part because of their level of education. Compared to persons in upper Midwestern states like Montana, Nebraska, and Iowa, white people in low-income counties in southern states—which are defined as those in Appalachia and the shorter Mississippi Valley—had much shorter life expectancies since 2000. (In their paper, the authors describe the definitions and boundaries of the groups.)
According to Bollyky, the difference between these white, low-income groups could not be explained by opioid usage or HIV prevalence. However, by 2010, over 90% of white persons in the northern group had completed high school, while only over 80% of those in the southeastern U.S. had done so.
When compared to other groups, the education effect did not apply to Latino populations. Latinos lived longer on average but had lower high school graduation rates than white people. Due to COVID, this long-standing practice among Latinos in the Southwest has lately shifted. Black and Hispanic/Latino individuals were nearly twice as likely to die from the illness.
With the exception of Native Americans, Black people in the US have historically had poorer health than those of other races and ethnicities. However, from 2000 to around 2012, the life expectancy of Black people steadily increased, according to this data. The difference in life expectancy between Black and white people decreased over this time.
This is true for all three groups of Black people in the analysis: Black people in heavily segregated and metropolitan counties, like Queens, New York, and Wayne, Michigan, where many neighborhoods are almost entirely Black or entirely white; Black people in low-income counties in southeastern states, like Mississippi, Louisiana, and Alabama; and Black people everywhere else.
For many Americans, the improvements between 2000 and 2010 can be attributed in part to improved medications for HIV and high blood pressure. Additionally, Black people saw significant increases in college education and high school graduation throughout that time.
By 2016, however, Black populations’ progress had stalled. Wealth disparities increased. Asians and many white Americans, who lived in counties with per capita incomes of about $50,000, had the highest earnings in the research by 2021. In the analysis, all three Black groups stayed below $30,000.
Slavery, Jim Crow laws, and policies that prohibited Black people from owning property in neighborhoods better served by public schools and other amenities are all historical causes of the wealth disparity between Black and white people. A historical wealth disparity among Native Americans can be linked to the population’s near extinction and widespread uprooting during the 19th and 20th centuries.
A growing pay disparity between low-wage workers, who are disproportionately persons of color, and corporate executives, who are largely white, is one of the factors contributing to the ongoing rise in inequality. Additionally, KFF Health News reports that the health of hundreds of thousands of individuals living in poverty has been put at risk as a result of decisions not to expand Medicaid.
In order to remedy historical injustices that resulted in racial wealth disparities, researchers have looked into the possible health advantages of reparations payments. According to a recent study, these payments could result in a 29% decrease in Black Americans’ early deaths.
Community-specific treatments are less contentious. Policymakers might fund after-school programs that provide kids with a space to interact with others, be active, and consume nutritious food, as obesity frequently starts in childhood, Harris said. For kids whose parents are unable to pay for them and provide transportation, such activities would have to be free.
However, Harris stated that the nation’s total life expectancy may worsen if policy changes are not made to increase low wages, lower medical costs, provide safe housing and effective public education, and guarantee access to reproductive health care, including abortion.
“The federal government could grade states on their health metrics and provide incentives to improve if it truly cares about America’s health,” she said.
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Kaiser Health News, 2025, www.khn.org.Tribune Content Agency, LLC is the distributor.
