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US State Disparities in Life Expectancy, Disability-Free Life Expectancy, and Disabled Life Expectancy Among Adults Aged 25 to 89 Years

Mateo P. Farina, Anna Zajacova, Jennifer Karas Montez & Mark D. Hayward

American Journal of Public Health, March 2021

Jennifer Karas Montez

Jennifer Karas Montez

Objectives: To estimate total life expectancy (TLE), disability-free life expectancy (DFLE), and disabled life expectancy (DLE) by U.S. state for women and men aged 25 to 89 years and examine the cross-state patterns.

Methods: The study used data from the 2013–2017 American Community Survey and the 2017 U.S. Mortality Database to calculate state-specific TLE, DFLE, and DLE by gender for U.S. adults and hypothetical worst- and best-case scenarios.

Results: For men and women, DFLEs and DLEs varied widely by state. Among women, DFLE ranged from 45.8 years in West Virginia to 52.5 years in Hawaii, a 6.7-year gap. Men had a similar range. The gap in DLEs across states was 2.4 years for women and 1.6 years for men. The correlation among DFLE, DLE, and TLE was particularly strong in southern states. The South is doubly disadvantaged: residents have shorter lives and spend a greater proportion of those lives with disability.

Conclusions: The stark variation in DFLE and DLE across states highlights the large health inequalities present today across the United States, which have significant implications for individuals’ well-being and U.S. states’ financial costs and medical care burden.