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Life expectancy is one of the most important and commonly cited indicators of population health -- and in the United States, life expectancy is falling at a historic rate. According to the Centers for Disease Control and Prevention, life expectancy at birth declined by 1.5 years in 2020, the largest one-year decline since World War II.

The CDC attributes the decline to the COVID-19 pandemic and 93,000 drug overdose deaths -- an all-time one-year high. Homicide, diabetes, and liver disease were also contributing factors. Here is a look at the states with the most drug overdose deaths in 2020.

While the national trend is alarming, there are parts of the country where life expectancy is far higher than the national average. In Lincoln County, South Dakota, for example, life expectancy at birth is an estimated 84.3 years -- about five years longer than the comparable national average of 79.2 years.

Variations in life expectancy across populations are closely linked to a number of factors -- and one of the strongest predictors of life expectancy is income level. Poverty presents challenges and stressors that can take a cumulative toll on both physical and mental health. Additionally, lower-income Americans are less able to afford adequate health care and healthy options related to diet and lifestyle. Recent studies have shown that life expectancy among the wealthiest 1% of Americans exceeds that of the poorest 1% by well over a decade.

In Lincoln County, 4.1% of the local population live on poverty-level income, below the comparable 13.4% national poverty rate.

All data on life expectancy came from the Robert Wood Johnson Foundation and the University of Wisconsin Population Health Institute joint program's 2021 County Health Rankings & Roadmaps report. All life expectancy figures are averages for the years 2017 through 2019 -- the most recent period for which county-level data is available. Poverty rates are five-year estimates from the U.S. Census Bureau's 2019 American Community Survey.

Counties were excluded if life expectancy data was unavailable, if the confidence interval for the estimate was deemed too large, or if the county's 2019 five-year population estimate from the Census Bureau was less than 1,000.


RankCountyLife expectancy at birth (yrs.)Poverty rate (%)Median household income ($)
1Summit County, CO98.98.079,277
2Pitkin County, CO94.46.778,935
3Liberty County, MT91.216.244,875
4Golden Valley County, ND90.67.558,690
5Oliver County, ND90.48.078,929
6Eagle County, CO89.48.084,790
7Stanley County, SD89.24.771,382
8Presidio County, TX88.839.025,098
9Haines Borough, AK87.511.358,059
10Teton County, WY87.56.184,678
11Manassas Park city, VA86.56.488,046
12San Juan County, WA86.210.263,622
13Sweet Grass County, MT86.25.749,886
14Collier County, FL86.111.269,653
15Ouray County, CO86.17.266,417
16Aleutians West Census Area, AK86.06.887,466
17Arlington County, VA85.96.8120,071
18Granite County, MT85.67.949,881
19Park County, CO85.67.373,622
20Fairfax County, VA85.66.1124,831
21Steele County, ND85.65.870,724
22Lake County, CO85.514.650,565
23Frontier County, NE85.59.054,659
24Marin County, CA85.57.2115,246
25New York County, NY85.315.886,553
26Blaine County, ID85.312.556,694
27Valley County, ID85.37.264,475
28Summit County, UT85.15.6102,958
29San Mateo County, CA85.06.7122,641
30Grand County, CO84.99.571,198
31Santa Clara County, CA84.97.5124,055
32Kidder County, ND84.810.854,643
33Marshall County, SD84.88.563,723
34Loudoun County, VA84.73.4142,299
35Gilliam County, OR84.610.447,500
36Montgomery County, MD84.66.8108,820
37Hudspeth County, TX84.524.431,677
38Potter County, SD84.57.554,583
39Wayne County, NE84.312.256,456
40Lincoln County, SD84.34.182,473
41Hoonah-Angoon Census Area, AK84.210.359,803
42Jeff Davis County, TX84.23.953,088
43Glades County, FL84.117.440,977
44Queens County, NY84.112.268,666
45Routt County, CO84.110.977,443
46Alexandria city, VA84.110.3100,939
47Judith Basin County, MT84.012.743,661
48San Francisco County, CA84.010.3112,449
49Burke County, ND84.05.977,232
50Douglas County, CO84.03.1119,730


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