The County in Every U.S. State With the Shortest Life Expectancy

Life expectancy in the United States has increased dramatically over the past century thanks to advances in medicine, safer living conditions, and improved public health. But in recent years, that progress has faced new challenges.

Between 2019 and 2021, life expectancy dropped sharply during the COVID-19 pandemic and has only recently begun to recover. Even today, some communities continue to experience significantly shorter lifespans than others.

Using data from County Health Rankings and Roadmaps, we identified the county in each state with the lowest life expectancy. In these areas, residents often face higher rates of health risks such as smoking, obesity, and limited access to healthcare, all of which can impact long-term health outcomes.

Average life expectancy at birth is one of the most important and commonly cited public health indicators. Since record keeping began, life expectancy has steadily improved in the United States. Recently, however, that trend has reversed, as the COVID-19 pandemic and deaths attributable to substance abuse have undone decades of progress. Though average life expectancy has begun to climb once again, Americans are still not expected to live as long as they did in 2019 — and in many parts of the country, life expectancy at birth is in line with what the national average was as far back as the mid-20th century.

• Avg. life expectancy at birth: 67.6 years (73.3 years statewide)
• Adult obesity rate: 49.6% (38.4% statewide)
• Adult smoking rate: 21.9% (16.2% statewide)
• Adult uninsured rate: 11.6% (13.3% statewide)
• Adults not exercising regularly: 36.2% (27.8% statewide)
• Median household income: $42,011 ($62,248 statewide)
• Number of counties or county equivalents considered in state: 67

• Avg. life expectancy at birth: 65.0 years (76.3 years statewide)
• Adult obesity rate: 46.0% (32.3% statewide)
• Adult smoking rate: 38.3% (16.2% statewide)
• Adult uninsured rate: 21.0% (15.2% statewide)
• Adults not exercising regularly: 40.3% (21.3% statewide)
• Median household income: $42,029 ($88,696 statewide)
• Number of counties or county equivalents considered in state: 23

• Avg. life expectancy at birth: 63.8 years (76.7 years statewide)
• Adult obesity rate: 39.1% (33.5% statewide)
• Adult smoking rate: 27.1% (13.1% statewide)
• Adult uninsured rate: 15.9% (14.4% statewide)
• Adults not exercising regularly: 31.6% (22.6% statewide)
• Median household income: $43,121 ($77,158 statewide)
• Number of counties or county equivalents considered in state: 15

• Avg. life expectancy at birth: 67.4 years (73.7 years statewide)
• Adult obesity rate: 51.3% (37.9% statewide)
• Adult smoking rate: 24.9% (19.9% statewide)
• Adult uninsured rate: 10.7% (11.9% statewide)
• Adults not exercising regularly: 41.6% (30.2% statewide)
• Median household income: $37,338 ($58,748 statewide)
• Number of counties or county equivalents considered in state: 75

• Avg. life expectancy at birth: 73.1 years (79.4 years statewide)
• Adult obesity rate: 32.9% (28.3% statewide)
• Adult smoking rate: 15.9% (9.9% statewide)
• Adult uninsured rate: 10.0% (9.1% statewide)
• Adults not exercising regularly: 21.6% (21.6% statewide)
• Median household income: $58,975 ($95,473 statewide)
• Number of counties or county equivalents considered in state: 57

• Avg. life expectancy at birth: 69.8 years (78.5 years statewide)
• Adult obesity rate: 31.0% (25.0% statewide)
• Adult smoking rate: 20.5% (10.9% statewide)
• Adult uninsured rate: 11.2% (9.6% statewide)
• Adults not exercising regularly: 24.4% (16.7% statewide)
• Median household income: $47,421 ($92,790 statewide)
• Number of counties or county equivalents considered in state: 59

• Avg. life expectancy at birth: 77.2 years (79.2 years statewide)
• Adult obesity rate: N/A (30.7% statewide)
• Adult smoking rate: N/A (10.3% statewide)
• Adult uninsured rate: N/A (7.2% statewide)
• Adults not exercising regularly: N/A (22.5% statewide)
• Median household income: N/A ($91,477 statewide)
• Number of counties or county equivalents considered in state: 8

• Avg. life expectancy at birth: 75.1 years (76.8 years statewide)
• Adult obesity rate: 39.3% (38.0% statewide)
• Adult smoking rate: 15.2% (13.8% statewide)
• Adult uninsured rate: 9.1% (8.2% statewide)
• Adults not exercising regularly: 25.1% (22.7% statewide)
• Median household income: $72,498 ($81,615 statewide)
• Number of counties or county equivalents considered in state: 3

• Avg. life expectancy at birth: 67.9 years (78.1 years statewide)
• Adult obesity rate: 42.5% (31.7% statewide)
• Adult smoking rate: 21.4% (12.0% statewide)
• Adult uninsured rate: 13.2% (16.2% statewide)
• Adults not exercising regularly: 31.3% (23.5% statewide)
• Median household income: $60,843 ($73,283 statewide)
• Number of counties or county equivalents considered in state: 67

• Avg. life expectancy at birth: 67.3 years (75.6 years statewide)
• Adult obesity rate: 41.7% (37.4% statewide)
• Adult smoking rate: 21.8% (12.8% statewide)
• Adult uninsured rate: 16.6% (16.5% statewide)
• Adults not exercising regularly: 33.4% (23.2% statewide)
• Median household income: $50,799 ($74,521 statewide)
• Number of counties or county equivalents considered in state: 158

• Avg. life expectancy at birth: 79.5 years (81.4 years statewide)
• Adult obesity rate: 26.0% (27.0% statewide)
• Adult smoking rate: 13.8% (10.5% statewide)
• Adult uninsured rate: 6.3% (4.8% statewide)
• Adults not exercising regularly: 19.3% (20.6% statewide)
• Median household income: $73,092 ($96,716 statewide)
• Number of counties or county equivalents considered in state: 4

• Avg. life expectancy at birth: 73.4 years (78.0 years statewide)
• Adult obesity rate: 36.2% (33.6% statewide)
• Adult smoking rate: 18.0% (12.4% statewide)
• Adult uninsured rate: 13.7% (11.5% statewide)
• Adults not exercising regularly: 27.3% (21.0% statewide)
• Median household income: $53,212 ($74,859 statewide)
• Number of counties or county equivalents considered in state: 42

• Avg. life expectancy at birth: 69.7 years (77.5 years statewide)
• Adult obesity rate: 43.0% (33.0% statewide)
• Adult smoking rate: 22.9% (12.8% statewide)
• Adult uninsured rate: 6.8% (9.4% statewide)
• Adults not exercising regularly: 30.9% (22.1% statewide)
• Median household income: $45,550 ($80,346 statewide)
• Number of counties or county equivalents considered in state: 102

• Avg. life expectancy at birth: 69.1 years (75.1 years statewide)
• Adult obesity rate: 39.5% (38.4% statewide)
• Adult smoking rate: 23.2% (16.9% statewide)
• Adult uninsured rate: 9.9% (9.4% statewide)
• Adults not exercising regularly: 32.8% (26.6% statewide)
• Median household income: $62,584 ($69,458 statewide)
• Number of counties or county equivalents considered in state: 92

• Avg. life expectancy at birth: 74.5 years (77.8 years statewide)
• Adult obesity rate: 38.7% (37.8% statewide)
• Adult smoking rate: 14.9% (15.5% statewide)
• Adult uninsured rate: 6.4% (6.1% statewide)
• Adults not exercising regularly: 24.0% (24.9% statewide)
• Median household income: $63,557 ($71,662 statewide)
• Number of counties or county equivalents considered in state: 99

• Avg. life expectancy at birth: 61.0 years (76.4 years statewide)
• Adult obesity rate: 40.7% (36.5% statewide)
• Adult smoking rate: 17.8% (15.1% statewide)
• Adult uninsured rate: 12.3% (12.3% statewide)
• Adults not exercising regularly: 24.8% (22.6% statewide)
• Median household income: $54,731 ($70,316 statewide)
• Number of counties or county equivalents considered in state: 102

• Avg. life expectancy at birth: 64.5 years (73.3 years statewide)
• Adult obesity rate: 41.2% (38.1% statewide)
• Adult smoking rate: 25.6% (17.6% statewide)
• Adult uninsured rate: 7.4% (7.6% statewide)
• Adults not exercising regularly: 31.8% (25.1% statewide)
• Median household income: $35,000 ($61,099 statewide)
• Number of counties or county equivalents considered in state: 120

• Avg. life expectancy at birth: 68.2 years (73.3 years statewide)
• Adult obesity rate: 44.7% (40.3% statewide)
• Adult smoking rate: 25.9% (17.1% statewide)
• Adult uninsured rate: 9.8% (10.2% statewide)
• Adults not exercising regularly: 38.3% (27.5% statewide)
• Median household income: $37,255 ($58,273 statewide)
• Number of counties or county equivalents considered in state: 64

• Avg. life expectancy at birth: 72.3 years (77.2 years statewide)
• Adult obesity rate: 37.7% (33.4% statewide)
• Adult smoking rate: 18.6% (16.0% statewide)
• Adult uninsured rate: 13.7% (9.6% statewide)
• Adults not exercising regularly: 26.8% (20.7% statewide)
• Median household income: $48,104 ($73,463 statewide)
• Number of counties or county equivalents considered in state: 16

• Avg. life expectancy at birth: 70.6 years (77.8 years statewide)
• Adult obesity rate: 38.5% (33.5% statewide)
• Adult smoking rate: 16.6% (9.8% statewide)
• Adult uninsured rate: 7.5% (7.9% statewide)
• Adults not exercising regularly: 27.2% (20.5% statewide)
• Median household income: $58,616 ($98,568 statewide)
• Number of counties or county equivalents considered in state: 24

• Avg. life expectancy at birth: 76.3 years (79.7 years statewide)
• Adult obesity rate: 35.9% (27.1% statewide)
• Adult smoking rate: 17.3% (10.7% statewide)
• Adult uninsured rate: 3.8% (3.3% statewide)
• Adults not exercising regularly: 31.1% (20.6% statewide)
• Median household income: $67,155 ($99,750 statewide)
• Number of counties or county equivalents considered in state: 14

• Avg. life expectancy at birth: 72.8 years (76.2 years statewide)
• Adult obesity rate: 36.9% (34.6% statewide)
• Adult smoking rate: 19.7% (16.0% statewide)
• Adult uninsured rate: 11.1% (6.6% statewide)
• Adults not exercising regularly: 25.1% (22.8% statewide)
• Median household income: $49,622 ($69,097 statewide)
• Number of counties or county equivalents considered in state: 83

• Avg. life expectancy at birth: 68.5 years (79.3 years statewide)
• Adult obesity rate: 44.3% (33.6% statewide)
• Adult smoking rate: 26.2% (13.4% statewide)
• Adult uninsured rate: 10.2% (6.2% statewide)
• Adults not exercising regularly: 29.7% (19.9% statewide)
• Median household income: $54,177 ($85,070 statewide)
• Number of counties or county equivalents considered in state: 87

• Avg. life expectancy at birth: 65.3 years (71.9 years statewide)
• Adult obesity rate: 48.4% (40.1% statewide)
• Adult smoking rate: 24.0% (18.1% statewide)
• Adult uninsured rate: 18.9% (16.1% statewide)
• Adults not exercising regularly: 41.5% (30.9% statewide)
• Median household income: $35,552 ($54,386 statewide)
• Number of counties or county equivalents considered in state: 81

• Avg. life expectancy at birth: 65.6 years (75.2 years statewide)
• Adult obesity rate: 43.8% (36.7% statewide)
• Adult smoking rate: 26.0% (17.8% statewide)
• Adult uninsured rate: 14.4% (12.0% statewide)
• Adults not exercising regularly: 34.4% (24.2% statewide)
• Median household income: $42,080 ($68,484 statewide)
• Number of counties or county equivalents considered in state: 115

• Avg. life expectancy at birth: 60.4 years (76.9 years statewide)
• Adult obesity rate: 40.6% (30.8% statewide)
• Adult smoking rate: 28.5% (16.0% statewide)
• Adult uninsured rate: 16.3% (11.8% statewide)
• Adults not exercising regularly: 30.3% (18.5% statewide)
• Median household income: $51,596 ($70,939 statewide)
• Number of counties or county equivalents considered in state: 48

• Avg. life expectancy at birth: 63.2 years (78.1 years statewide)
• Adult obesity rate: 48.8% (35.6% statewide)
• Adult smoking rate: 24.1% (13.6% statewide)
• Adult uninsured rate: 10.5% (9.2% statewide)
• Adults not exercising regularly: 31.6% (24.1% statewide)
• Median household income: $57,810 ($74,727 statewide)
• Number of counties or county equivalents considered in state: 78

• Avg. life expectancy at birth: 68.4 years (76.4 years statewide)
• Adult obesity rate: 35.0% (33.9% statewide)
• Adult smoking rate: 20.7% (14.9% statewide)
• Adult uninsured rate: 12.1% (15.3% statewide)
• Adults not exercising regularly: 28.0% (25.7% statewide)
• Median household income: $58,039 ($76,332 statewide)
• Number of counties or county equivalents considered in state: 16

• Avg. life expectancy at birth: 73.9 years (78.9 years statewide)
• Adult obesity rate: 35.9% (30.0% statewide)
• Adult smoking rate: 17.5% (11.5% statewide)
• Adult uninsured rate: 8.7% (7.0% statewide)
• Adults not exercising regularly: 22.0% (19.0% statewide)
• Median household income: $59,592 ($97,031 statewide)
• Number of counties or county equivalents considered in state: 10

• Avg. life expectancy at birth: 73.7 years (79.0 years statewide)
• Adult obesity rate: 36.8% (29.0% statewide)
• Adult smoking rate: 16.9% (10.7% statewide)
• Adult uninsured rate: 13.0% (9.5% statewide)
• Adults not exercising regularly: 28.0% (22.8% statewide)
• Median household income: $64,240 ($99,716 statewide)
• Number of counties or county equivalents considered in state: 21

• Avg. life expectancy at birth: 63.9 years (74.4 years statewide)
• Adult obesity rate: 37.4% (33.4% statewide)
• Adult smoking rate: 31.1% (15.5% statewide)
• Adult uninsured rate: 18.2% (13.0% statewide)
• Adults not exercising regularly: 31.6% (23.9% statewide)
• Median household income: $41,427 ($62,286 statewide)
• Number of counties or county equivalents considered in state: 32

• Avg. life expectancy at birth: 74.5 years (79.4 years statewide)
• Adult obesity rate: 36.5% (30.3% statewide)
• Adult smoking rate: 18.7% (11.5% statewide)
• Adult uninsured rate: 7.7% (6.8% statewide)
• Adults not exercising regularly: 26.4% (25.1% statewide)
• Median household income: $55,944 ($82,052 statewide)
• Number of counties or county equivalents considered in state: 62

• Avg. life expectancy at birth: 67.3 years (75.9 years statewide)
• Adult obesity rate: 36.8% (34.2% statewide)
• Adult smoking rate: 21.3% (14.9% statewide)
• Adult uninsured rate: 23.6% (13.5% statewide)
• Adults not exercising regularly: 27.0% (22.7% statewide)
• Median household income: $54,357 ($70,838 statewide)
• Number of counties or county equivalents considered in state: 100

• Avg. life expectancy at birth: 59.6 years (77.8 years statewide)
• Adult obesity rate: 49.4% (36.2% statewide)
• Adult smoking rate: 36.8% (15.8% statewide)
• Adult uninsured rate: 9.3% (8.0% statewide)
• Adults not exercising regularly: 43.0% (23.6% statewide)
• Median household income: $46,931 ($77,346 statewide)
• Number of counties or county equivalents considered in state: 50

• Avg. life expectancy at birth: 67.6 years (75.2 years statewide)
• Adult obesity rate: 41.2% (38.4% statewide)
• Adult smoking rate: 26.5% (17.7% statewide)
• Adult uninsured rate: 10.0% (8.1% statewide)
• Adults not exercising regularly: 32.5% (24.0% statewide)
• Median household income: $52,999 ($67,873 statewide)
• Number of counties or county equivalents considered in state: 88

• Avg. life expectancy at birth: 68.2 years (73.7 years statewide)
• Adult obesity rate: 45.1% (40.6% statewide)
• Adult smoking rate: 23.9% (16.0% statewide)
• Adult uninsured rate: 20.9% (17.1% statewide)
• Adults not exercising regularly: 37.9% (28.6% statewide)
• Median household income: $48,589 ($62,120 statewide)
• Number of counties or county equivalents considered in state: 77

• Avg. life expectancy at birth: 73.3 years (78.0 years statewide)
• Adult obesity rate: 38.4% (31.1% statewide)
• Adult smoking rate: 17.2% (12.8% statewide)
• Adult uninsured rate: 11.0% (8.8% statewide)
• Adults not exercising regularly: 23.3% (18.5% statewide)
• Median household income: $54,630 ($80,061 statewide)
• Number of counties or county equivalents considered in state: 35

• Avg. life expectancy at birth: 70.9 years (76.9 years statewide)
• Adult obesity rate: 40.4% (32.9% statewide)
• Adult smoking rate: 22.4% (15.6% statewide)
• Adult uninsured rate: 8.8% (7.0% statewide)
• Adults not exercising regularly: 29.0% (20.8% statewide)
• Median household income: $48,084 ($73,826 statewide)
• Number of counties or county equivalents considered in state: 67

• Avg. life expectancy at birth: 78.2 years (78.9 years statewide)
• Adult obesity rate: 32.9% (30.9% statewide)
• Adult smoking rate: 13.5% (12.3% statewide)
• Adult uninsured rate: 4.6% (6.1% statewide)
• Adults not exercising regularly: 20.6% (23.4% statewide)
• Median household income: $89,914 ($83,518 statewide)
• Number of counties or county equivalents considered in state: 5

• Avg. life expectancy at birth: 67.2 years (74.7 years statewide)
• Adult obesity rate: 42.3% (35.5% statewide)
• Adult smoking rate: 28.2% (16.2% statewide)
• Adult uninsured rate: 17.1% (13.4% statewide)
• Adults not exercising regularly: 38.6% (25.0% statewide)
• Median household income: $45,269 ($67,988 statewide)
• Number of counties or county equivalents considered in state: 46

• Avg. life expectancy at birth: 54.0 years (76.8 years statewide)
• Adult obesity rate: 44.4% (37.2% statewide)
• Adult smoking rate: 35.2% (14.6% statewide)
• Adult uninsured rate: 18.1% (11.5% statewide)
• Adults not exercising regularly: 37.8% (22.3% statewide)
• Median household income: $32,803 ($72,794 statewide)
• Number of counties or county equivalents considered in state: 61

• Avg. life expectancy at birth: 68.0 years (73.5 years statewide)
• Adult obesity rate: 41.5% (39.1% statewide)
• Adult smoking rate: 25.0% (19.2% statewide)
• Adult uninsured rate: 15.4% (13.2% statewide)
• Adults not exercising regularly: 33.9% (26.5% statewide)
• Median household income: $47,491 ($67,651 statewide)
• Number of counties or county equivalents considered in state: 95

• Avg. life expectancy at birth: 68.2 years (76.7 years statewide)
• Adult obesity rate: 39.9% (35.7% statewide)
• Adult smoking rate: 20.6% (12.0% statewide)
• Adult uninsured rate: 21.2% (22.3% statewide)
• Adults not exercising regularly: 30.4% (25.3% statewide)
• Median household income: $49,265 ($75,778 statewide)
• Number of counties or county equivalents considered in state: 236

• Avg. life expectancy at birth: 72.8 years (78.8 years statewide)
• Adult obesity rate: 35.0% (31.8% statewide)
• Adult smoking rate: 13.9% (6.9% statewide)
• Adult uninsured rate: 10.8% (10.7% statewide)
• Adults not exercising regularly: 23.3% (17.1% statewide)
• Median household income: $59,838 ($93,030 statewide)
• Number of counties or county equivalents considered in state: 27

• Avg. life expectancy at birth: 76.2 years (78.7 years statewide)
• Adult obesity rate: 32.9% (26.9% statewide)
• Adult smoking rate: 16.3% (13.7% statewide)
• Adult uninsured rate: 6.5% (5.8% statewide)
• Adults not exercising regularly: 21.9% (18.5% statewide)
• Median household income: $59,906 ($80,626 statewide)
• Number of counties or county equivalents considered in state: 14

• Avg. life expectancy at birth: 64.3 years (77.6 years statewide)
• Adult obesity rate: 46.5% (35.4% statewide)
• Adult smoking rate: 18.4% (12.3% statewide)
• Adult uninsured rate: 8.9% (8.7% statewide)
• Adults not exercising regularly: 29.2% (20.2% statewide)
• Median household income: $46,216 ($89,864 statewide)
• Number of counties or county equivalents considered in state: 133

• Avg. life expectancy at birth: 72.9 years (78.8 years statewide)
• Adult obesity rate: 32.8% (31.6% statewide)
• Adult smoking rate: 13.9% (10.1% statewide)
• Adult uninsured rate: 9.4% (8.8% statewide)
• Adults not exercising regularly: 18.4% (17.1% statewide)
• Median household income: $63,611 ($94,553 statewide)
• Number of counties or county equivalents considered in state: 39

• Avg. life expectancy at birth: 65.1 years (72.1 years statewide)
• Adult obesity rate: 44.3% (41.5% statewide)
• Adult smoking rate: 28.1% (22.3% statewide)
• Adult uninsured rate: 13.0% (9.1% statewide)
• Adults not exercising regularly: 38.6% (27.9% statewide)
• Median household income: $35,161 ($55,875 statewide)
• Number of counties or county equivalents considered in state: 55

• Avg. life expectancy at birth: 63.0 years (77.8 years statewide)
• Adult obesity rate: 43.4% (38.1% statewide)
• Adult smoking rate: 27.1% (15.0% statewide)
• Adult uninsured rate: 5.4% (7.0% statewide)
• Adults not exercising regularly: 27.8% (21.3% statewide)
• Median household income: $49,791 ($74,671 statewide)
• Number of counties or county equivalents considered in state: 72

• Avg. life expectancy at birth: 70.5 years (76.4 years statewide)
• Adult obesity rate: 37.9% (34.6% statewide)
• Adult smoking rate: 18.6% (15.9% statewide)
• Adult uninsured rate: 23.1% (16.6% statewide)
• Adults not exercising regularly: 23.1% (21.7% statewide)
• Median household income: $64,170 ($73,558 statewide)
• Number of counties or county equivalents considered in state: 23