Hawaii once again finished atop the Centers for Disease Control and Prevention’s state rankings for life expectancy, even with a slight drop from the previous year partially attributed to COVID-19.
Among the 50 states and the District of Columbia, Hawaii had the highest life expectancy at birth of 80.7 years, as well as the highest life expectancy for men (77.6 years) and women (83.8 years), according to the CDC’s National Center for Health Statistics’ annual report on mortality in the U.S. released Tuesday. The report was based on 2020 figures, the last year for which data is available.
The state also ranked first in life expectancy for residents age 65, at 21 years. When considering gender, Hawaii men of that age could expect to live an additional 19 years, and women, 22.7 years — tops in the nation for both genders, the CDC report said.
Hawaii’s historically strong showing in longevity studies is often attributed to the islands’ warm weather, outdoor lifestyles, low obesity and smoking rates, and near-universal health care.
But the latest data did not provide a breakdown for the state’s various racial or ethnic groups, a concern for health officials who work with Native Hawaiian, Pacific Islander and other population groups known to experience disparities in health care and access to amenities such as recreational spaces and groceries that sell fresh produce that facilitate more healthful lifestyles.
“On one hand, it is good news that Hawaii has the highest life expectancy among all other U.S. states, on average,” Keawe‘aimoku Kaholokula, associate professor and chair of Native Hawaiian health at the University of Hawaii’s John A. Burns School of Medicine, said in a statement. “On the other hand, this report fails to highlight the large gaps in life expectancy between people who live in different areas of our islands, people of different income levels, and people from different racial and ethnic groups.”
Kaholokula, a licensed clinical psychologist, pointed to state Department of Health data showing as much as a 14.4-year difference in life expectancy between Hawaii’s diverse groups, “with more affluent communities having the highest life expectancies on average.”
“And, Native Hawaiians and Pacific Islanders have 7 to 10 years less in life expectancy than Chinese and Japanese residents,” he said. “What needs to be highlighted and addressed are these inequities in life expectancy between different social groups here in Hawaii.”
Nationally, life expectancy dropped in 2020 by 1.8 years from 2019 — to 77 years — due to COVID-19 and “unintentional accidents,” mainly drug overdoses, according to the CDC report.
Life expectancy declined for all 50 states and Washington, D.C., but Hawaii registered the smallest decline of 0.2 years, while New York had the largest at three years.
The highest life expectancies at birth, behind Hawaii, were predominantly found in the West and Northeast: Washington, Minnesota, California, Massachusetts, New Hampshire, Vermont, Oregon, Utah and Connecticut.
Mostly southern states recorded the lowest life expectancy, with Mississippi ranked last at 71.9 years, followed by West Virginia, Louisiana, Alabama, Kentucky, Tennessee, Arkansas, Oklahoma, New Mexico and South Carolina.
In an earlier study, the CDC reported that nine of the 10 leading causes of death nationally in 2020 remained the same as in 2019, with COVID-19 joining the rankings for the first time following the start of the pandemic.
Heart disease and cancer were the top two leading causes of death in the U.S. in 2020, followed by the coronavirus, to which 350,831 deaths were attributed. By comparison, heart disease killed 696,962 in the U.S. in 2020 and cancer, 602,350.
The Hawaii Health Data Warehouse shows that 322 of the 12,027 deaths recorded in Hawaii in 2020 were due to COVID-19. Nearly half of the COVID-19 deaths involved people ages 75 and older.
Heart disease was the leading cause of death in Hawaii in 2020 (3,698 deaths), followed by cancer (2,478 deaths) and unintentional injuries (673 deaths).
As of Aug. 17, the state Department of Health had counted 1,619 coronavirus-related deaths since the start of the pandemic.
Lola Irvin, administrator of DOH’s Chronic Disease Prevention and Health Promotion Division, said many factors affect longevity, and that the pandemic further exposed some of the disparities that exist in the state.
“Where you live directly affects your health in a number of ways, from the accessibility of healthy food, to the availability of green space to be physically active, to access to primary health care,” Irvin said in a statement. “The COVID-19 pandemic has revealed how health disparities and economic disadvantages impact the health of individuals and our communities.
“Focusing on health equity is integral to our post-pandemic recovery and resilience efforts, and essential for ensuring the health of current and future generations,” she said. “DOH will continue to partner with communities to advance health equity by creating sustainable changes where people live, learn, work and play, to make healthy options the easiest choice.”
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The states with the highest life expectancy at birth, based on 2020 figures:
1. Hawaii: 80.7 years
2. Washington: 79.2 years
3. Minnesota: 79.1 years
4. California: 79 years
5. Massachusetts: 79 years
6. New Hampshire: 79 years
7. Vermont: 78.8 years
8. Oregon: 78.8 years
9. Utah: 78.6 years
10. Connecticut: 78.4 years
Source: U.S. State Life Tables, 2020, Centers for Disease Control and Prevention
Leading causes of death in Hawaii, 2020
1. Heart disease 3,698
2. Cancer 2,478
3. Accidents (unintentional injuries) 673
4. Alzheimer’s disease 562
5. Chronic lower respiratory diseases 372
6. Diabetes 338
7. COVID-19 322
8. Influenza/pneumonia 239
9. Suicide 184
10. Other respiratory diseases 165
Source: Hawaii Health Data Warehouse