Here is why Hawaii has the longest life expectancy in the country
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Hawaii has the longest life expectancy at birth out of all 50 states, according to the U.S. Centers for Disease Control and Prevention.
On average, a person born in Hawaii can now expect to live until 80.7 years of age.
The factors that go into lifespan are complicated, but a few things that can positively affect life expectancy are diet, exercise and access to medical care.
Hawaii’s rich natural beauty and year-round warm weather are not the only perks of the Aloha State. Research shows Hawaii residents, on average, live the longest out of anyone else in the United States.
In 2021, the average life span in the U.S. followed a now yearslong trend by dropping to 76.1 years, the shortest it has been since 1996.
That decline stems mostly from COVID-19 and overdose deaths, according to the U.S. Centers for Disease Control and Prevention.
But while every state’s life expectancy has decreased since 2019, Hawaii is the only state to have not fallen below the 80-year mark.
The Hill spoke to experts to try to understand why life expectancy in Hawaii is longer than the national average. Experts agreed on a few things but wanted to stress that not everyone on the archipelago is living a longer life. Disparities concerning life expectancy exist along race, education, income and gender lines.
Here are few factors that contribute to the archipelago’s long life expectancy:
Low rates of heart disease and cancer
Apart from COVID-19 and accidents, the leading causes of death in the United States are cardiovascular disease, cancer and stroke.
In 2020, almost 697,000 people in the U.S. died from cardiovascular disease, and another 602,305 passed away from some type of cancer, according to data from the Centers for Disease Control and Prevention.
And while Hawaii residents have their face share of strokes, inhabitants of the archipelago have the second-lowest cardiovascular disease death rate and cancer death rate in the country, according to CDC data.
Those low rates of cancer deaths and heart disease are, in part, linked to Hawaii’s low smoking rate and relatively low rate of obesity, according to Deborah Carr, a professor of sociology at Boston University.
Lack of exercise and poor diet are the two main contributors to obesity, and Hawaii residents have a few advantages in those two areas, explained Carr.
“The fact that they have really temperate weather there helps people to exercise and to walk outdoors,” said Carr. “So, they have that strength going for them.”
CDC data also show that out of all 50 states, Hawaii has the second lowest obesity rate, with 25 percent of residents 18 years of age and older considered obese.
While that number has gone up in recent years, it is still far lower than the national average. Meanwhile, about 42 percent of U.S. adults 20 years old and older are considered obese, according to the most recent National Health Statistics report.
Better access to healthcare
Along with healthy lifestyle choices, Hawaii residents might have the longest life expectancy out of anyone in the U.S. due to health care on the archipelago, according to Yeonjung Jane Lee, an associate professor of sociology at the Thompson School of Social Work & Public Health at the University of Hawai’i at Manoa.
Hawaii ranked the highest out of all 50 states and Washington, D.C., in state health care system performance in 2022, according to a study from the Commonwealth Fund.
The Aloha State was also deemed the best state for health care in the nation in a U.S. News and World Report analysis published last year. Hawaii earned the top spot in the analysis in part because of the low number of preventable hospital admissions and low uninsured rate.
Hawaii had 2,109 preventable hospital admissions per 100,000 Medicaid and Medicare patients in 2021, a far fall from the national average of 4,378, according to the U.S. News and World Report analysis.
The analysis also found that a very small percentage of Hawaii residents are uninsured. Only 5.9 percent of the state’s population between the ages of 19 and 64 doesn’t have health insurance — 7 percentage points lower than the national average.
This is in part due to the Hawaii Prepaid Healthcare Act, a 1970s-enacted law that requires private employers to provide health insurance to employees who work at least 20 hours a week for at least four weeks a year.
Sunshine and clean(er) air
Hawaii is famous for its sunny and temperate climate. And that climate essentially remains unchanged throughout the year. The longest and shortest days of the year only have a two- and half-hour difference in length, at 13.5 and 11 hours respectively, according to the National Weather Service.
The resulting minimal seasonal variations in climate mean Hawaii gets a constant and plentiful supply of sunshine all year round. That sunshine means that many Hawaii residents get a significant amount of vitamin D, which is essential to maintain good health.
Adequate vitamin D is needed to keep bones healthy, but some studies show that proper vitamin D intake can protect humans against other diseases like breast cancer and hypertension.
Lee added that Hawaii’s air quality might also play a role in the state’s extended lifespan. At least two cities in Hawaii, Honolulu and the Kahului-Wailuku-Lahaina area, made it to the top five cleanest cities for year-round particle pollution in a 2022 American Lung Association “State of the Air” report.
Studies indeed show that air quality does have an effect on life expectancy. Air pollution takes about 2.2 years off a person’s life expectancy, according to a report from the Energy Policy Institute at the University of Chicago.
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