Over 20 years, college graduates saw their life expectancy rise by 2.5 years to 84.2 years, ranking fourth globally if treated as a country. In contrast, those without a high school diploma had a stagnant life expectancy of 73.5 years, ranking 137th globally.
A new analysis by the Institute for Health Metrics and Evaluation (IHME) at the University of Washington’s School of Medicine, published in The Lancet Public Health, reveals significant and growing disparities in life expectancy across more than 3,000 U.S. counties based on educational attainment.
The study found that the gap in life expectancy between the most and least educated individuals has widened over time, growing from 8 years in 2000 to nearly 11 years in 2019. Life expectancy for college graduates increased by 2.5 years, reaching 84.2 years, while those with some college education saw a smaller gain of 0.7 years, reaching 82.1 years. High school graduates experienced only a 0.3-year increase, with their life expectancy rising to 77.3 years. In stark contrast, individuals without a high school diploma showed no improvement, with their life expectancy remaining at 73.5 years.
Education, Employment, and Health
“In the US, more formal education often translates to better employment opportunities, including higher-paying jobs that have fewer health risks,” said the study’s senior author and IHME Associate Professor Laura Dwyer-Lindgren. “This puts people in a better position to build a healthy life and, when needed, obtain high-quality health care.”
For all education groups combined, lifespans ranged from 68.2 to 93.2 years across counties. The variation across counties was largest for those who didn’t finish high school at 57.9 to 90.1 years, a difference of 32.2 years. The range across counties was smallest for college graduates at 75.2 to 93.9 years, a difference of 18.7 years. Simply put, college graduates in the county where LE was as high as 93.9 years are living 36 years longer than those who didn’t finish high school in the county where LE was 57.9 years. The disparities in LE across educational attainment populations and counties are large even on a global scale. For example, if US college graduates were a country, their life expectancy would have ranked fourth (out of 199 countries) globally in 2019. In contrast, those with less than a high school degree would have ranked 137th.
Geographic and Demographic Disparities
Geographic disparities were large within and across levels of education. Counties in the Southeast, parts of Appalachia, and parts of South Dakota had relatively low LE, especially among those who didn’t finish high school. Among those who had some college education, certain counties in Ohio, Indiana, Illinois, Missouri, Arkansas, Nebraska, Oklahoma, Louisiana, Alabama, Tennessee, Kentucky, and Florida, as well as in northern Arizona, had relatively large declines in LE. High school graduates in parts of Virginia and the Carolinas, as well as parts of Texas, Louisiana, and Nebraska also experienced notably larger declines than most other counties. For those without a high school diploma, declines were especially large in parts of Michigan, Ohio, Indiana, Kentucky, and West Virginia.
However, those who did not finish high school in California had large increases in LE while many other counties had declines. This may be related to the state’s large immigrant population. Immigrants often have longer life expectancy than their US-born counterparts, likely in large part due to the factors that shape who is able to immigrate to the US.
Female LE was generally higher than that of their male counterparts. Lifespan for females who didn’t finish high school was almost 72 years nationally, but for males, it was almost 68 years. Additionally, the gaps in LE between the least educated and most educated were bigger and grew more for males than females during the 20 years studied.
IHME researchers were the first to study educational disparities in life expectancy (LE) for both sexes at age 25 in 3,110 counties from 2000 to 2019 for four educational levels covering those without high school diplomas, high school graduates, those with some college education, and college graduates.
Reference: “Life expectancy by county and educational attainment in the USA, 2000–19: an observational analysis” by Dillon O Sylte, Mathew M Baumann, Yekaterina O Kelly, Parkes Kendrick, Omnia M M Ali, Kelly Compton, Chris A Schmidt, Ethan Kahn, Zhuochen Li, Wichada La Motte-Kerr, Farah Daoud, Emmanuela Gakidou, Simon I Hay, Paula D Strassle, George A Mensah, David M Murray, Elizabeth Arias, Stephanie M George, Eliseo J Pérez-Stable, Christopher J L Murray, Ali H Mokdad and Laura Dwyer-Lindgren, 23 January 2025, The Lancet Public Health.
DOI: 10.1016/S2468-2667(24)00303-7
Funding: Intramural Research Program, National Institute on Minority Health and Health Disparities, National Heart, Lung and Blood Institute, National Cancer Institute, National Institute on Aging, National Institute of Arthritis and Musculoskeletal and Skin Diseases, Office of Disease Prevention, Office of Behavioral and Social Sciences Research, NIH/National Institutes of Health
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1 Comment
So people who like to keep learning throughout life, live longer? I am not shocked. WE have a lot of poor white folk in my State, intergenerational poverty is common. I have to visit my Doctor for regular lab work. I take public transportation. Last month. A couple just left their Doctor’s office with a wheelchair bound family member with a recent amputation to board the bus. They were loudly discussing how disrespected they were by the Doctor treating the amputee. Apparently, the Doctor said that if their diabetic family member’s diet didn’t change that “it would kill him” They couldn’t believe that a Doctor would speak to them “like that”
I have always been struck by the idea that many families have a lot of difficulty understanding what healthcare providers tell them, and it is only getting worse.