Understanding Life Expectancy in America: Why the Southeast, Especially South Carolina, Lags Behind
At CCN, we’re diving in to life expectancy in South Carolina, there are stark disparities across the United States, and these are particularly pronounced between regions. According to the National Center for Health Statistics, the average life expectancy at birth for Americans was 77 years in 2020, but Southern states, including South Carolina, fall notably below this national average. South Carolina’s life expectancy is 74.8 years, ranking 42nd out of the 50 states, while Mississippi, with a life expectancy of 71.9 years, has the lowest in the nation. This trend is part of a broader pattern in the Southeast, where several states rank among the lowest for life expectancy.
The Regional Health Crisis in the Southeast
Life expectancy is influenced by multiple factors, including socioeconomic conditions, lifestyle choices, and access to healthcare. In the Southeast, many of these factors align in ways that contribute to shorter lifespans. The region has some of the highest rates of chronic illnesses, such as diabetes, heart disease, and hypertension, which are strongly linked to lifestyle choices and environmental factors.
Diet plays a significant role in the health of the Southeast. Southern cuisine is often rich in fried foods, sugary beverages, and processed ingredients, all of which contribute to obesity and related health problems. According to the CDC, obesity rates in the Southeast are among the highest in the country, with over one-third of adults in South Carolina classified as obese. Obesity is a known risk factor for cardiovascular disease, diabetes, and certain types of cancer, all of which can significantly impact life expectancy.
Lifestyle Choices: Smoking, Drinking, and Exercise
In addition to dietary habits, smoking remains prevalent in many Southern states. South Carolina has a smoking rate of around 16%, which is above the national average. Tobacco use is a leading cause of preventable death in the U.S., and its prevalence in the Southeast is a significant contributor to the region’s lower life expectancy. The South also leads in rates of chronic obstructive pulmonary disease (COPD) and lung cancer, both of which are strongly linked to smoking.
Alcohol consumption patterns also play a role. The Southeast has higher instances of binge drinking, which can lead to liver disease, alcohol poisoning, and an increase in accidents and violence-related deaths. In South Carolina, excessive drinking is a problem, particularly in rural areas, where healthcare access and support services may be limited.
Physical inactivity is another factor that affects health in the region. Only 23% of South Carolina residents meet the CDC’s physical activity guidelines, which recommend at least 150 minutes of moderate-intensity exercise per week. A lack of exercise can contribute to weight gain, cardiovascular problems, and mental health issues, all of which negatively impact life expectancy.
Socioeconomic and Healthcare Challenges
The Southeast also struggles with socioeconomic issues that influence health outcomes. South Carolina, for instance, has a poverty rate of around 13%, which is above the national average. Financial constraints can limit access to healthy foods, exercise facilities, and healthcare services. Moreover, individuals living in poverty are more likely to experience stress, which has been linked to a range of health issues, from heart disease to weakened immune function.
Healthcare access remains a critical challenge in South Carolina and throughout the Southeast. Many rural areas face a shortage of healthcare providers, and preventive care services are often limited. The state has one of the highest uninsured rates in the country, which means that many residents delay or forego medical care due to cost. Delayed care can lead to worsened health conditions that, if left untreated, reduce life expectancy.
The Broader Impact of Social and Environmental Factors
Life expectancy is not only influenced by individual behaviors and healthcare access but also by social and environmental factors. In South Carolina, higher levels of pollution and poor air quality contribute to respiratory issues, which can lower life expectancy. Additionally, there is a significant correlation between educational attainment and health outcomes. States like South Carolina have lower rates of high school and college graduation compared to the national average, which impacts health literacy and the ability to make informed health decisions.
Food Choices for People Today Versus the 1970’s and 80’s
In the 1970s and 1980s, as public health authorities began to associate dietary fat with heart disease and obesity, food manufacturers responded by removing fats from many products to create “low-fat” and “fat-free” options. However, removing fat often left foods bland and less satisfying, so manufacturers began adding sugar to enhance flavor and texture. This shift led to a significant increase in sugar consumption, as sugars became a primary ingredient in countless processed foods. Over time, these sugar-laden products contributed to a rise in obesity, diabetes, and other health issues, ironically exacerbating the very problems the low-fat movement aimed to prevent.
In the 1970s, childhood diabetes was relatively rare and was primarily limited to Type 1 diabetes, an autoimmune condition where the body cannot produce insulin. At that time, Type 1 diabetes was the most common form among children, with Type 2 diabetes—typically associated with obesity and lifestyle factors—almost unheard of in children. Estimates suggest that Type 1 diabetes affected around 1 in 10,000 children per year during this period.
Today, the landscape has changed significantly. Childhood diabetes rates have increased, with both Type 1 and Type 2 diabetes becoming more prevalent. According to recent estimates, around 1 in 400 children and adolescents have diabetes, with Type 2 diabetes now accounting for a growing percentage of cases. The rise in Type 2 diabetes among children is closely linked to increasing rates of childhood obesity, sedentary lifestyles, and high-sugar diets. This shift reflects broader changes in lifestyle and diet over the past few decades, underscoring the importance of preventative health measures for children.
Steps Toward Improving Life Expectancy in South Carolina and the Southeast
Addressing these issues requires a multifaceted approach that involves community programs, public health interventions, and policy changes. Improving access to healthcare, particularly in rural areas, is essential. Expanding Medicaid, for example, could provide coverage to thousands of uninsured residents in South Carolina, enabling them to seek preventive care and manage chronic illnesses.
Programs that encourage healthier lifestyles—such as initiatives to reduce smoking and promote physical activity—can have a significant impact on life expectancy. Additionally, improving access to affordable, nutritious food and implementing educational programs focused on diet and exercise can empower individuals to make healthier choices.
The challenges are significant, but through targeted interventions and community support, South Carolina and the Southeast can begin to close the life expectancy gap, providing residents with longer, healthier lives. The entire report can be accessed here (PDF.).