On Jan. 10, 2025, the Institute for Health Metrics and Evaluation (IHME) reported that when it comes to life expectancy, the U.S. is falling farther and farther behind its peers.

In 2021, the most recent year for which data are available, the U.S. ranked 46th and 47th in life expectancy worldwide for males and females, respectively, a decrease from 1990, when it ranked 19th for females and 35th for males globally.

IHME has published updated briefings breaking down life expectancy trends at the state level, which indicate that many states are slipping in global life expectancy rankings. Looking at Mississippi and West Virginia, the states with the lowest life expectancy for males and females, respectively, in 2021, life expectancy rankings fell by more than 40 points over the past three decades.

Similar trends are evident in even the healthiest US states. In Hawaii, which had the highest life expectancy ranking for males and females, the state’s ranking dropped by more than 15 points from 1990 to 2021.

Universal health coverage in the U.S. is part of the solution to protect not only people’s health but also their financial well-being—medical debt can drive people into poverty. Equally important is preventing health problems from occurring in the first place. Prevention programs need to be routinely evaluated to ensure effectiveness and modified accordingly.