Policymakers have a thumb on the scale when it comes to how long we live. Jennifer Karas Montez, a sociologist and demographer at Syracuse University, has spent her career studying the social causes of death and disease in the United States - how differing state policies have contributed to a 7 year gap between the state with the highest (Hawaii) and the lowest (West Virginia) life expectancy in the U.S.

Though COVID-19 has shined a light on how different state approaches to health affect day-to-day life, even in non-pandemic times, longevity and health are deeply impacted by what’s going on at the state level. From how generous paid leave is where you live, to how easy marijuiana is to access, the patchwork of policies across the U.S affect health outcomes.

Three Takeaways:

• State policy decisions matter a whole lot when it comes to extending life expectancy. Montez says the “heavy-hitters” in this regard are labor, environmental, immigration, civil rights, and tobacco policies. “If we could get those right across the 50 states,” she believes the U.S could get its life expectancy on par with other high-income countries.
• Minimum wage policy shapes our risk of death. A higher minimum wage lowers the risk of cardiovascular disease for working adults and lessens economic distress in mothers, making it more likely they will have a baby at a healthy weight and avoid “coping health behaviors” like smoking. Montez believes that studying other policies with the same scrutiny minimum wage has received would reveal similarly complex ripple effects.
• The pandemic has highlighted how state politics can produce better or worse health outcomes depending on where you live in the U.S. Montez says that the adoption of “policies that protect profit over people” holds states back from adopting healthier policies, and that the outsize influence of money on politics has to go if the U.S is to buck its “worrying” trend when it comes to life expectancy.

More Reading:

• This recent publication from Montez and her colleagues dives deeper into how state policies have led to growing differences in life expectancy across the United States.
• Interested in seeing where your state stands on life expectancy? CNBC has you covered. Spoiler: Southern states generally fare worse than their Northeastern and Western counterparts.
• In 2019, prior to the pandemic, life expectancy in the U.S. declined for the third year in a row, leaving America in 46th place globally.
• Feeling stressed about the influence of state politics on your lifespan? There are still things under your control. The NIH suggests a few simple healthy habits known to lengthen life.