A new study co-authored by two University of Wisconsin–Madison professors suggests longevity gains across all states and regions for people born between 1941 and 2000, in contrast to previous estimates suggesting a century of stagnation or even declines in parts of the South.
Published in the journal BMJ Open, the study by Héctor Pifarré i Arolas and Jason Fletcher of the La Follette School of Public Affairs, along with José Andrade of the Max Planck Institute for Demographic Research, challenges recent estimates that portrayed progress on extending longevity in the United States as sharply divergent across states and regions.
Using new data from the United States Mortality Database, their updated analyses suggest substantially less disparity in longevity gains since the mid-20th century than a recent paper led by Theodore Holford of the Yale School of Public Health and colleagues. Rather than a simple story of steady divergence, the new study describes a more complex, two- phase pattern: rapid convergence in mid-century, when Southern states made up lost ground with much of the rest of the country—driven in large part by gains in child survival in the South—followed by a second phase in which that convergence largely stalled over the second half of the 20th century.
“Our forecasts point to universal gains in cohort life expectancy between 1941 and 2000 for all birth cohorts, sexes, and states,” Pifarré i Arolas says. “States are not expected to experience equal gains in longevity, and convergence across states appears to have stalled since the 1950s, but we find no evidence of the radical increase in disparities across states suggested by some earlier estimates.” Holford’s paper argues that many Southern states saw little gain or even declines in cohort life expectancy in the second half of the 20th century, while states such as New York saw rapid gains, widening disparities across states. The new paper challenges these estimates.
For example, Holford’s paper estimated that Mississippi experienced no female gain in longevity over 50 years, while the updated figures in the BMJ Open study found roughly 7 years.
By investigating regional and state-specific trends, the authors hope this research leads to increased understanding of key drivers of longevity gains, as U.S. states have differed significantly in populations and policies over this period. “Understanding that all statesexperienced gains—especially the substantial improvements in the South earlier in the century—helps shift the conversation toward what drove those successes and why progress has slowed since. That’s where the real policy lessons are,” Fletcher says. In the context of slowing longevity gains in high-income countries, as suggested in recent work by Pifarré i Arolas, Andrade, and colleagues, the study adds to a growing body of research that uses birth cohorts and forecasting methods to clarify how policies and living conditions may contribute to longer or shorter lives.
BMJ Open
Observational study
Not applicable
Life expectancy gains across US states between 1941 and 2000: a cohort study
8-Apr-2026