# List of U.S. counties with shortest life expectancy (2014)

This list of U.S. counties with shortest life expectancy includes 50 counties, or county equivalents, out of a grand total of 3,142 counties or county equivalents in the United States. With the exception of one city (Baltimore), the counties with shortest life expectancy at birth have a largely rural population. The counties listed include 24 with a population consisting of more than 50 percent of non-Hispanic whites, 18 with a population consisting of more than 50 percent of African-Americans, and 8 with a population consisting of more than 50 percent of Native Americans
The U.S. states represented on the list are Kentucky (14 counties); Mississippi (8 counties); Alabama and South Dakota (5 counties each); Arkansas, Louisiana, and West Virginia (three counties each); Missouri (2 counties), and Alaska, Florida, Maryland, Montana, North Dakota, South Carolina, and Tennessee (one county each).
The 14 counties in Kentucky on the list are located in the Eastern Kentucky Coalfield, a region with an economy formerly dominated by coal mining. The three counties in West Virginia on the list also have economies formerly dominated by coal. The population of these counties consists largely of non-Hispanic whites.
The 8 counties on the list in Mississippi are located mostly in the Mississippi Delta, a region heavily populated by African Americans.

## Dynamics

The 50 listed counties have a life expectancy at birth of 6 to 12 years less than the average life expectancy of the United States. Ten of the counties on the list, 9 of them with majority non-Hispanic white populations, experienced declines in life expectancy between 1980 and 2014.
There is a wide range in life expectancy among counties in the US. The residents of Summit County, Colorado live an average of 86.83 years. The residents of Oglala Lakota County (formerly Shannon County) of South Dakota live an average of 66.81 years – twenty years less. Moreover, the gap between the counties with the longest life expectancy and the shortest is widening. Life expectancy in the US as a whole increased by more than 5 years between 1980 and 2014. The life expectancy of most of the longest-lived counties equaled or exceeded that increase. The life expectancy of most of the shortest-lived counties increased less than 5 years – and in a few counties life expectancy decreased.
A study published in the Journal of the American Medical Association in 2016 concluded that income was a major component of the difference in life expectancy in states, counties, races, and regions of the U.S. Men in the richest one percent of the population lived 15 years longer than men in the poorest one percent of the population. Women in the richest one percent of the population lived 10 years longer.
Counties with small populations, and therefore small numbers of deaths, have a larger margin of error in determining life expectancy than counties with larger populations.

## List

U.S. counties (and county equivalents) with shortest life expectancy from birth: 1980 and 2014 :
| No. | County and state | Life expectancy (years) | Life expectancy (years) | Majority population 2014 (%) | Other factors |
| No. | County and state | 2014 | 1980 | Majority population 2014 (%) | Other factors |
| 1. | Oglala Lakota County (Shannon County), South Dakota | 66.81 | 61.25 | Native American: 92.9% | The county lies entirely within the Pine Ridge Indian Reservation. |
| 2. | Union County, Florida | 67.57 | 65.84 | Non-Hispanic White: 70.7% | Large prison population |
| 3. | Todd County, South Dakota | 68.52 | 63.62 | Native American: 86.5% | The county lies entirely within the Rosebud Indian Reservation. |
| 4. | Sioux County, North Dakota | 68.59 | 66.01 | Native American: 82.0% | The county lies entirely within the Standing Rock Indian Reservation |
| 5. | Buffalo County, South Dakota | 69.05 | 64.49 | Native American: 79.4% | The Crow Creek Indian Reservation makes up the majority of Buffalo County. |
| 6. | Owsley County, Kentucky | 70.21 | 72.41 | Non-Hispanic White: 97.9% | Poorest county in the nation, 2010 per capita income was $10,742; declining life expectancy |
| 7. | Breathitt County, Kentucky | 70.22 | 71.24 | Non-Hispanic White: 97.5% | As of 2014 had the highest morbidity rate in the state; declining life expectancy |
| 8. | McDowell County, West Virginia | 70.27 | 69.22 | Non-Hispanic White: 89.0% | High rates of drug abuse and poverty |
| 9. | Perry County, Kentucky | 70.60 | 71.17 | Non-Hispanic White: 95.9% | High rates of smoking and obesity and a low level of physical activity; declining life expectancy |
| 10. | Tunica County, Mississippi | 70.93 | 68.06 | African American: 75.1% | |
| 11. | Holmes County, Mississippi | 71.01 | 69.42 | African American: 82.9% | |
| 12. | Dewey County, South Dakota | 71.02 | 68.47 | Native American: 72.9% | Most of county lies in the Cheyenne River Indian Reservation. |
| 13. | Coahoma County, Mississippi | 71.14 | 68.99 | African American: 75.1% | |
| 14. | Leslie County, Kentucky | 71.17 | 72.55 | Non-Hispanic White: 98.2% | Declining life expectancy |
| 15. | Roosevelt County, Montana | 71.20 | 69.92 | Native Americans: 60.4% | |
| 16. | Kusilvak Census Area, Alaska | 70.83 | 66.51 | Native Americans: 96.93% | |
| 17. | Wolfe County, Kentucky | 71.15 | 71.10 | Non-Hispanic White: 98.0% | |
| 18. | Phillips County, Arkansas | 71.28 | 68.98 | African American: 62.0% | |
| 19. | Mingo County, West Virginia | 71.38 | 69.39 | Non-Hispanic White: 96.2% | |
| 20. | Harlan County, Kentucky | 71.47 | 70.84 | Non-Hispanic White: 95.3% | |
| 21. | Madison Parish, Louisiana | 71.57 | 69.94 | African American: 62.2% | |
| 21. | Walker County, Alabama | 71.57 | 71.79 | Non-Hispanic White: 91.6% | Declining life expectancy |
| 23. | Powell County, Kentucky | 71.60 | 73.41 | Non-Hispanic White: 96.8% | Declining life expectancy |
| 24. | Lee County, Kentucky | 71.61 | 73.06 | Non-Hispanic White: 96.0% | Declining life expectancy |
| 24. | Sunflower County, Mississippi | 71.61 | 70.43 | African American: 72.8% | |
| 26. | Bolivar County, Mississippi | 71.72 | 69.30 | African American: 64.7% | |
| 27. | Clay County, Kentucky | 71.78 | 73.75 | Non-Hispanic White: 92.6% | Declining life expectancy |
| 28. | Washington County, Mississippi | 71.81 | 69.58 | African American: 72.3% | |
| 29. | Humphreys County, Mississippi | 71.90 | 68.85 | African American: 74.7% | |
| 30. | Floyd County, Kentucky | 71.97 | 71.82 | Non-Hispanic White: 98.0% | |
| 31. | Marlboro County, South Carolina | 72.02 | 69.28 | African American: 51.2% | |
| 32. | Pemiscot County, Missouri | 72.04 | 69.61 | Non-Hispanic White: 69.2% | |
| 33. | Corson County, South Dakota | 72.13 | 68.82 | Native American: 64.8% | |
| 34. | Baltimore City, Maryland | 72.14 | 67.60 | African American: 63.3% | |
| 34. | Poinsett County, Arkansas | 72.14 | 71.33 | Non-Hispanic White: 87.8% | |
| 36. | East Carroll Parish, Louisiana | 72.17 | 69.91 | African American: 68.0% | |
| 37. | Wilcox County, Alabama | 72.21 | 70.41 | African American: 71.2% | |
| 38. | Logan County, West Virginia | 72.22 | 70.66 | Non-Hispanic White: 95.9% | |
| 39. | Perry County, Alabama | 72.31 | 72.71 | African American: 67.6% | Declining life expectancy |
| 39. | Crittenden County, Arkansas | 72.31 | 69.57 | African American: 51.5% | |
| 41. | Letcher County, Kentucky | 72.35 | 71.62 | Non-Hispanic White 97.9% | |
| 42. | Wilkinson County, Mississippi | 72.38 | 69.42 | African American 70.0% | |
| 43. | Dallas County, Alabama | 72.39 | 70.77 | African American: 69.6% | |
| 44. | Pike County, Kentucky | 72.41 | 71.59 | Non-Hispanic White: 97.3% | |
| 45. | Grundy County, Tennessee | 72.46 | 72.72 | Non-Hispanic White: 96.6% | Declining life expectancy |
| 46. | Lowndes County, Alabama | 72.57 | 70.62 | African American: 73.1% | |
| 47. | Whitley County, Kentucky | 72.59 | 71.08 | Non-Hispanic White: 97.1% | |
| 48. | Magoffin County, Kentucky | 72.60 | 71.93 | Non-Hispanic White: 98.0% | |
| 49. | Dunklin County, Missouri | 72.62 | 71.78 | Non-Hispanic White: 81.4% | |
| 50. | East Feliciana Parish, Louisiana | 72.64 | 72.39 | Non-Hispanic White: 53.5% |
| | United States (all) | 79.08 | 73.75 | Non-Hispanic White: 62.1% | |