The Longevity Spread Across US Metros Grew to 12.5 Years. Life Insurance Premiums Didn’t Move.

A child born today in Naples, Florida, is expected to live to 84. In Huntington, West Virginia, that number is 72. The gap between the longest- and shortest-lived major U.S. metros widened from 8.6 years to 12.5 years in five years, wider than the life expectancy difference between the U.S. and most middle-income countries.

Part of the widening reflects pandemic-era mortality, which weighed disproportionately on the metros that fell furthest in the rankings. The structural side traces to causes that have shaped the U.S. regional health profile for decades: income, infrastructure, smoking prevalence and preventive-care utilization.

MoneyGeek's refreshed analysis of life expectancy across 194 U.S. metropolitan areas, drawn from the latest County Health Rankings release of 2021 to 2023 mortality data, finds the widening was geographically concentrated. The heaviest losses landed in fast-growing Sun Belt metros: Tucson dropped 80 places in the ranking; Phoenix and Brownsville each dropped 62.

The widening hasn't shown up in life insurance pricing. A healthy 40-year-old nonsmoker buying a 20-year, $500,000 term life policy pays about $59 a month (men) or $47 (women) regardless of whether they live in Naples, Huntington, Memphis or Boulder.

The distance between Naples-Marco Island, Florida (84.06 years) and Huntington-Ashland, West Virginia-Kentucky-Ohio (71.55 years) is 12.5 years. Both are major metros with at least 250,000 residents within the same federally regulated insurance market.

The premium gap between them is roughly zero. Across all 194 metros in MoneyGeek's analysis, the average monthly premium for a healthy 40-year-old male nonsmoker buying a 20-year, $500,000 term policy varies by less than one dollar. The same premium applies in Memphis and San Francisco, Mobile and Boulder, Huntington and Naples.

The 12.5-year longevity spread exceeds the gender gap in U.S. life expectancy (75.8 years for men vs. 81.1 years for women, per the CDC's 2023 data) and the gap between the U.S. and most middle-income countries, per the World Bank.

The disconnect isn't a market failure. It reflects how the life insurance market was designed. For policyholders in shorter-lived metros, that design creates an opportunity to lock in below-actuarial pricing.

California holds 10 of the top 25 spots, and Florida holds four, including three retirement-destination metros (Naples-Marco Island, Cape Coral-Fort Myers and North Port-Bradenton-Sarasota) where in-migration of healthier-than-average seniors shapes the numbers. The university-anchored tier at the top has held across data vintages: Boulder, Ann Arbor, Madison, Fort Collins, Boston and the Bay Area cluster all anchor economies built around research institutions.

Bridgeport-Stamford-Danbury, Connecticut (known as Bridgeport-Stamford-Norwalk in the 2021 OMB delineations) anchored the top of the previous study at 83 years. In the refresh, it fell 1.17 years to 81.83 and now ranks seventh. Naples-Marco Island and San Jose-Sunnyvale-Santa Clara both now rank above the previous top mark.

Across the full 194-metro universe, mean life expectancy in Southern metros is 76.08 years; in non-Southern metros, it's 78.14 years. The 2.06-year regional gap tracks what CDC and County Health Rankings research has found: income, access to preventive care, smoking prevalence and rural-versus-urban infrastructure all weigh more heavily in the South than in any other region.

Three non-Southern metros rank in the bottom 25. Flint, Michigan, and Youngstown-Warren, Ohio, reflect the long tail of industrial decline: lead exposure history, opioid burden and population health consequences of decades of disinvestment. Bakersfield-Delano sits in California's agricultural Central Valley, where poor air quality, lower median incomes than the state's coastal markets and elevated rates of obesity and diabetes produce a regional health profile closer to the South than to the rest of California.

Four metros that ranked in the top 20 of the 2021 study each dropped at least 30 places in the 2026 data.

COVID-era mortality struck fast-growing Sun Belt metros harder than the East Coast and Pacific Northwest. Rapid population growth in metros with underfunded health infrastructure also drove down preventive-care utilization and primary-care access.

The top 20 included three Arizona and Texas Sun Belt metros in 2021. None appear in the 2026 ranking.

The bottom 25 includes three non-Southern metros, and two lower-income metros rank far above where the income-only model would place them.

The Non-Southern Bottom Tier: Flint, Youngstown and Bakersfield

Flint, Michigan (73.41 years), Youngstown-Warren, Ohio (73.91 years) and Bakersfield-Delano, California (74.54 years) are the only major non-Southern metros in the bottom 25. Flint carries the documented public health legacy of the 2014 to 2019 water crisis, including measured lead exposure in children and elevated cardiovascular mortality among adults. Youngstown reflects 40 years of post-steel population decline, a rising opioid burden and the measurable health consequences of long-term disinvestment. Bakersfield sits in California's agricultural Central Valley, where poor air quality, lower median incomes and elevated obesity and diabetes rates produce a regional health profile closer to the South than to the rest of California.

Salinas and Brownsville: Lower-Income Metros With Higher Life Expectancy

Salinas, California ranks 11th at 81.04 years despite median household income well below the top tier. Brownsville-Harlingen, Texas sits mid-pack even after its post-2021 decline. Both metros show life expectancy higher than income alone would predict. The mechanisms remain an active area of research.

This analysis covers 194 U.S. Metropolitan Statistical Areas with 250,000 or more residents, using the 2023 Office of Management and Budget CBSA delineations published by the Census Bureau. Life expectancy at birth is the average number of years a person born today would live if current mortality patterns held. County-level life expectancy values are drawn from the University of Wisconsin Population Health Institute’s County Health Rankings 2025 Annual Release (2020 to 2022 NCHS mortality vintage) and March 2026 Supplemental Release (2021 to 2023 NCHS mortality vintage), with supplemental values preferred where both are available. Metro-level life expectancy is computed as a population-weighted average of county values, using 2023 Census Bureau county population estimates.

Below is the complete ranking of all 194 major U.S. metropolitan areas analyzed for this study, sorted from longest to shortest life expectancy. Five Connecticut metros marked with an asterisk use a published Census Bureau crosswalk between the state’s 2022 planning regions and predecessor counties; the methodology section above documents the approach.