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Where’s the best place in America to live if you want to stay healthy in your later years?


Residents in Hawaii have the longest life expectancy, 81.3 years. But when focusing on health as well as longevity, Minnesota outranks every state and the District of Columbia for average length of healthy life expectancy, 70.3 years.

In short, on average Minnesotans are healthier longer than everyone else in the country.

This discovery is based on an authoritative new state-by-state study of the American burden of disease, disability and premature death.

(Full disclosure: My first newspaper job after graduating from college was in Minneapolis, a city I still love.)

Minnesotans joke that the long months of subfreezing temperatures preserve them, but the biology of the native population most likely plays a role in how long and how healthfully people live in various parts of the country. And the opportunities people have for a good education, financial security, quality medical care and environmental safety also make important contributions.

But the big enchilada, as this extraordinarily comprehensive study demonstrates, is how people live their lives: if they smoke, what and how much they eat and whether they abuse alcohol or drugs. These, along with high levels of blood sugar and blood pressure, both of which are influenced by diet, are the main factors dictating poor health.

“About three-fourths of the variation in life expectancy between counties can be explained by these big risk factors,” said Dr. Christopher J.L. Murray, the study’s lead author and an epidemiologist at the University of Washington. “Much more is due to the sociocultural environment, especially what people eat, than to their genes or the physical environment.”

Alas, the study did not measure the contribution of regular exercise to longevity and long-lasting health.

“There’s not as much research on the effects of physical activity as there should be,” Murray said, adding that exercise most likely contributes to the major risks that were measured.

Even if you live in Minnesota, there are things you can do to improve your odds of staying healthy, including eschewing smoking.

Although enormous progress has been made in curbing tobacco use in the past half-century, “there are still 35 million adult smokers and more than half a million deaths from tobacco-related causes each year,” said Dr. Howard Koh, a professor of public health at Harvard’s T.H. Chan School of Public Health. “Lung cancer, 85 percent of which is preventable, remains the leading cause of cancer deaths. Why are we tolerating this?”

Eating healthfully is another factor.

“Diet really needs our attention, ” Murray said. People should eat more whole grains, fruits and vegetables, nuts and seeds, legumes, fiber and foods rich in omega-3 fatty acids but less salt and no processed meats and trans fats, he said.

Murray said that medical practice also needs tweaking.

“Primary care providers are too focused on diagnosing disease and treating it,” he said. “They need to focus on the big contributors to risk, like high blood pressure and high cholesterol, which are easy to detect and easy to treat.”