Life expectancy is considered a measure of progress in a society. In the United States, with life expectancy steadily rising since at least 1900, there is likely an expectation that people will live increasingly longer lives.

In 2015, however, the first drop in U.S. life expectancy was reported since 1993. The typical American born in 2015 could expect to live 78.8 years, down slightly from 78.9 years in 2014. There is considerable variation in life expectancy between U.S. cities.

To highlight variations in life expectancy by geography, even within a state, 24/7 Wall St. listed the city with the shortest life expectancy at birth in every state. Looking at all U.S. metro areas, life expectancy is highest in Naples-Immokalee-Marco Island, Florida, where life expectancy at birth is 83.4 years. In contrast, life expectancy at birth in Gadsden, Alabama is nearly 10 years shorter, at 73.9 years.

Click here to see the cities with the shortest life expectancy in every state.

The association between wealth and longevity is not fully understood but well established. For a variety of reasons, including access to higher quality medical care, less financial-related stress, and living in better-served high income areas, wealthier individuals tend to be healthier, and poorer individuals less healthy.

Adults living in poverty are nearly five times more likely to report being in poor or fair health than more affluent adults. According to a 2016 study published in the Journal of the American Medical Association, the richest 1% of Americans live on average nearly 15 years longer than the poorest 1%.

The cities on this list tend to have lower household incomes and a larger share of residents living in poverty than metro areas with longer life expectancies. This is also the case when comparing each metro area to the respective state poverty rates — the cities with the shortest life expectancies have higher poverty rates than the state as a whole. In relatively affluent states, residents of the city with the lowest life expectancy do not necessarily have especially high poverty rates. In the national context, poverty rates in 29 of the cities on this exceed the national poverty rate of 15.5%.

The same is true for longevity. Residents of 10 cities on this list, despite reporting the lowest statewide life expectancy at birth, tend to live longer than Americans nationwide.

Another common trend among the cities with the shortest life expectancy in their state is the tendency to report less healthy behaviors than among cities with longer life expectancies. In cities with shorter life expectancies, physical inactivity and unhealthy eating habits contribute to higher obesity rates. As an area’s obesity rate increases, the risk of life-shortening diseases also increases. Obesity rates in the majority of cities with the shortest life expectancy in their state are higher than the nationwide obesity rate. Smoking rates in these cities are also nearly always higher than the respective statewide rates.

To determine the metropolitan areas in each state where people live the shortest, 24/7 Wall St. reviewed 2014 county-level life expectancy at birth figures provided by the Institute for Health Metrics and Evaluation (IHME), a global research center affiliated with the University of Washington. The data came from the report, “United States Life Expectancy Estimates by County 1985-2014.” Using death records data from the National Center for Health Statistics, researchers estimated age-specific mortality rates for U.S. counties from 1985 to 2014.

To obtain metro area life expectancy estimates, we mapped the counties to their corresponding metro areas and calculated the average life expectancy across all counties in a given metro area. County estimates were weighted by 5-year population figures from the 2014 American Community Survey (ACS)

Metro-level median household income came from the U.S. Census Bureau’s 2016 American Community Survey. Obesity rates came from County Health Rankings & Roadmaps program, a collaboration between the Robert Wood Johnson Foundation and the University of Wisconsin Population Health Institute.

1. Alabama
> Metro area: Gadsden, AL
> Life expectancy: 73.9 years (bottom 10%)
> Statewide life expectancy: 75.7 years (2nd lowest)
> Metro area obesity rate: 35.1% (top 10%)
> Metro area median household income: $39,220 (bottom 10%)

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2. Alaska
> Metro area: Anchorage, AK
> Life expectancy: 78.5 years
> Statewide life expectancy: 78.4 years (18th lowest)
> Metro area obesity rate: 27.8%
> Metro area median household income: $76,917 (top 10%)

3. Arizona
> Metro area: Lake Havasu City-Kingman, AZ
> Life expectancy: 75.7 years (bottom 10%)
> Statewide life expectancy: 79.6 years (17th highest)
> Metro area obesity rate: 29.6%
> Metro area median household income: $38,488 (bottom 10%)

4. Arkansas
> Metro area: Pine Bluff, AR
> Life expectancy: 74.7 years (bottom 10%)
> Statewide life expectancy: 76.2 years (6th lowest)
> Metro area obesity rate: 39.8% (top 10%)
> Metro area median household income: $36,963 (bottom 10%)

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5. California
> Metro area: Redding, CA
> Life expectancy: 76.7 years (bottom 25%)
> Statewide life expectancy: 80.8 years (3rd highest)
> Metro area obesity rate: 26.5% (bottom 25%)
> Metro area median household income: $44,620

6. Colorado
> Metro area: Pueblo, CO
> Life expectancy: 77.5 years
> Statewide life expectancy: 80.2 years (8th highest)
> Metro area obesity rate: 25.9% (bottom 25%)
> Metro area median household income: $41,286 (bottom 25%)

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7. Connecticut
> Metro area: Worcester, MA-CT
> Life expectancy: 79.6 years
> Statewide life expectancy: 80.6 years (4th highest)
> Metro area obesity rate: 27.3%
> Metro area median household income: $64,367 (top 10%)

8. Delaware
> Metro area: Dover, DE
> Life expectancy: 77.5 years
> Statewide life expectancy: 78.7 years (21st lowest)
> Metro area obesity rate: 32.8% (top 25%)
> Metro area median household income: $54,976

9. Florida
> Metro area: Panama City, FL
> Life expectancy: 76.5 years (bottom 25%)
> Statewide life expectancy: 79.5 years (21st highest)
> Metro area obesity rate: 30.0%
> Metro area median household income: $47,003

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10. Georgia
> Metro area: Macon, GA
> Life expectancy: 74.9 years (bottom 10%)
> Statewide life expectancy: 77.4 years (10th lowest)
> Metro area obesity rate: 31.5%
> Metro area median household income: $39,501 (bottom 10%)

11. Hawaii
> Metro area: Kahului-Wailuku-Lahaina, HI
> Life expectancy: 81.0 years (top 10%)
> Statewide life expectancy: 81.2 years (the highest)
> Metro area obesity rate: 22.4% (bottom 10%)
> Metro area median household income: $66,476 (top 10%)

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12. Idaho
> Metro area: Pocatello, ID
> Life expectancy: 77.9 years
> Statewide life expectancy: 79.5 years (20th highest)
> Metro area obesity rate: 28.1%
> Metro area median household income: $43,779 (bottom 25%)

13. Illinois
> Metro area: Danville, IL
> Life expectancy: 76.2 years (bottom 25%)
> Statewide life expectancy: 79.0 years (25th lowest)
> Metro area obesity rate: 35.4% (top 10%)
> Metro area median household income: $42,977 (bottom 25%)

14. Indiana
> Metro area: Terre Haute, IN
> Life expectancy: 76.3 years (bottom 25%)
> Statewide life expectancy: 77.7 years (11th lowest)
> Metro area obesity rate: 32.9% (top 25%)
> Metro area median household income: $42,089 (bottom 25%)

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15. Iowa
> Metro area: Sioux City, IA-NE-SD
> Life expectancy: 78.8 years
> Statewide life expectancy: 79.7 years (16th highest)
> Metro area obesity rate: 34.3% (top 10%)
> Metro area median household income: $50,650

16. Kansas
> Metro area: St. Joseph, MO-KS
> Life expectancy: 77.2 years (bottom 25%)
> Statewide life expectancy: 78.7 years (22nd lowest)
> Metro area obesity rate: 32.5% (top 25%)
> Metro area median household income: $47,140

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17. Kentucky
> Metro area: Huntington-Ashland, WV-KY-OH
> Life expectancy: 75.7 years (bottom 10%)
> Statewide life expectancy: 76.3 years (7th lowest)
> Metro area obesity rate: 35.9% (top 10%)
> Metro area median household income: $42,766 (bottom 25%)

18. Louisiana
> Metro area: Hammond, LA
> Life expectancy: 74.3 years (bottom 10%)
> Statewide life expectancy: 75.8 years (3rd lowest)
> Metro area obesity rate: 39.1% (top 10%)
> Metro area median household income: $41,302 (bottom 25%)

19. Maine
> Metro area: Lewiston-Auburn, ME
> Life expectancy: 78.3 years
> Statewide life expectancy: 79.3 years (23rd highest)
> Metro area obesity rate: 33.2% (top 25%)
> Metro area median household income: $47,537

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20. Maryland
> Metro area: Hagerstown-Martinsburg, MD-WV
> Life expectancy: 77.4 years
> Statewide life expectancy: 79.2 years (25th highest)
> Metro area obesity rate: 34.0% (top 25%)
> Metro area median household income: $55,798 (top 25%)

21. Massachusetts
> Metro area: Springfield, MA
> Life expectancy: 79.3 years
> Statewide life expectancy: 80.4 years (5th highest)
> Metro area obesity rate: 25.3% (bottom 25%)
> Metro area median household income: $52,759

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22. Michigan
> Metro area: Flint, MI
> Life expectancy: 76.1 years (bottom 25%)
> Statewide life expectancy: 78.3 years (16th lowest)
> Metro area obesity rate: 33.0% (top 25%)
> Metro area median household income: $42,327 (bottom 25%)

23. Minnesota
> Metro area: Duluth, MN-WI
> Life expectancy: 79.0 years
> Statewide life expectancy: 80.9 years (2nd highest)
> Metro area obesity rate: 28.3%
> Metro area median household income: $48,905

24. Mississippi
> Metro area: Gulfport-Biloxi-Pascagoula, MS
> Life expectancy: 75.4 years (bottom 10%)
> Statewide life expectancy: 74.9 years (the lowest)
> Metro area obesity rate: 32.1%
> Metro area median household income: $44,193 (bottom 25%)

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25. Missouri
> Metro area: Joplin, MO
> Life expectancy: 76.5 years (bottom 25%)
> Statewide life expectancy: 77.7 years (12th lowest)
> Metro area obesity rate: 33.7% (top 25%)
> Metro area median household income: $42,255 (bottom 25%)

26. Montana
> Metro area: Great Falls, MT
> Life expectancy: 78.8 years
> Statewide life expectancy: 78.9 years (24th lowest)
> Metro area obesity rate: 28.2%
> Metro area median household income: $45,205

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27. Nebraska
> Metro area: Grand Island, NE
> Life expectancy: 79.3 years
> Statewide life expectancy: 79.6 years (17th highest)
> Metro area obesity rate: 33.3% (top 25%)
> Metro area median household income: $50,633

28. Nevada
> Metro area: Carson City, NV
> Life expectancy: 76.8 years (bottom 25%)
> Statewide life expectancy: 78.1 years (15th lowest)
> Metro area obesity rate: 24.6% (bottom 25%)
> Metro area median household income: $47,668

29. New Hampshire
> Metro area: Manchester-Nashua, NH
> Life expectancy: 80.1 years (top 25%)
> Statewide life expectancy: 80.2 years (9th highest)
> Metro area obesity rate: 28.5%
> Metro area median household income: $71,244 (top 10%)

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30. New Jersey
> Metro area: Vineland-Bridgeton, NJ
> Life expectancy: 76.6 years (bottom 25%)
> Statewide life expectancy: 80.0 years (10th highest)
> Metro area obesity rate: 34.5% (top 10%)
> Metro area median household income: $49,984

31. New Mexico
> Metro area: Farmington, NM
> Life expectancy: 77.3 years
> Statewide life expectancy: 78.4 years (17th lowest)
> Metro area obesity rate: 31.7%
> Metro area median household income: $48,671

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32. New York
> Metro area: Buffalo-Cheektowaga-Niagara Falls, NY
> Life expectancy: 78.5 years
> Statewide life expectancy: 80.4 years (6th highest)
> Metro area obesity rate: 27.4%
> Metro area median household income: $50,962

33. North Carolina
> Metro area: Rocky Mount, NC
> Life expectancy: 75.8 years (bottom 10%)
> Statewide life expectancy: 77.9 years (13th lowest)
> Metro area obesity rate: 34.9% (top 10%)
> Metro area median household income: $39,061 (bottom 10%)

34. North Dakota
> Metro area: Bismarck, ND
> Life expectancy: 80.4 years (top 25%)
> Statewide life expectancy: 80.0 years (12th highest)
> Metro area obesity rate: 30.3%
> Metro area median household income: $63,836 (top 10%)

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35. Ohio
> Metro area: Weirton-Steubenville, WV-OH
> Life expectancy: 76.3 years (bottom 25%)
> Statewide life expectancy: 77.9 years (14th lowest)
> Metro area obesity rate: 36.6% (top 10%)
> Metro area median household income: $42,136 (bottom 25%)

36. Oklahoma
> Metro area: Lawton, OK
> Life expectancy: 76.0 years (bottom 10%)
> Statewide life expectancy: 76.1 years (5th lowest)
> Metro area obesity rate: 34.9% (top 10%)
> Metro area median household income: $46,245

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37. Oregon
> Metro area: Grants Pass, OR
> Life expectancy: 77.3 years
> Statewide life expectancy: 79.4 years (22nd highest)
> Metro area obesity rate: 27.1%
> Metro area median household income: $37,665 (bottom 10%)

38. Pennsylvania
> Metro area: Scranton–Wilkes-Barre–Hazleton, PA
> Life expectancy: 77.7 years
> Statewide life expectancy: 78.8 years (23rd lowest)
> Metro area obesity rate: 30.0%
> Metro area median household income: $46,298

39. Rhode Island
> Metro area: Providence-Warwick, RI-MA
> Life expectancy: 79.6 years
> Statewide life expectancy: 79.8 years (15th highest)
> Metro area obesity rate: 27.5%
> Metro area median household income: $56,849 (top 25%)

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40. South Carolina
> Metro area: Florence, SC
> Life expectancy: 74.2 years (bottom 10%)
> Statewide life expectancy: 76.9 years (9th lowest)
> Metro area obesity rate: 35.3% (top 10%)
> Metro area median household income: $40,345 (bottom 10%)

41. South Dakota
> Metro area: Rapid City, SD
> Life expectancy: 80.2 years (top 25%)
> Statewide life expectancy: 79.6 years (19th highest)
> Metro area obesity rate: 27.4%
> Metro area median household income: $51,244

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42. Tennessee
> Metro area: Morristown, TN
> Life expectancy: 75.6 years (bottom 10%)
> Statewide life expectancy: 76.3 years (8th lowest)
> Metro area obesity rate: 32.4% (top 25%)
> Metro area median household income: $39,772 (bottom 10%)

43. Texas
> Metro area: Odessa, TX
> Life expectancy: 75.1 years (bottom 10%)
> Statewide life expectancy: 78.5 years (19th lowest)
> Metro area obesity rate: 31.6%
> Metro area median household income: $57,150 (top 25%)

44. Utah
> Metro area: Salt Lake City, UT
> Life expectancy: 79.3 years
> Statewide life expectancy: 79.9 years (13th highest)
> Metro area obesity rate: 25.7% (bottom 25%)
> Metro area median household income: $62,192 (top 25%)

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45. Vermont
> Metro area: Burlington-South Burlington, VT
> Life expectancy: 80.9 years (top 25%)
> Statewide life expectancy: 80.2 years (7th highest)
> Metro area obesity rate: 21.8% (bottom 10%)
> Metro area median household income: $63,255 (top 10%)

46. Virginia
> Metro area: Roanoke, VA
> Life expectancy: 77.8 years
> Statewide life expectancy: 79.2 years (24th highest)
> Metro area obesity rate: 28.4%
> Metro area median household income: $50,340

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47. Washington
> Metro area: Longview, WA
> Life expectancy: 77.5 years
> Statewide life expectancy: 80.0 years (11th highest)
> Metro area obesity rate: 32.1%
> Metro area median household income: $47,452

48. West Virginia
> Metro area: Beckley, WV
> Life expectancy: 74.9 years (bottom 10%)
> Statewide life expectancy: 76.0 years (4th lowest)
> Metro area obesity rate: 35.6% (top 10%)
> Metro area median household income: $38,967 (bottom 10%)

49. Wisconsin
> Metro area: Janesville-Beloit, WI
> Life expectancy: 78.9 years
> Statewide life expectancy: 79.8 years (14th highest)
> Metro area obesity rate: 36.9% (top 10%)
> Metro area median household income: $50,324

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50. Wyoming
> Metro area: Casper, WY
> Life expectancy: 77.7 years
> Statewide life expectancy: 78.6 years (20th lowest)
> Metro area obesity rate: 29.4%
> Metro area median household income: $56,871 (top 25%)

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