A recent study by the Centers for Disease Control and Prevention (CDC) shared a ranking of states on who has the longest and shortest life expectancy in the United States as of 2019.

Of the fifty states and the District of Columbia, Hawaii came out on top of the pack with a total life expectancy of 80.9 years. Following the Aloha state was California which tied it at 80.9 years, New York with 80.7 years, and a tie between Minnesota and Massachusetts at 80.4 years of age.

On the reverse end of the ranking, Mississippi ranked last with an average life expectancy of 74.4 years of age. Rounding out the bottom five were West Virginia (74.5), Alabama (75.2), Kentucky (75.5) and Tennessee (75.6).

To be certain, there are gaps in the CDC’s report that muddle the exact picture of how long citizens in each state ultimately live. For one, the data the agency used was for 2019, a year before the COVID-19 pandemic struck, a factor that preliminary studies are already suggesting cut down Americans’ life expectancy by as muchas 1.8 years.

While the data accounts for differences in life expectancy between men and women, there is none related to race or ethnicity. White Americans already on average live longer than their non-white counterparts, but COVID-19 has had a particularly disproportionate impact on communities of color throughout the last two years.

What available data exists to explain the differences in life expectancy between states suggests that socioeconomic differences are what drive these disparities.

"When you look at the map of life expectancy, and if you were to look at a map of socioeconomic status — which includes poverty, education attainment — you would see that they would look very similar," said Elizabeth Arias, the lead author of the new report, told NBC News.

Poverty rates in particular correlate with a state’s ranking on life expectancy. According to U.S Census Bureau data from 2019, Mississippi was the poorest state in the country with 19.6% of the population living below the poverty line compared to only 9.3% in Hawaii. A ranking of states by levels of unemployment by the U.S Labor Department in 2019 also found that 5.5% of Mississippians in the labor force were unemployed, the highest in the United States, compared to only 2.5% in Hawaii.

The percentage of residents who have access to healthcare did not appear to play a consistent role in the ranking of life expectancy.

While states that had a higher percentage of uninsured citizens ranked towards the top end of life expectancy, several states with larger gaps in healthcare insurance still scored higher on life expectancy than the bottom five. For example, West Virginia recorded a statewide uninsured rate of 6.6% in 2019 compared to states that overtook it on life expectancies like Florida or Texas, according to data by the Kaiser Family Foundation.

Finally, there remains an interplay between health and poverty that may play a role in the CDC’s ranking. Heart disease and cancerare among the leading causes of death in the United States and the states with lower life expectancy levels suffer higher mortality rates in each category.

Here again, Mississippi had the highest mortality rates for cancer and heart disease in 2019, according to the CDC. In contrast, Hawaii each had some of the lowest in each category.

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