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Perspective | Magazine

The brutal calculus of life expectancy and where you can afford to live

Massachusetts policies can add years to one’s life. The problem is too few can afford to live here.

A billboard from Stop Handgun Violence, a Massachusetts based organization, in 2018.handout

Anyone confronting Boston-area rent or home prices has, at some point, probably questioned their life choices. After all, you could buy a bigger house for a lot less money in North Carolina, where the median home sold for just $340,000 in February, according to Redfin, compared with $523,000 in Massachusetts.

From 2019 to 2020, more than 5,000 Bay Staters relocated to North Carolina, and who can blame them? Home prices and rents are excruciatingly high, largely because communities throughout Greater Boston haven’t allowed enough housing construction to keep pace with growth.

That said, there are many reasons people still stretch their budgets and commutes to live here if they can, from familial obligations to economic or educational opportunities. One of the most compelling is that living in Massachusetts can add literal years to one’s life.


Yes, saving nearly $200,000 on a home is a big discount, but it comes with a horrible catch: almost three years of life expectancy, according to Centers for Disease Control and Prevention data. North Carolina residents born in 2020 could expect to live an average of 76.1 years, compared with 79 years in Massachusetts. Raise three kids there, and statistics suggest it could cost a decade of their collective lives.

Thinking about moving to the Nashville metro area, where the median two-bedroom apartment rents for $641 less per month than in Greater Boston, according to Apartment List? It’ll cost you in other ways — namely, about five years on earth: Tennessee residents live just 73.8 years on average.

The reasons for these types of discrepancies aren’t all that mysterious. For one thing, Massachusetts has high-quality hospitals and its robust MassHealth program. But states with the highest life expectancies year after year, such as Hawaii, Washington, California, and much of New England, also have tougher gun laws, for example, so residents are less likely to shoot themselves or others; as well as higher taxes on tobacco, discouraging smoking and its myriad harmful health effects. Stricter environmental regulations, meanwhile, reduce the likelihood that you and your kids are drinking or breathing toxic chemicals.


The horrific shooting at a Nashville elementary school in March, in which three 9-year-old children and three adults were gunned down, is an awful reminder of the real-world suffering behind the statistics. Tennesseans are five times more likely to be shot than Massachusetts residents, according to the CDC, and four times more likely to be murdered.

Unthinkable gun violence can shatter lives anywhere, even in places with strict gun laws, as residents of Newtown, Connecticut, are all too painfully aware. But it happens far more often in gun-drenched America than in any other developed nation, and more often still in states with lax firearms laws.

Jennifer Karas Montez, a sociology professor at Syracuse University, has studied how state policies affect life spans, and found that even less obvious policies play a significant role in determining how long we live. A higher minimum wage, for example — like the one in Massachusetts — has been shown to lower the risk of teenage pregnancy, smoking, obesity, low birth weights, and infant mortality, Montez says. “There are all of these collateral benefits to what we think of as an economic policy, but it’s really a health policy, too.”


Americans young and old, and across every demographic and income level, die years younger than their peers in other wealthy nations. And we don’t have to. Just a few policy changes — particularly those related to gun safety, minimum wage, and paid leave — could make dramatic improvements to life expectancy, Montez says. In one study, she and other researchers found that, if every state simply implemented the same policy environment as Connecticut, “The US would increase its life expectancy by roughly two years,” she says. “That is a massive increase.”

This isn’t just about people living a few more years in their 70s. What many fail to see, Montez says — including policy makers — is that “life expectancy is an average, and ours [in the United States] is low because people are dying before the age of 50 — that’s what’s driving it down. It’s not just that people here aren’t living as long into retirement. It’s that we’re dying young.”

Montez acknowledges it’s virtually impossible to prove cause and effect in this type of research. But she offers a useful analogy to frame the findings, which are stronger than mere correlations: Imagine driving 40 miles per hour over the speed limit on the way to work each day. “Speeding, driving recklessly, significantly increases your risk of dying in a car crash. It doesn’t mean it’s going to happen today when I speed, it doesn’t mean it’s going to happen tomorrow,” she says. “But eventually it’s going to catch up with me, and I’m going to be more likely to die in a car crash than my friend who actually follows the speed limit.”


Would you want your kids riding in that speeding car day after day? Would you force other people’s kids into that car?

Because that is, in a sense, what we’re doing in Massachusetts, by pricing out so many families.

People shouldn’t need to give up precious years of their lives to afford a home, or forgo necessities to live in a place that supports a longer, healthier life. Lawmakers in other states should, frankly, learn from Massachusetts — but there’s a lesson for our state, too. We urgently need to permit and build more and denser housing throughout Greater Boston, until everyone who wants or needs to live here can do so affordably.

Until then? The next time you wince at the financial flotsam your rent or mortgage payment has left behind, you might find some solace by recalling one of the more iconic billboards ever to greet drivers along the Mass. Pike, courtesy of the gun-violence prevention nonprofit Stop Handgun Violence. It read: “Welcome to Massachusetts. You’re more likely to live here.”

Jon Gorey is a frequent contributor to the Globe Magazine. Send comments to