A new U.S. state ranking focused on health infrastructure and environmental risks finds Ohioans are living shorter lives than residents of most states, and points to high smoking rates, poor air quality and limited access to healthy food and exercise options as key contributors. The report, compiled by healthcare staffing platform Nursa and summarized in local coverage, places Ohio among the states with the lowest life expectancy and uses measures such as number of parks and gyms, store food offerings, pollution and smoking prevalence to explain variation across states (Mahoning Matters).
Life expectancy is a shorthand measure of a population’s overall health and of the social and environmental conditions that shape everyday life. For Ohio, the Centers for Disease Control and Prevention recorded life expectancy at birth of about 74.5 years in 2021, well below the U.S. average and substantially lower than top-performing states such as Hawaii and Massachusetts (CDC interactive map). Ohio’s ranking in the Nursa analysis — which blends built environment, pollution and health behavior metrics — highlights how place, policy and personal habits combine to shorten lives in some communities more than others (StudyFinds report on Nursa rankings).
There is no single cause behind Ohio’s shorter life span; researchers and public-health experts point to a cluster of risk factors that are unevenly distributed across the state. The Nursa index flagged Ohio’s adult smoking rate, a high proportion of “unhealthy” food outlets compared with healthy stores, and a high pollution score as major drags on longevity (Mahoning Matters summary of Nursa findings). Official data give more nuance: Ohio’s adult cigarette smoking prevalence has been declining and was estimated at roughly 15% in 2023 by the Ohio Department of Health and America’s Health Rankings, though older or different datasets can show higher percentages depending on definitions and years used (Ohio Department of Health slides 2023; America’s Health Rankings — Smoking).
Air quality and pollution are another recurring theme. Ohio has historically ranked poorly on exposure to fine particulate matter (PM2.5), which is linked to heart and lung disease and premature death; analysis by state policy researchers shows Ohio ranked among the worst states on PM2.5 exposure in recent multi-year windows (Health Policy Institute of Ohio — outdoor air pollution factsheet). Global analyses likewise show that ambient air pollution reduces life expectancy by measurable amounts; reducing PM2.5 improves population longevity in a matter of years, not decades (State of Global Air — life expectancy impact).
Local reporting and county-level studies also illustrate how uneven Ohio’s life prospects are. A county-by-county analysis from Miami University and reporting by The Dispatch show life expectancy ranges from more than 81 years in the wealthier suburban county to under 70 in several rural counties, with access to health care, local economic conditions and social determinants such as education and transportation playing decisive roles (Miami University county study reported by The Dispatch). Health officials quoted in that reporting emphasised that medical care is only part of the story; housing, income, isolation and behavioral health — often grouped as social determinants of health — are the larger, slower-moving drivers of premature death.
Experts quoted in regional coverage frame the problem as solvable but complex. An associate director at a university gerontology centre told reporters there is no one-size-fits-all fix and that local, tailored strategies are required; a Health Policy Institute of Ohio executive pointed to overdoses and smoking as tractable targets for policy action (Dispatch reporting and expert quotes). Clinicians noted that loneliness, lack of transportation and poor access to nutritious food undermine medical care and accelerate chronic disease, reinforcing that public-health interventions must combine medical, social and environmental strategies to raise life expectancy across communities (Dispatch reporting).
Putting the Nursa ranking and CDC life-expectancy estimates together shows how different data products can tell complementary stories. Nursa’s index uses a composite of built-environment items (parks, gyms, walking routes), retail food environments (healthy vs unhealthy store counts), pollution measures, smoking prevalence and hospital readmission data to create a “Healthy States Index,” with states scored on a 0–10 scale for some variables; Ohio’s pollution score in that index was reported as high, roughly 8.9/10 in media summaries (Mahoning Matters summary of Nursa results; StudyFinds summary). The CDC’s life-expectancy numbers use vital statistics on deaths and births and therefore are a direct measure of mortality; those figures placed Ohio’s life expectancy around 74.5 years for 2021, a drop from earlier years that reflects the combined toll of COVID-19, overdoses and chronic disease burdens (CDC interactive map and life tables).
Methodological differences matter. Composite indices like Nursa’s are valuable for pointing to modifiable features of environments — more parks, better retail food mix, cleaner air — but they rely on choices about which variables to include and how to weight them. Life expectancy at birth is an outcome that reflects years of accumulated exposures and policy choices. When numbers diverge (for example, a smoking rate cited in a media summary may be higher than state health-department estimates), the gap often arises from differing data years, definitions (current daily smokers vs. ever-smokers), or sample frames; responsible reporting therefore cites sources and clarifies measures rather than treating one number as definitive (Mahoning Matters on Nursa; Ohio Department of Health tobacco slides).
For policy-makers, the Ohio case is instructive because it shows how interconnected causes accumulate. Tobacco control remains critical: stronger cessation programmes, higher tobacco taxes, expanded quitline access and community-based campaigns have reliably reduced smoking prevalence in multiple settings and would likely improve longevity if scaled in Ohio (Ohio tobacco data and policy resources). Environmental policy to cut PM2.5 and ozone — from industrial emissions rules to cleaner transport and urban planning — can yield measurable gains in average life expectancy on relatively short timescales, according to environmental health research (State of Global Air — life expectancy impact; WHO ambient air pollution factsheet).
Community-level approaches also matter. The Dispatch’s county analysis highlights how pockets of higher life expectancy tend to have concentrated health-care resources, stronger local economies and better social services, showing that targeted investments — rural clinic networks, expanded broadband for telehealth, transportation subsidies for medical visits and food-access programs — can reduce geographic gaps in lifespan (Dispatch county analysis). In short, improving life expectancy is as much about social policy and infrastructure as it is about hospitals.
Thai readers and policy-makers can draw parallels and lessons from the Ohio story. Thailand’s life expectancy at birth (about 76.4 years in 2023) is comparable to — and in recent years has edged above — Ohio’s figure reported for 2021, though direct comparisons should account for different datasets and years (World Bank — life expectancy Thailand 2023). Like Ohio, Thailand faces major, partly overlapping drivers of premature mortality: tobacco use among men remains high compared with women, urban air pollution (notably PM2.5 episodes in Bangkok and northern provinces during haze season) contributes to respiratory and cardiovascular disease, and rising obesity and diabetes are changing the chronic-disease profile (Tobacco Atlas — Thailand; WHO Thailand country data).
Thailand’s strengths — a long-standing universal health coverage scheme, a strong primary-care workforce and community health volunteers — provide an advantage in translating policy into health gains, but the Ohio case shows that health insurance alone is not enough. Thailand can amplify gains by pairing universal care with environmental policy, tobacco control, and community-based prevention that aligns with cultural strengths such as family caregiving and community volunteerism. Measures that have traction in Thailand include stricter tobacco taxation and enforcement, clean-air zoning and transport policy, promotion of active travel and park access in dense urban areas, and school- and workplace-based healthy-food initiatives — all policies that echo recommendations for U.S. states trying to raise life expectancy (WHO ambient air pollution factsheet; Tobacco Atlas — Thailand).
There are also specific cultural and operational advantages Thailand can leverage. Community health volunteers and village health workers are a resource for scaling cessation support, hypertension and diabetes screening, and nutrition education in a way that respects Thai cultural norms around family and elders. Buddhist social values that emphasise care for the vulnerable and communal duty can be mobilised to reduce stigma around mental health and addiction, issues that have driven overdose deaths in parts of the U.S. and which carry their own social burdens in Thailand as well (Dispatch reporting on social determinants and loneliness).
Looking forward, the Ohio example suggests several likely developments for places with similar profiles. First, without sustained policy action, life expectancy gaps within states and between states will probably widen as the slow-moving social determinants continue to erode health in poorer and rural communities. Second, targeted public-health investments — tobacco cessation, obesity prevention, overdose response, clean-air interventions and improved surgical and emergency access in underserved counties — can produce measurable improvements in life expectancy over a decade. Third, the rise of composite “healthy states” indices and local dashboards will continue to influence political priorities by translating complex data into actionable scores for elected officials, even while the details of index methodology will remain a subject of debate (StudyFinds summarising Nursa index).
For Thai health officials, hospital administrators and concerned citizens, the Ohio findings crystallise practical steps. At a national level, maintain and strengthen tobacco control (taxes, plain packaging, cessation services); at a municipal level, invest in cleaner urban transport and green spaces to reduce PM2.5 exposure; at the community level, expand primary-care outreach, nutrition programs and mental-health support that work within family networks; and at the individual level, support smoking cessation, regular health screenings for blood pressure and diabetes, active lifestyles and participation in local health initiatives. These interventions are evidence-based, culturally adaptable, and in many cases cost-effective (WHO ambient air pollution factsheet; Ohio Department of Health tobacco data).
The Ohio case is a cautionary tale and a prompt for action: where people live shapes how long they live, and reversing short life expectancy requires joining clinical care to environmental policy, economic support and social programmes. For Thai readers, the lesson is twofold: first, monitor local indicators (air quality, smoking rates, food environments) rather than assuming national averages capture local risks; second, use Thailand’s strong primary-care and community networks to implement prevention-focused programmes that can blunt the same drivers that shortened lives in parts of Ohio. Policymakers who combine straightforward, evidence-based measures with community engagement and respect for local cultural norms stand the best chance of closing life-expectancy gaps and ensuring more citizens reach old age in good health (CDC life-expectancy visualization; Health Policy Institute of Ohio — outdoor air pollution).
Sources cited in this report include the Mahoning Matters summary of the Nursa analysis, the CDC state life-expectancy visualization and life tables, Ohio public-health publications on tobacco use, regional reporting and county studies in Ohio, Health Policy Institute of Ohio research on air quality, and global analyses of air pollution’s impact on life expectancy. All readers should note that composite indices and single-year life-expectancy estimates use different methods and timeframes; comparing them is useful for hypothesis generation and policy discussion but requires careful attention to definitions and data years (Mahoning Matters on Nursa; CDC state life-expectancy data; Ohio Department of Health tobacco slides 2023; Health Policy Institute of Ohio — outdoor air pollution; State of Global Air — life expectancy impact; StudyFinds summarising Nursa index).
Actionable recommendations: local leaders should measure and publish county-level life-expectancy trends, expand cessation and mental-health programmes, invest in clean-air strategies and equitable food access, and use community health workers to deliver prevention at scale. Thai policymakers should adapt these lessons within Thailand’s strong primary-care framework, pairing universal coverage with targeted anti-tobacco, clean-air and healthy-food policies that respect local customs and use family- and temple-based community networks to reach people who are at highest risk.