Matthews: California’s famously high costs can buy you a longer life
Come to California if you want to live.
That’s my New Year’s suggestion for a new state slogan. California is losing population for the first time since it became a state. The biggest reason for that is well known: The cost of living in the Golden State is among America’s highest.
Less well known is that our high costs buy you more living. Literally. On average, Californians live to 79, better than the American average by two-plus years, and better than all but three other states.
Lately, only Hawaii residents, who reach an average 80.7 years, have lived longer. Our biggest metro areas are among the country’s healthiest places. The Bay Area ranks second in life expectancy nationally, and Los Angeles third.
Nor do you have to spend your whole life here to gain the extra time. Stanford and MIT researchers found that moving to California after age 65 can increase your life span by more than a year.
Why do we live longer? Wealthier, higher-income states with relatively high levels of education — like California — tend to rank highest in life expectancy. Money buys more access to better health care, and California’s rich people live near some of the world’s best hospitals and health systems.
Healthy behavior helps. The percentage of us who smoke is lower than that of any state besides Vermont. Our obesity rate is the fourth-lowest in the U.S. We have some of the country’s lowest rates of infant mortality and suicide.
Our more liberal public policy counts too. California’s strong environmental protections for air and water help us live longer. Gun control keeps us alive — we have the eighth-lowest rate of gun deaths and the sixth-lowest gun ownership. A new study from the gun control nonprofit Everytown for Gun Safety finds that the Golden State has America’s strongest gun laws. If every other state copied our regulations, the study found, nearly 300,000 lives could be saved over the next decade.
Then there’s our nation-leading commitment to health care coverage. This month, California became the first state in the union to make all unauthorized immigrants eligible for Medi-Cal, California’s name for the federal health care program Medicaid. With this historic advance, Golden State becomes the first state to expand Medicaid to cover all low-income residents, who usually have the highest mortality rates.
The news is not all good. California life expectancy dropped below 80 years during the pandemic. But the overall U.S. life expectancy dropped further, to just over 76 years. And there is a significant disparity — approaching 7 years — in expected life span between residents of California’s urban and suburban coastal counties, and those who live in the North State and Central Valley.
Frustratingly, California also lags in rankings of mental health services — which is why Prop 1, a $6.38 billion mental health measure, is on the March ballot. The state has the largest population of people who are unhoused, a life circumstance that according to a UCSF study makes you 16 times more likely to die suddenly.
California also struggles to prevent deadly drug use, especially among young people. A new “report card” from the advocacy coalition Children Now gives the state a “D-” on substance abuse prevention, saying that California’s “unfocused” plan “requires kids to ‘fail first’ before getting the help they need.”
Of course, the other states also struggle with drugs, mental health and homelessness, and many of them offer less in services than we do. The statistics demonstrate that California, for all its failures, is a great place to settle if your goal is to stick around a while.
If my formulation — “Come to California if you want to live” — seems too sharp, then let’s instead borrow a line from the comedian Mort Sahl, who spent his final years in Marin County, whose residents enjoy the state’s longest life expectancy.
“You haven’t lived,” Sahl said, “until you’ve died in California.”
He died in 2021 at 94.
Joe Mathews writes the Connecting California column for Zócalo Public Square.