The geography of men’s health in the United States, by state and race/ethnicity

Population health research often treats men as a single group, despite important differences across race/ethnicity and place. This study examines geographic and racial/ethnic variation in men’s health in the United States. We use pooled 2019–2024 data from the Behavioral Risk Factor Surveillance System, 2019–2024 CDC WONDER mortality data, and 2019 estimates from the Institute for Health Metrics and Evaluation to assess state-level variation in self-rated health, mortality, and life expectancy among six racial/ethnic groups. Using descriptive analyses and hierarchical models with race-specific geographic variance components, we assessed the relative contributions of national racial/ethnic disparities and within-group state variation in life expectancy. Men’s health varied substantially across race/ethnicity and place. Asian men generally reported the highest self-rated health and lowest mortality, while American Indian or Alaska Native men had some of the lowest life expectancy, which fell below 63 years in some states. Black men also had poor outcomes, particularly in the Midwest and South. Although White men had relatively favorable national averages, they rarely ranked highest within individual states. Native Hawaiian or Pacific Islander men showed greater variability and higher mortality when examined separately from Asian men. Geographic differences accounted for a larger share of within-group variation in life expectancy among American Indian or Alaska Native and Black men than among White or Asian and Native Hawaiian or Pacific Islander men. These findings show that national averages may not fully capture geographic variation in men’s health inequalities. Public-health research and policy should account for the interaction between race/ethnicity and place.