Alabamians have a life expectancy nearly four years shorter than the national average, according to a new report from the Public Affairs Research Council of Alabama (PARCA) examining the state’s health challenges, public health system and access to care.
The report found Alabama’s life expectancy was 73.8 years in 2022, placing the state among the lowest in the nation. Alabama also ranked 47th out of 50 states in the 2025 America’s Health Rankings annual report.
The findings come as health care has become a growing concern for Alabama residents. According to PARCA’s 2026 public opinion survey, health care is now tied with education as the top issue Alabamians want state government to address.
PARCA cited high rates of chronic disease, poverty and limited access to health care as major factors contributing to the state’s poor health outcomes.
Among the report’s findings:
- Life expectancy: Alabamians lived an average of 73.8 years in 2022, nearly four years below the national figure.
- Death rate: Alabama recorded 11.4 deaths per 1,000 residents, compared with the national average of 9.
- Leading causes of death: Heart disease, cancer and stroke accounted for roughly half of all deaths in the state.
- Infant health: One in 10 babies was born underweight, the fourth-highest rate in the country, and 414 infants died before their first birthday.
- Rural health care: Only 15 of Alabama’s 58 rural counties have hospital labor and delivery units.
- Hospital closures: At least seven rural hospitals have closed since 2010, and 37% of those remaining were considered at immediate risk of closure as of July 2026.
Despite those challenges, PARCA noted improvements in several measures in recent years, including declines in overall death rates, teen pregnancies, low-birthweight births, homicides, cancer deaths and deaths from lung disease.
Meanwhile, access to medical care remains a particular concern in rural communities. According to the Alabama Department of Public Health, 58 of the state’s 67 counties are considered rural, and more than 40% of Alabamians live in rural areas.
PARCA found nearly 90% of women in rural Alabama live more than 30 minutes from a hospital offering childbirth services, compared with 26% of women in urban areas. In 2023, six rural counties had life expectancies below 70 years, compared with a statewide average of about 75 years.
Alabama received $203.4 million in 2026 through the federal Rural Health Transformation Program, with funding directed toward rural health services, workforce development, mental health, medical practices and health technology. PARCA noted, however, that the program is scheduled to end in fiscal 2030.
The report also examined the Alabama Department of Public Health, which operates approximately 75 offices and employs more than 2,600 people statewide. Despite Alabama’s poor health rankings, the state spent $137 per person on public health in 2022-23, above the national average of $124 and the highest rate among Southeastern states, according to PARCA.
The full report, part of PARCA’s Issues and Agencies series, includes additional information on health outcomes, public health spending, rural health care and interactive tools for examining Alabama health statistics.
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