Hawai'i leads the nation in longevity — one of only two states with an average life expectancy topping 80, according to a report issued yesterday.

The life expectancy in Hawai'i is 81.3 years, according to a Manhattan Institute for Policy Research report. That's followed by Minnesota at 80.3 years.

Sylvia Yuen, director of the University of Hawai'i Center on the Family, said several factors help Hawai'i residents live longer.

Yuen said residents, particularly children and the elderly, have access to medical care. She said the Islands have a cleaner and warmer environment that allows residents to be outdoors year-round to exercise and do other recreational activities.

Yuen also said that Hawai'i has a higher proportion of Asians who generally have a long life expectancy. She said a strong family base also contributes to longevity.

"You see this flow of assistance across generations and even to extended family," Yuen said. "Lots of our families, maybe more so than on the Mainland, help support their elderly parents, take them into their own homes, or if their parents are living on their own they cook or they go over and they clean and take them to the doctor. All of those help to keep people supported and living longer."

But Yuen cautioned that Hawai'i may not be among the leaders in life expectancy years from now because of the growing number of obese residents here. She said that projections show that a decline is likely "because we have this rising number of people who are obese and not taking care of their health."

While Hawai'i residents lived the longest, New York residents had the biggest gain in longevity from 1991 to 2004, and one reason was access to new medications, a study showed.

The state's 4.3-year increase pushed a resident's life expectancy at birth to 79.2 years, according to the study. California was second, gaining 3.4 years from 1991 to 2004, followed by New Jersey, Illinois and Connecticut, the study showed.

States that had quicker growth in access to new drugs for Medicare and Medicaid patients were more likely to see longevity increases that exceeded the average U.S. gain of 2.33 years, the report said.

"What I've found out is that medical innovation is responsible for most longevity increases in the U.S.," said Frank Lichtenberg, the study's author, in a telephone interview from New York. "People should be aware of this in the debate about risks versus benefits in medical innovation."

Obesity, smoking and AIDS slowed longevity increases, the report showed. Also, as state incomes rose, gains in life expectancy lessened.

"If obesity and income had not increased, life expectancy at birth would have increased by 3.88 years, not just 2.33," said Lichtenberg, the Courtney C. Brown Professor of Business at Columbia University, in the report.

Excluding the effect of obesity and income, greater access to new drugs would have accounted for 63 percent of that potential increase in longevity, said Lichtenberg, also a research associate at the National Bureau of Economic Research, based in Cambridge, Mass.

Lichtenberg's primary measure of access to new prescription drugs used data from Medicaid, the government health plan for the poor. States with the biggest jump in newer medicines for those patients included California, New Jersey and Connecticut, with Illinois and New York in the next tier.

The researcher also measured medicines doctors administered to Medicare patients, such as chemotherapy, a much smaller group. Medicare is the federal health program for the elderly and disabled.

California's longevity increased to 79.5 years, according to the study. New Jersey added 3.3 years, raising the state's life expectancy to 78.9 years; Illinois increased its longevity rate by three years to 77.9 years; and Connecticut gained 2.7 years, to 79.9 years, according to the report.

Lichtenberg's research was financed by the nonprofit Manhattan Institute in New York. Drug companies paid for some of his previous research.