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Former Rhode Islander here. Rhode Island can perhaps best be explained by saying that they fail (or perhaps decline) to benefit from the factors that the rest of New England benefits from.
Rhode Island cuisine is unusually rich, fatty, and salty compared to what most of the rest of the region is eating most of the time. They’re often heavy drinkers. And they often make other poor choices that put them in danger.
They are comparatively poorer drivers, such that even single-car roadway fatalities are comparatively higher. (One study determined that Rhode Islanders are the worst drivers in the entire country, concluding that *one in four* Rhode Islanders drivers shouldn’t be on the road at all.)
It’s no one thing, but several cultural factors, that play into Rhode Island’s lower overall life expectancy against the rest of New England.