Tuesday, April 04, 2023

The Republican Death Wish

Paul Krugman has been crunching some numbers. And he's made a grisly discovery. He writes:

America’s dismal Covid performance was part of a larger story. I don’t know how many Americans are aware that over the past four decades, our life expectancy has been lagging ever further that of other advanced nations — even nations whose economic performance has been poor by conventional measures. Italy, for example, has experienced a generation of economic stagnation, with basically no growth in real G.D.P. per capita since 2000, compared with a 29 percent rise here. Yet Italians can expect to live about five years longer than Americans, a gap that has widened even as the Italian economy flounders.

What explains the American way of death? A large part of the answer seems to be political.

One important clue is that the problem of premature death isn’t evenly distributed across the country. Life expectancy is hugely unequal across U.S. regions, with major coastal cities not looking much worse than Europe but the South and the eastern heartland doing far worse.

But wasn’t it always thus? No. Geographic health disparities have surged in recent decades. According to the U.S. mortality database, as recently as 1990, Ohio had slightly higher life expectancy than New York. Since then, New York’s life expectancy has risen rapidly, nearly converging with that of other rich countries, while Ohio’s has hardly risen at all and is now four years less than New York’s.

The data is pretty stark:

A 2021 paper published in The Journal of Economic Perspectives examined various possible causes, like the increasing concentration of highly educated Americans (who tend to be healthier than those with less education) in states that are already highly educated and the widening per capita income gaps among states. The authors found that these factors can’t explain more than a small fraction of the growing mortality gap.

Instead, they argued, the best explanation lay in policy: “The most promising explanation for our findings involve efforts by high-income states to adopt specific health-improving policies and behaviors since at least the early 1990s. Over time, these efforts reduced mortality in high-income states more rapidly than in low-income states, leading to widening spatial disparities in health.”

There is, in fact, a strong correlation between how much a state’s life expectancy rose from 1990 to 2019 and its political lean, as measured by Joe Biden’s margin over Donald Trump in the 2020 election — a correlation slightly stronger, by my estimates, than the correlation with income.

There are several reasons to believe that America’s death trip is largely political rather than economic. One is the comparison with European nations, which have had much better health trends even when, as in Italy, their economies have performed badly.

Another is the fact that some of the poorest states in America, with the lowest life expectancy, are still refusing to expand Medicaid, even though the federal government would cover the bulk of the cost (and the failure to expand Medicaid is killing many hospitals). This suggests that they’re failing to improve health because they don’t want to, not because they can’t afford to.

Finally, since Covid struck, residents of Republican-leaning counties have been far less likely to get vaccinated and far more likely to die of it than residents of Democratic-leaning counties — even though vaccines are free.

Republicans have a death wish. And those who buy what they sell are like lemmings, marching over a cliff.

Image: Encyclopedia Britannica


Cap said...

In addition to the reasons for reduced life expectancies listed above, more than half the states now allow concealed carrying of loaded weapons without permits, background checks or firearms safety courses. More than half the states now threaten the life expectancy of women with pregnancy complications and those who wish to terminate their pregnancies for any reason. No points for guessing which party governs those states.

Then, there's Covid, where the whole country has decided to pretend the pandemic's over, despite racking up more Covid- related deaths last year than any other year of the pandemic. But, we've done the same thing, as have most European countries, so that won't necessarily show up in comparative life expectancies. It seems we've all got a death wish.

Owen Gray said...

And apparently, Cap, the number one cause of child mortality in the United States is gun violence.

rumleyfips said...

Fatal car crashes and drug related deaths are also driving the fall in US life expectancy.

Life expectancy and live birth percentage are two important metrics when comparing the success of different countries.

Owen Gray said...

And when one considers the national wealth of nations, the fact that mortality rates are so high in the United States is an obscenity, rumley.

Trailblazer said...

FWIW; I think that the dismal turnout of Trump supporters at both Trump Towers and Mar a Largo, throught this process has become a media event rather than a political event!!
Trumps support is within the core support that is driven by a religiosity that defies conventional values and norms.
Short of gerrymandering and fraud Trump is finished but not forgotten!!
Trump and his acolytes have summoned the deepest most rotten values that humanity has provided
Whilst Trump may fail he has exposed and promoted a segment of not only US politics but those of his admirers world wide.
Kind of like the Nike symbol; cute for a while until you understand the origins and implications!!!

Trailblazer said...

Life expectancy and live birth percentage are two important metrics when comparing the success of different countries.!!

In the USA the most important metric is how many F35's do we have compared to brad X's SU 27's!

Sarcasm aside most US persons have no idea what a successful health care system looks like or a cult less political system!

FWIW , in years gone by US right wing media lambasted Canada's health care system.
For some time now it's been mute .
The many US cheap drug seekers along the 49th that are coming to Canada for drugs re testament to the change in attitude.


Owen Gray said...

Trump appeals to the deepest roots of human depravity, TB. He may be on the way out. But his movement lives on. Mark Antony was right. The evil that men do lives after them.

Owen Gray said...

A lot of Americans still haven't figured out that they have been conned, TB. But, as the emails from Fox News leak out, some of them are beginning to get the picture.