Your Red State Is Trying To Kill You

Freedom's just another word for several years shorter lifespan.

Photo (cropped) by Cory Doctorow, Creative Commons License 2.0

We already knew from the COVID-19 pandemic that death and infection rates from the coronavirus were higher among Republicans than Democrats, reflecting the parties’ vastly different messaging (and preferred media sources) on vaccines and public health measures like masking. Now, a data analysis from the Washington Post (gift link) indicates that, even in areas that are very similar demographically, states’ political orientation may play a difference in who’s dying early and who’s living longer.

The USA, which spends way more per capita on healthcare thanks to our absolute mess of a healthcare “system,” has a higher death rate among people under 65 than comparable nations do. And as the Post analysis suggests,

Many of those early deaths can be traced to decisions made years ago by local and state lawmakers over whether to implement cigarette taxes, invest in public health or tighten seat-belt regulations, among other policies, an examination by The Washington Post found. States’ politics — and their resulting policies — are shaving years off American lives.

For the sake of comparison, the Post looks at three counties with very similar demographics that line up neatly along the shore of Lake Erie but are in different states: Ashtabula County in Ohio, Erie County in Pennsylvania, and Chataqua County in New York. They’ve all had tough times, what with declining jobs and the opioid epidemic, but Ashtabula has a much higher rate of deaths among people aged 35 to 65 than residents of the other two counties, “especially from smoking, diabetes-related complications or motor vehicle accidents.”

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The Post adds that those trends held up during the pandemic, when “Ashtabula residents died of covid at far higher rates than people in Chautauqua and Erie.”

The story notes that 30 years ago, Ohio and California had roughly the same health outcomes, “with nearly identical death rates for adults in the prime of life — ranking in the middle among the 50 states.” But the states’ politics have changed, with California electing more Democrats and Ohio more Republicans. During that time, California has seen death rates drop, while Ohio’s stayed about the same, according to research by health and policy professor Ellen Meara of the Harvard T.H. Chan School of Public Health. The Post analysis found that, as of 2017, “California had the nation’s second-lowest mortality rates, falling behind only Minnesota; Ohio ranked 41st.”

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The GOP Is From The Government, And They're *NOT* Here To Help!

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Also, in part, we can blame some of this on Goddamn Ronald Reagan, who made “government is the problem” even more of a core Republican belief than it had already been:

State lawmakers gained autonomy over how to spend federal safety net dollars following Republican President Ronald Reagan’s push to empower the states in the 1980s. Those investments began to diverge sharply along red and blue lines, with conservative lawmakers often balking at public health initiatives they said cost too much or overstepped. Today, people in the South and Midwest, regions largely controlled by Republican state legislators, have increasingly higher chances of dying prematurely compared with those in the more Democratic Northeast and West, according to The Post’s analysis of death rates.

We do wish that the Post had gone a bit more into the disparities mentioned by one of its sources for the piece, Dan Skinner, a health policy professor at Ohio University, which does not have a pretentious “the” in its name. Skinner, among others, identified differences in states’ safety net and Medicaid funding as a factor along with tobacco taxes and road safety laws, which the Post seems to give more attention to. (A 2021 study, for instance, found that between 2010 and 2018, states that accepted Medicaid expansion under Obamacare saw a decline in all-cause mortality compared to those that didn’t, although the reductions varied by state.)

Still, there’s a lot to chew on here, like the fact that Ohio Gov. Mike DeWine, who actually supports higher tobacco taxes and stronger enforcement of seatbelt laws, gets called a “nanny stater” by many Ohio Republicans. Seatbelt use has steadily declined in Ohio, because of course safety is tyranny, and attempts to raise tobacco taxes die in the state Legislature because lobbyists for big tobacco and retail stores worry it’ll be bad for business and argue that if Ohio taxed tobacco at rates similar to nearby states, it would lose all the money and jobs that come from out-of-staters coming to buy their ciggies there. The story includes handy charts showing that in general, states with higher cigarette taxes have far fewer smoking-related deaths, too.

But then, Ohio has politicians like Republican state Rep. Bill Seitz — he’s the one who said DeWine has a “nanny state” mentality — who smoked for 50 years and only stopped when he got kidney cancer. He’s very big on Free Dumb:

“I’m not going to turn into a smoke Nazi just because I used to smoke and I don’t anymore,” Seitz said.

Seitz also denies that donations from tobacco companies affect his thinking on the issue, explaining, “I already was thinking in line with their thinking before I even knew who they were, okay?” And Crom help us, we believe him. It’s not corruption if you already had terrible ideas.

The Post points out that, like most other states at the time, Ohio initially used its big payout from the 1998 tobacco settlement to set up smoking cessation programs and ad campaigns to warn about the health effects of tobacco, and the state’s smoking rate for adults dropped 25 percent between 2001 and 2008. Yay, Ohio, that was one of the sharpest smoking declines in the USA, at least until the 2008 recession hit. The GOP Lege and then-Gov. Ted Strickland — yes, a Democrat — shunted $230 million of tobacco settlement money to support state programs hit by tax shortfalls. The diverted funding was never returned to tobacco programs, and now Ohio smoking rates are right back where they had been, hooray for freedom.

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It’s a good read, emphasizing yet again that public policy has very real effects on what Republicans want to tell you is entirely a matter of individual “choice,” although it’s also frustrating to read the whole thing (remember, gift link, no paywall) and get to the comments section, where people keep talking about the “bad individual choices” people in red states make.

Yikes. That’s yet another reminder of how badly Reaganesque rhetoric has poisoned us. Yes, we have free will. What we do with it is shaped by politics, for chrissakes!

Also too, check out this similar piece from Politico last month, which independently looks at life expectancy as they relate to the prevailing politics around the USA, and makes similar comparisons between very similar communities that have remarkably different average lifespans; it notes that even among the poorest communities in parts of blue America, average life expectancy can exceed that of wealthy people in the Deep South. Yikes again!

[WaPo (gift link) / Politico / Photo: Cory Doctorow, Creative Commons License 2.0]

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