deaths of despair

Voting Cultural Issues Instead of Economic Needs

 Voting Culture Instead of Economic Needs

                                    Robert A. Levine

Overall, Republican dominated states in America have worse life expectancies and quality of life than states where Democrats prevail. With the quality of life and survival in Red states considerably lagging the Blue states, why do their citizens consistently vote for candidates who do not support their needs. It is because the GOP politicians tend to focus on cultural issues rather than quality of life. In this current election however, they have pummeled the Democrats on some quality of life issues, such as crime and inflation. Though there has indeed been a spike in crime over the last five years, it started during President Trump’s time in office and still has not come close to the peak that was present thirty years ago.

According to the World Bank, in 1991, the homicide rate in the US was 9.71 per 100,000. There was then a fairly steady decline in homicides until 2015 and 2016, when the rates turned around, peaking at 6.52 in 2020, Trump’s last year in office. That was almost a 29% increase prior to Biden’s presidency. In 2021, Biden’s first year in office, violent crime statistics in the US were basically unchanged from the year before according to the DOJ. Statistics are not available for the full year 2022 currently, but it appears that homicide rates are decreasing from the previous year, though not total crime. In 2021, four of the five states with the most homicides were Red states, with Texas far in the lead, followed by North Carolina and Ohio.

So-called deaths of despair, which include drug overdoses, alcohol related deaths and suicides are far more frequent in Red states than Blue ones. In 2020, the top two states from drug overdoses were Missouri and West Virginia. Suicide rates were highest in Wyoming and Alaska followed by Montana and New Mexico. In 2021, alcoholism was most prevalent in Wisconsin, North Dakota, Iowa, Nebraska and Minnesota. According to the CDC, the states with the lowest life expectancy was mainly in the South, prior to the onset of Covid. With Covid, the average life expectancy for the ten lowest states was 73.6 years in 2020, again mainly in the South, compared to the national average of 77 years. The ten states with the longest life expectancy were all Blue, including New York, New Jersey, Colorado, and states from New England and the West Coast.

Obviously, the deaths of despair contributed to the diminished lifespan for people in some of the Red states, but poor health care is a significant factor. People tend not to see physicians regularly and do not get the preventative care that is necessary. This is because medical care is not easily accessible or it is not affordable. The highest rates of poverty are seen in the Red states, with nine of the top ten led by Mississippi and Louisiana.

Yet with all the poverty and health care problems of their constituents, Republican politicians have fought against expanding Medicaid in many states because it was initiated by Obama and is called Obamacare- the Affordable Care Act. Senate campaign chairman Rick Scott and other Republicans have spoken of reducing Medicare and Medicaid benefits if the GOP controls Congress, possibly raising the age for Medicare to 70. Likewise, the Republicans would like to raise the age when Social Security benefits can be obtained to 70. They say they are concerned about the Federal deficit, yet they cut the tax rate for the wealthy during the Trump years and refuse to increase taxes on the wealthy.

These are but a few of the ways that the Republicans are willing to harm ordinary or poor Americans in order to cater to the rich people who fund their campaigns. They lie about the Democratic motives and focus on cultural issues to obtain the votes of the electorate in their states who they are more than willing to ignore once in office and take advantage of them. People in the Red states have to learn which politicians are out to help them and those who really don’t care. Democratic legislation favors the middle classes and the poor while the Republicans constantly favor the wealthy. Education, gay marriage and similar issues are used by Republicans to distract voters from their plans to cut Medicare, Medicaid and Social Security which would have a devastating effect on American society.

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Why America's Life Expectancy Is Shrinking- Not Just Covid

Why Is America’s Life Expectancy Shrinking?  Not Just Covid

                                    Robert A. Levine, M.D.  10-18-22

Life expectancy of Americans has lagged that of other industrialized nation for decades, the differences ranging from one to seven years. In addition, Americans life expectancy dropped steeply in 2020 and 2021, the greatest two year drop in the last century. As of 2022, average life expectancy in Japan was 84.82 years, 87.8 for women and 81.7 for men. For the U.S. it was 78.2 years, 81.0 for women and 75.4 for men. U.S. life expectancy was below that of virtually every nation in Europe, and many in Asia including China. While some of this decline was due to deaths from Covid 19, the shrinkage in life expectancy was even greater than might have been anticipated.

The effect of Covid itself on America’s population was worse than every industrialized nation in the world, because of poor government planning and unwillingness of large segments of the population to take the disease seriously. The use of preventative measures such as masks, social distancing, vaccination and booster rates lagged those of other advanced countries. Verified deaths from Covid 19 in the U.S. have been reported at over one million, though the actual number was undoubtedly higher. Many deaths occurring at home or without testing were not ascribed to Covid though it was the likely cause. According to the World Health Organization in May, the U.S, had the highest number of reported Covid deaths in the world.

In addition to Covid deaths, America led the world in so called “deaths of despair;” those caused by drug overdoses and suicides. These deaths occurred mainly in people (particularly men) whose lives were of poor quality, in dead end jobs, with little education or hope for the future. As of 2020, the U.S. had the highest suicide rate of any advanced nation at 14 deaths per 100,000 people. This was twice the rate of the United Kingdom. Nearly 46,000 Americans died by suicide in 2020 with similar numbers in 2021 according to the CDC.

The CDC also reported there were over 104,000 deaths due to drug overdoses in the U.S. in the 12 month period ending in April 2021. These were mainly from synthetic opioids such as fentanyl or psychostimulants such as methamphetamine. Drug overdose was the leading cause of death in the U.S. for people under age fifty. Drug overdose deaths were far higher in the U.S. than in any other developed nation, almost 28 per 100,000 population. Though deaths from alcoholism is a worldwide problem, the CDC announced in April 2022 that alcohol consumption was responsible for 140,000 deaths in the U.S. 

The National Highway Traffic Safety Administration noted that there were nearly 43,000 deaths in the U.S. in 2021 because of motor vehicle accidents. While the rates of accidents and deaths are higher in less industrialized nations, America again has the highest rate of motor vehicle accidents in the developed world by far, more than three to four times the rates in European nations.

Also in 2021, the Centers for Disease Control and Prevention reported there were close to 49,000 Americans killed by guns. These included all types of guns and in all kinds of situations. Again, there was no high income country that even approached that number of gun deaths. The rate of homicides caused by firearms in the U.S. is 23 times the rate in Australia, a nation thought to be similar to the U.S. in values.

In addition to the above statistics which show the United States as an outlier in the rates of death from Covid 19, suicides, drug overdoses, motor vehicle accidents and gun violence, there is also infant mortality and maternal mortality included in computing life expectancies. In America, infant mortality is 5.44 per 1000 live births, 50th of 195 countries. This death rate is considerably higher than virtually all nations with advanced economies. Some of the variation in infant mortality may be because of how it is defined by different nations. However, it is also true that prenatal care for low income women is worse in the United States compared to other developed nations. In fact, in comparison to ten other developed countries, the U.S. was found to have the highest maternal mortality rate, 17.2 deaths per 100,000 live births. In some advanced nations, the rate was only 3 maternal deaths per 100,000 live births.

Both in terms of infant and maternal mortality, the statistics in the United States reflect the poor quality of health care offered to many pregnant women, particularly those of low income. That the U.S. health care system is deficient in providing adequate health care in general is shown by excessive Covid deaths, maternal and perinatal deaths.

The drop in life expectancy in the United States may have economic repercussions in the future, with quality of life being impacted besides years of life. Politicians and CEOs in the United States should take notice.