Red States, Blue States…And Death Rates

The other day, during a political discussion (these days, pretty much every discussion gets political) my youngest son wondered aloud whether it had been a mistake to win the Civil War. The red states of the South have been an economic drag on the blue states for a long time–they send significantly fewer dollars to Washington than they receive courtesy of blue state largesse.

My son was being flip, but his characterization of Red and Blue states wasn’t far off. As Paul Krugman wrote in a recent column in the New York Times, “the political divide is also, increasingly, an economic divide.”

Democratic-leaning areas used to look similar to Republican-leaning areas in terms of productivity, income and education. But they have been rapidly diverging, with blue areas getting more productive, richer and better educated. In the close presidential election of 2000, counties that supported Al Gore over George W. Bush accounted for only a little over half the nation’s economic output. In the close election of 2016, counties that supported Hillary Clinton accounted for 64 percent of output, almost twice the share of Trump country.

Evidently, however, we don’t just live in different economies–lately, we also die differently.

Back in the Bush years I used to encounter people who insisted that the United States had the world’s longest life expectancy. They hadn’t looked at the data, they just assumed that America was No. 1 on everything. Even then it wasn’t true: U.S. life expectancy has been below that of other advanced countries for a long time.

The death gap has, however, widened considerably in recent years as a result of increased mortality among working-age Americans. This rise in mortality has, in turn, been largely a result of rising “deaths of despair”: drug overdoses, suicides and alcohol. And the rise in these deaths has led to declining overall life expectancy for the past few years.

What I haven’t seen emphasized is the divergence in life expectancy within the United States and its close correlation with political orientation. True, a recent Times article on the phenomenon noted that life expectancy in coastal metropolitan areas is still rising about as fast as life expectancy in other advanced countries. But the regional divide goes deeper than that.

It turns out that the “death divide” Krugman is addressing is closely correlated with political orientation.

I looked at states that voted for Donald Trump versus states that voted for Clinton in 2016, and calculated average life expectancy weighted by their 2016 population. In 1990, today’s red and blue states had almost the same life expectancy. Since then, however, life expectancy in Clinton states has risen more or less in line with other advanced countries, compared with almost no gain in Trump country. At this point, blue-state residents can expect to live more than four years longer than their red-state counterparts.

There are a number of possible explanations: blue states expanded Medicaid while most red states didn’t, for example. The gap in educational levels is probably implicated as well; better-educated people tend to be healthier than the less educated, for a number of reasons.

Krugman also notes differences in behavior and lifestyle that affect mortality. (Although obesity has dramatically increased all across America, obesity rates are significantly higher in red states.)

Krugman references–and debunks–conservative explanations for the death divide:

Conservative figures like William Barr, the attorney general, look at rising mortality in America and attribute it to the collapse of traditional values — a collapse they attribute, in turn, to the evil machinations of “militant secularists.” The secularist assault on traditional values, Barr claims, lies behind “soaring suicide rates,” rising violence and “a deadly drug epidemic.”

But European nations, which are far more secularist than we are, haven’t seen a comparable rise in deaths of despair and an American-style decline in life expectancy. And even within America these evils are concentrated in states that voted for Trump, and have largely bypassed the more secular blue states.

Although he doesn’t mention it, I’d also be interested in seeing a comparison of gun deaths in Red and Blue states.

Actually, conservatives like Barr inadvertently make a point: culture and values matter. Just not the way they think.


  1. Well, what would one expect?

    When you see Bill Barr talk, when you see him put on his Barnum & Bailey flimflam shebang, he looks miserable. He doesn’t believe a word coming out of his own mouth, his lies flow like effluvium! Of course they die quicker, because they are more miserable. If you have to form your own reality to support your lies, that would be quite Hopelessly Burdensome. People who thrive on deception, already have major issues. Either they are the deceivers, or, they are the ones deceived, or, those of whom deceive themselves. So people who live in these realms of booby hatchery, do so by choice. Why? Look at the 3 realms of deception in sentence above. Just the stress sustaining this nincompoopery would be enough to shorten anyone’s lifespan.

    Don’t get me wrong, the blue states are not a panacea, but, they give you some hope. The old “Bob Evans down on the farm” thing isn’t bad, we all need farmers, that in itself is a very tough life. But to claim an agrarian society based on lies and innuendo, deception and corrupted behavior, is a superior way to live, it’s obviously a more Christendom based type of self flagellation.

    Imagine the weight of all of that hatred, fear, jealousy, guilt, corrupt intent, and gluttony, because you can’t have weight without gluttony, am I right? And I’m not just talking about food, I’m talking about “garbage in, garbage out” Sinclair and Fox are the best suppliers available today. And, I’ll doubt highly if the televisions of all of these ill red staters are tuned to NPR or BBC America or CNN. Fox and Sinclair promote themselves as life’s water, listen to us, and we will give you what you need, and listening to carnival barkers is an acquired taste that can be quite addicting to those living the lie.

    Why people choose to be ignorant is beyond me, not only is it painful, but those slings and arrows are like deadly boomerangs sucking the health right out of them.

    They love to listen to those described in Romans, “Their throat is an open grave; they have deceived with their tongues.” “Venom of asps is behind their lips.”

    They end up like those described in Proverbs, ‘By wisdom the shrewd man understands the way he is going, But the stupid are deceived by their foolishness.”

    But hey, it’s their choice, so I’m sure they’re good with it!

  2. i would agree, the red states down south still have a great work ethic,per se,but alot of the short life spans are due the working outside of safe practices. ive witnessed many times over,workers doing jobs that required tools and equipment,but were done without them ,because of costs,availability,and just dont have any…end results, many are killed or hurt.. they say its the way daddy did it to justify it. the lack of capital and the lack of wages,go hand and hand here. seems they are expected to get hurt or near hurt to prove a point..i deliver machinery,parts,supplies to small buisnesses and plain folk, many do not have access to equipment to off load my truck,hense,out come the mule and tackle…life is good,getting hurt sucks..up north, coastal west,even the south west,i seldom have this issue,and i find more people healthier,and more robust when working. scars and broken bones that didnt heal,or make a docs office,are more prevelent down own observations here,40 years hauling the oddball freight has its education,,and learning curve..i still have all ten toes and fingers…

  3. There are numerous factors to consider in calculating the life expectancy in various states. One factor that is overlooked, IMO, is the declining population in states like Indiana due to so many young people leaving the state for better opportunities in blue states. As this happens, the average age of the population increases, the state becomes even more conservative with the resulting lowering level of social services and thus a continued decline in life expectancy.
    Look for these factors to push Indiana to yet more of a decrease in life expectancy as Indiana’s working age citizens, the real driving forced in the economy, head for Illinois and Ohio both of which increased their minimum wage starting this year.

  4. The red states have a letter of the alphabet missing in their reasoning on health statistics. They seem to equate morality with mor’t’ality, and THAT, my friends is not a valid comparison.

  5. Well, listening to ANYTHING the Republican meme machine puts out is an exercise in folly and disinformation. Irrespective of blue v. red, the underlying factor to life expectancy and quality of life that avoids the deaths of despair situation is POVERTY. Mississippi, for example, is statistically the poorest per capita state in the country. They also have one of the highest obesity rates and the highest gun death rates.

    It’s capitalistic economics that throws the citizens under the bus who “don’t make good decisions”, another Republican B.S. line. As our income inequality gap continues to grow, watch for the death from poverty rates increase also. Gun deaths will increase. Hate crimes will increase. Despair and hopelessness from grinding poverty is our bane, as a nation, and the oligarchs just don’t care.

  6. Stephen,

    There definitely is an equitable relationship between mortality and morality. Read the book Mortality and Morality by Hans Jonas.

  7. Vernon, well well well put.

    You pounded that last coffin nail in the lid, not only insightful, but, a lot of factual truth-tellin in your comment.

  8. Merrill Benson, M.D., a wise and witty man, frequently reminded me that the increase in life expectancy was due primarily to a decrease in infant mortality. We were a more reasonable people for a period of time when we strove to limit infant mortality. I recently read that it is on the rise once again. That not only portends a significant decrease in life expectancy, but also says much about who we’ve become as a country and it’s not good for our collective future.

  9. We should have lost the civil war? The south wanted to secede from the union because they wanted to continue to enslave Africans. The Southern States believed they had the God given right to enslave blacks. To this day white supremacists continue to promote a false agenda about black criminality, sexuality, and intelligence. Racism is now institutionalized within American culture. South Carolina became the first State to secede. “A committee of the convention drafted a Declaration of Immediate Causes Which Induce and Justify the Secession of South Carolina which was adopted on December 24, 1860.[10] The secession declaration stated the primary reasoning behind South Carolina’s declaring of secession from the U.S., which was described as:

    …increasing hostility on the part of the non-slaveholding States to the Institution of Slavery …

    — Declaration of the Immediate Causes Which Induce and Justify the Secession of South Carolina, (December 24, 1860).[10]”

  10. I watched a piece on Hitler and Eugenics and the claims they made about the racial divide. Those in the “lower” parts of the society were a drag on the Germanic race, it had ties to an occult past.
    Of course it’s totally different here as we are a diverse nation that is more fully aware and tolerant of the needs of all in our society. Many people in the rural areas or Midwest have lost jobs that add to the GDP.
    Taxes are therefore lower. They voted against the establishment and many Democrats are silent Trump supporters.
    With the polls showing a possible 20% turnout amongst minorities for President Trump some are claiming the dynamics of this argument may change as there is more money going to the treasury than ever before from all sectors and even one stated a 40- 50 state sweep if this were to happen.
    The real problem is the unions that have led the way for wage increases will again take it on the chin. Republicans because historically after impeachment will regain the house, then have the senate and presidency too.
    Balance is the key to any nation and voters in the working class regardless of color or creed are going to vote jobs and economy. But if there is this shift will we be balanced as a nation.
    One more thing, what about the national debt?

  11. What, the Nanny states want less government? LOL

    By the way, propaganda works!

    It’s relatively predictable, but sad at the same time…voting against your self-interest requires a lot of people who are desensitized to the truth.

    The comment about losing to the south was flippant, but in my experience, very accurate. It’s why the Koch’s and Fox News have been very successful in their pursuits.

  12. John,

    Thank you, but it breaks my heart to have to point out these things. You might like to read my book, “Racing to the Brink: The End Game for Race and Capitalism”. It’s available on

    Happy New Year, and let’s try to stay sane.

  13. Paul Krugman is undoubtedly a smart man. But he answers his own question and doesn’t know it: Why does falling life expectancy track political orientation? Most of the red states (read rural and blue collar America) have been left behind in income, education, health and other resources, and left with “deaths of despair” as Krugman puts it.

    Most of liberal America who have better experiences don’t understand, don’t help, don’t care and are mockingly flip about it. Until we have a Marshall Plan for the rest of America, they will follow anybody whose slogan is “Make America Great Again.”

  14. Here is an interesting Web Site concerning life expectancy and other statistics.

    This is a very user friendly site.

    At least according to this Web Site, Indiana ranks number 39. Mississippi is the worst. If Indiana was a country it would rank Number 70 in the World.

    Medicare 4 All would go a long way to solving this problem. Some counties are losing hospitals and Doctors because they are not “profitable”.

  15. Barr would take us back to a Holy Roman Empire status where the pope approves the secular leaders (see Charlemagne – who was illiterate), a “Holy Roman Empire” which Voltaire famously noted was “neither holy, Roman, nor an empire.” Barr is working on the first phase of delivery of secular government to religious figures by insisting that the Constitution in Article II gives the executive (in this case Trump) “unitary executive powers,” aka dictatorship. The second phase is, having usurped all power and ending the Madisonian concept of Separation of Powers, the dictator yields his new power grab voluntarily or via coup to the pope or Graham or some other pretender to the connection between God and his flock. Trump is not the only delusional figure on the Potomac or at the badly misnamed Liberty University. Barr and Graham qualify.

    There is in fact an economic divide between north and south with the exception of some progressive southern cities such as Atlanta, Charlotte, Austin and others, but northern resentment of southern welfare status is tempered by congressional welfare handouts (i.e., taxes and lack of oversight) to Wall Street and other capitalists up north. (See the Trump-Ryan tax bill that delivered almost two trillion dollars to the rich and corporate class which has resulted in trillions in long term and current debt.) There seems to be some subtle understanding between the north and south power bases, i.e., we in the south won’t complain about congressional largesse to the Yankee rich and corporate class if you rich Yankees use your considerable influence to keep the welfare checks coming south (speaking of quid pro quos).

    Sheila today rightly points out some of the results of the economic disrepair between north and south as noted by Krugman, and she is on to something, but I here note that there is a bigger market north of the Mason-Dixon Line and that proximity to market has its own positives, and I also note that welfare status is alive and well in the north as a result of policy choices based on free market and other economic myths rich Yankees have taught us to endure.

    So what to do, other than the obvious? Encourage capital investment in the south, end gigantic tax cuts for the rich and corporate class via amendment and repeal, stop the tariff games etc. The list is long, but doable if, as Sheila notes, we have the will to make it happen, so let’s go to work on will which again, as Sheila notes, has a political component, so let’s remove Trump and his ilk while rescuing our democracy from criminal and religious fruitcakes, and the time to start? Yesterday.

  16. Let’s face it, neither latitude nor longitude have any impact on political party affiliation. What does is culture, what each of us observes about the behavior of others who we deem to be “like” us. Of course the behavior that we observed is different depending on the resources at their times, like climate, that were prevalent at the location where our migrating ancestors finally stopped traveling to and settled down in. Those resources determined what those ancestors chose to build, permanently to them, temporarily to the universe, at that location which set the goals that our cultures adapted to. We are much more effects instead of causes of the cultures that define us individually and the demographics that define us more collectively and temporally.

    What then does location have to do with political party choice? In our modern day lingua franca, it is a result of “branding”, advertising effective at managing customers by the emotional appeal most common among them. Politicians and parties are created not born and more and more there has evolved target geographies and therefore cultures, that each party’s appeal more effectively sells among. Combine that with political ploys like redistricting and the current mess just happens and gets more and more extreme as the advertising gets more and more branded. Politics doesn’t create who we are but who we are attracts politicians and branded political advertising to our area which reinforces the local culture.

    The national democratic solution is of course to eliminate political parties that are branded in ways counter to national as compared to local culture.

    That needs to be our New Years Resolution.

  17. One construct sometimes useful for wondering is that each of us have a “political horizon” that defines the limits to our concern about improving. Some have a very small political horizon limited their skin or their household which was very understandable, in fact necessary, among pioneers vs the frontier.

    When I wonder about the future though what I see among my circles of concern and influence is an entire world and human population. I don’t see any of us doing well unless all of us are.

    When this concept is integrated with my previous post the current political mess gets a little better illuminated.

    What is the alignment between your political horizons and your local political environment? Almost by definition the answer most prevalent must be “pretty good”. If not you are a local rebel but could be a global or national hero.

  18. Shiela, you mentioned, ” I’d also be interested in seeing a comparison of gun deaths in Red and Blue states.” This information will shed light on that matter. It is as you anticipated, worst for red states. See graphics #5, 8, and 11 in particular.

    5) States with more guns have more gun deaths
    A chart comparing US gun deaths with levels of gun ownership, by state.

  19. John,

    Sorry to blow your mind brother, LOL. Eugenics was started in England and the United States almost simultaneously. The Germans learned eugenics from the United States, they also learned about American Manifest Destiny, which was called “Lebensraum” in it’s German form, IE; blood and soil. Agrarian society, removing, what they considered inferior indigenous occupants of the land, along with slavery to work the land.

    There is a whole lot more to the story John, I’ll leave it there for now. The occult aspect is interesting but one would have to go into a lot of detail.

  20. Vernon–Hear! Hear! Agree with every thing you have said. I moved from Indiana to Nashville, Tennessee for jobs since my husband (Internal IT auditor) had no where else to go in Indpls as most of the companies left.

    TN did not expand Medicaid and the rural hospitals are closing at alarming rates. If you live in the rural areas the closest ER can be one hour or longer. You are dead if you need immediate assistance. We live between Mt. Juliet and Lebanon, TN and it can take an ambulance 20 minutes to get to our area but we at least live near several ER’s

  21. You gave me a great idea for my statistics courses at the University of Indianapolis. I am using life expectancy for data for our displaying distributions and correlation labs. It is pretty clear that life expectancy is higher in blue states than red and that life expectancy is highly correlated to the smoking rate and poverty rate. Email me if you would like to see copies of my assignments.

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