Why Politics Matters

Do you know folks who think political decisions don’t affect them? Who think voting is a waste of time? Among all of the other reasons they’re wrong, it turns out that a state’s political environment affects how long its residents live.

That was the astonishing conclusion of a study reported by Inc.The study ranked life expectancy in all 50 states, and came to some truly eye-opening conclusions. Among them: residents of Mississippi have the same life expectancy as residents of Bangladesh.

This truly is a fascinating study, pulling together reams of data to create “the most comprehensive state-by-state health assessment ever undertaken,” according to a press release. (The study itself was published in the Journal of the American Medical Association.) It’s unusual because most big studies examine the United States as a whole, and yet there’s a vast disparity of health and longevity among the states.

The report itself focused primarily on the data, rather than on differences in the public policies of the various states, but the following excerpt from the Discussion section is illuminating on that score.

Mortality reversals in 21 states for adults ages 20 to 55 years are strongly linked to the burden of substance use disorders, cirrhosis, and self-harm, and this study shows that the trends for some of these conditions differ considerably across different states. Case and Deaton have called some of these conditions “deaths of despair” and argued that they are linked to the social and economic status of white US adults.

States differ widely in their support of interventions to curb substance and alcohol abuse, and in the availability of programs addressing those dependencies. As far as the statistics on “self-harm,” the language is guarded, but clear: “self-harm” is suicide, and most people who kill themselves use a gun.

The availability of guns is a huge public health issue, and medical and public-health professionals have been arguing for a public health approach to gun violence more  forcefully in recent years. The American Public Health Association and the American Medical Association have both issued statements calling gun violence a public-health problem, and advocating more research. (The “Dickey Amendment,” passed by Congress in 1996, effectively prohibited the CDC from even studying the issue.)

The larger “take away” from the data is economic. States where the percentages of low-income Americans are highest have higher incidences of alcoholism, drug abuse and suicide. It shouldn’t come as a shock that Mississippi, where citizens have poor health outcomes also has an economy that ranks in the bottom of American states.

The environment also plays a part: states that do a better job of controlling hazards like lead and coal ash, for example, reduce illnesses and deaths from avoidable environmental pollutants.

All of these influences on lifespan–the economic health of a state, the efficacy of local environmental protection, the easy availability of guns–are direct outcomes of the  public policies supported by state and local lawmakers. (It will not shock anyone who follows these issues that the states with the worst outcomes tend to be reliably Republican.)

If the disaster that is Donald Trump hasn’t brought home the importance of voting, perhaps explaining to the disengaged that local political policies have a demonstrable effect on our lifespans and those of our families and friends will do the trick.

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