Wednesday, April 5, 2023

Politics and Mortality: Recognizing that Life Expectancy Is a Political Variable

 Russia’s invasion of Ukraine and its dim prospects for success invite discussions about the nation’s warfighting capability.  It takes people to fight a war and Russia seems to have a people problem:  they tend to be in poor health, and they die early.  This is not a new discovery.  Experts have long sought an explanation for such high mortality in a modern society.  In Russia’s Population Nightmare, it was suggested that such high mortality can be caused by poor social conditions.  That line of thought arose from data presented in an article for The Economist: Why did 250,000Britons die sooner than expected?

The English took note of an unexpected increase in mortality that ended a long period of increasing longevity.  More people were now dying earlier than could be explained by the pandemic or any other factor.  The conclusion was that this was an effect caused by political decisions made by the party in power.

“A government press release in 2021, to mark the creation of an Office for Health Improvement and Disparities, acknowledged that around 80% of a person’s long-term health is determined not by the care they receive but by wider social factors.” 

The concept of a “level of deprivation” is introduced to characterize population groups and assess mortality rates.

“Outside London, there is almost a perfect correlation between life expectancy in a local authority and its level of deprivation—as measured by a government index of a battery of economic and other factors. Our calculations also suggest that between 2001 and 2016 income and employment deprivation alone accounted for 83% of the variation between local authorities in life expectancy.” 

The austerity policies of the ruling party over the last decade are blamed for excess deaths. 

“During the 2010s, spending per person decreased by 16% in the richest councils, but by 31% in the poorest. Benefits were also cut. Our analysis of a detailed dataset of local government spending from 2009-19, compiled by the Institute of Fiscal Studies, a think-tank, shows that places with the largest relative declines in adult social-care spending and housing services were the ones that suffered the greatest headwinds to life expectancy.”

“…in Middlesbrough, the gap in life expectancy between the richest and poorest fifth of the population is 11.3 years for men and 8.8 years for women.

It has long been known that stresses generated by economic worries, a lack of dignity, a feeling of being unequal and other issues can generate ill health and an early death.  Psychologists know this, but politicians seem to refuse to consider it.  Social legislation can produce winners and losers, but the winners tend to be rich and powerful while the losers tend to be poor and powerless.

Legislators from both sides of the aisle seem intent to shore up the economic health of the Social Security Program by raising the retirement age for gaining benefits.  The argument made is that such a move is reasonable because the population is living longer now than it once did. In Why You Don’t Want to Raise the Retirement Age for Social Security, this argument was seen to be misleading because the life expectancy of those who need social security benefits the most are not experiencing much of a change.  The wealthy experience the greatest life extension.  The following chart supports this conclusion.


Life expectancy is tremendously variable across the United States.  The differences appear to be influenced by political policies implemented at the federal, state and local levels.  Paul Krugman addresses this observation in a New York Times article: Understanding the Red State Death Trip. 

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

“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.”

These data indicate that people tend to live shorter lives in regions that are traditionally Republican states, and longer lives elsewhere.  Krugman explores the trajectories of red-leaning Ohio with blue-leaning New York.

“…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.”

“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.”

Life expectancies that vary by as much as twenty years from place to place in the U.S.is ridiculous.  A dystopian era is not in our future—it has already arrived.  The data indicates that one political party pursues policies that produce improved health outcomes and greater longevity, while the other political party pursues policies that produce poorer health outcomes and much shorter lives.  Does anyone even care?

 



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