There are many reasons, but it’s becoming more a matter of state policy than just federal government. It is beginning to shape the economic, family, environmental and behavioral conditions that affect people’s well-being. Some states have expanded social safety nets, raised minimum wages, and provided earned income tax credits while using sales taxes to discourage action. Smoking — has harmful health consequences.Other states moved in the opposite direction.
Researchers say the consequences of this growing polarization are clear. The overall health condition of the country continues to deteriorate. Americans can expect to live as long as they did in 1996 — 76.1 years old, with a shorter life expectancy due to high rates of chronic disease, childbirth mortality and covid.
Nancy Krieger, a social epidemiologist at the Harvard TH Chan School of Public Health and co-author of one of the two studies, said: “It’s about looking at the actions of different actors, some of whom have much more power than others to set standards, make demands and allocate resources. increase.”
Krieger said it was fair for people to ask elected officials, “Are we doing what we should be doing to protect our health?”
Researchers at Harvard University analyzed data on covid-19 mortality and stress on hospital intensive care units across 435 congressional districts from April 2021 to March 2022. Also, the lawmaker’s overall voting record, how she voted on the four coronavirus relief bills, and whether the state’s governor and legislature are controlled by one of her parties.
The study, published this month in the Lancet Regional Health-Americas, found that the more conservative the voting records of Congressmen and state legislators, the more Along with vaccination rates, age-adjusted covid mortality rates are high even after accounting for race, education, and income characteristics of each congressional district.
Covid mortality was 11% higher in states with Republican-dominated governments and 26% higher in areas with conservative voters. Similar results were obtained for capacity.
The findings cannot be explained as characteristics of the economic and social conditions of people living in different congressional districts, Krieger said. . [that members] represent. It suggests that something is going on through the political process related to the political voting patterns of elected officials,” she said.
Public policy, along with public opinion about masks and vaccines, and a constellation of other factors, have helped change the pattern of covid-related mortality in the country.
Washington Post analysis of covid data from the Centers for Disease Control and Prevention We found a change in age-adjusted mortality from covid from April 2020 to this summer. In the early days of the pandemic, communities of color, especially Black people, were disproportionately burdened. But by mid-October 2021, that pattern had changed, and white Americans, who form the core of the Republican base, were sometimes dying at rates higher than those of other groups.
Still, the unequal burden of death and disease goes beyond covid.Inequality cracks put communities of color at higher risk of chronic diseases that weaken their immune systems.This is a systemic race It reflects discrimination, public health experts say.
“Too often, public health and medical action are understood to be actions at the individual level. Politicians act. Institutions act,” Krieger said. “If your congressional representatives are encouraging you to wear a mask, or not to wear a mask, those are very different messages.
The divisions in American politics have become more bitter and polarizing, but they haven’t always been that way.
From the 1930s to the 1970s, large-scale investments were made to improve the lives of vulnerable people across the country. The Social Security Act of 1935. Medicare and Medicaid in 1965. Before these federal programs, the country was a hodgepodge of wildly changing state programs, said a political scientist at the University of Washington. Jake Grumbach, co-author of a study on the impact of state policies on working-age adult mortality, published in the journal PLOS One in October.
Everyone benefited, but previous federal legislation “lifted poorer states faster,” Grunbach said, adding that “we saw convergence between states” on health outcomes. .
Then came the collapse of the New Deal coalition. Nationalization of media. Increased funding for politics. And he explored the social upheavals of the 1960s and his 70s—the civil rights movement, the women’s movement, the sexual revolution, environmentalism.
“All of this contributed to the polarization,” Mr. Grumbach said, adding that the split “started in the ’90s” and “has really taken hold since 2010, a time when we’ve seen real radicalization of the Republican Party.” There are,’ he added. Trump. “
The deadlock and lack of productivity that polarization causes, he said, means that “if you want to do something, you have to do it at the state level.”
State elections have been a hotly contested area of the 2022 midterm elections. Did not produce the expected red wave.
of 36 gubernatorial electionsDemocrats flipped the three seats they were trying to win, and Republicans flipped one, so the country’s governors are now split roughly evenly along party lines. , passed a ballot initiative to protect abortion rights and expand access to health care. They opposed taking their own measures.
“People pick their noses and vote for candidates who represent their party, but they don’t have to hold their noses when voting on policy issues,” says Erin O’Brien, a political scientist at the University of America. Boston, Massachusetts.
That’s because conservative politics weighs identity as much as concern — even though health care is still very important, O’Brien said. How it is operated, assembled and used is different,” she said.
So while Grumbach’s recent study suggests that “if people want to live longer and healthier, they need to implement policies related to Democrats, not marijuana,” O’Brien says: says so. that? “
A sense of freedom brought about by a fatalistic acceptance that life is hard, she said, underpins many conservative communities. “If freedom means having a gun, and if they have access to that gun when they’re having a depressing episode, they’re not there to spoil other citizens,” O’Brien said. said.
According to an October report, if all states implemented liberal policies on the environment, gun safety, criminal justice, health and welfare, labor, marijuana, the economy and tobacco taxes, 170,000 people would die in 2019. More lives should have been saved. , about 217,000 people would have died that year if states had adopted conservative versions of these policies. This “equates to 600 passenger planes crashing every day per year,” the study said.
According to the report, the largest projected number of lives saved – about 201,000 – came from a more complex ideological menu of conservative marijuana policies and all other liberal policies. , the emergence of more conservative state policies and the migration of population to states governed by these policies only partially explain why life expectancy in the United States is abysmal compared to other high-income countries. He pointed out that it was not explained.
Jennifer Callas-Montes, director of the Center for Aging and Policy Research at Syracuse University and lead author of the October study, said the findings show: —just scary to think about—increased risk of dying before age 65.”
The Midterm Vote initiative demonstrated the direct role voters can play in determining state health policy. South Dakota voters passed legislation to expand Medicaid, arguing earlier that more people would be covered by health insurance than allowed under the Affordable Care Act. Joined voters in six states.
Despite 11 holdout states refusing to expand Medicaid and ongoing legal challenges, Republican health policy expert Jennifer Young says the issue has become “a little less politicized. “There is a growing awareness that people’s access to health insurance is being compromised.” And the state is leaving money on the table.
“The fact that these states continue their voting initiatives to push for some decision mirrors their actions in states that have not yet done so,” Young said during a panel discussion at the Kaiser Family Foundation. “I don’t want to be naive or Pollyanna, but I think it’s a more reasonable topic to discuss today than it was five years ago.”
Another issue that spooked Republicans during the midterm elections was abortion rights voted in five states after the Supreme Court. overthrow Law vs Wade in june.
California, Michigan and Vermont all have abortion rights in their constitutions, and voters in Kentucky and Montana have rejected anti-abortion measures.
“We’ve seen the state take a step back from the brink of the most aggressive intervention,” Young said. “Hopefully that’s a lesson the party will take seriously.” He added that he doubted he would abandon his “active stance against
But she said, “That’s not what voters are telling us.
When With abortion services no longer legalized nationwide, university researchers estimate that maternal mortality could increase by up to 25-30%, exacerbating the country’s maternal mortality and morbidity crisis. increase. Americans have shorter life expectancies than people in other countries because it’s the worst place to give birth among high-income countries.
The country is entering a period in which some political scientists say there will certainly be difficulties and deadlocks at the federal level. I expect some movement.
One of the reasons Democrats kept the Senate is because voters “fear of losing the protections people care about, whether it’s elections, abortions, or, frankly, health care in general.” Democratic health policy strategist Chris Jennings said. “Democrats feel somewhat reassured, both by their advocacy of policies and their positions to protect those rights.”
Health care is a priority agenda “for better or worse,” Jennings said, warning that “sometimes we have to lower our expectations about how big and wide-ranging policy outcomes can be.” “There is a bipartisan interest in post-incarceration collective compensation in the Medicaid program. There is a real interest in postpartum care.”
Political scientists also say there may be a bipartisan move on expanding the flexibility of telemedicine.
“It won’t be easy,” Jennings said at the same Kaiser Family Foundation panel.
