According to economists Anne Case and Angus Deaton, voting Republican will kill you.
In September, Case and Deaton released their findings at the Brookings Institution that life expectancy has plummeted for all Americans since the pandemic, especially among Americans without a college degree. Why don’t other countries have this problem? According to Case and Deaton’s New York Times column, it’s because those countries don’t have Republican-controlled states. Republicans, after all, are responsible for weakening unions, not raising minimum wages, and tolerating pollution and cigarettes. The Washington Post piled on, lamenting that Republican-led states often don’t require people to wear seatbelts and don’t tax cigarettes enough. These lapses, they argue, explain a large share of diverging life expectancy between those with and without college degrees.
In addition to being wrong, annoying, and condescending, this argument also distracts from the policy failures that have caused the national life-expectancy decline. Those failures are bipartisan, and they require smarter solutions than finger-pointing at one party.
Reasonable people can disagree about these economic issues and to what extent state governments should discourage smoking or punish people for not wearing seatbelts. But state policies have differed for decades, and America’s life-expectancy decline is a relatively recent development, tracing back only to about 2015.
Among the most significant contributors to Americans’ declining life expectancy is increasing opioid use, especially fentanyl use. The reasons for this are unique to the United States. Physicians made a well-intentioned but ultimately tragic change in prescription practices, regularly prescribing opioids to reduce pain, which had the effect of increasing opioid use, addiction, and overdose. Also, people who don’t work report higher use of opioids and more pain in general. It’s not clear in which direction the causality runs: Does being hooked on opioids lead to poor economic prospects, or do people with poor economic prospects turn to opioids? It may be a bit of both; members of rural communities with more depressed economies tend to have lower life expectancy and higher opioid use. This may partially explain the disproportionate life-expectancy decline among non-college-educated Americans, and especially among high school dropouts.
In any case, it is not clear that supporting unionization or higher minimum wages would solve these problems. Jobs are already going to countries that pay lower wages; expanding unionization would only make the problem worse by making labor more expensive. Raising minimum wages could boost some workers’ incomes but would tend to lower employment for marginal members of the labor force. These proposed solutions do not address other potential culprits, including the rise of single-parent families and loneliness, that contribute to poorer mental-health outcomes and can increase a person’s propensity for drug use.
Case and Deaton noted that cardiovascular problems and the generally poor health of lower-income Americans contribute to their disproportionate decline in life-expectancy. Brookings’s Caroline Hoxby cautions against reading too much into this cohort’s disproportionate life-expectancy declines during the Covid years, since those Americans often could not work from home and were thus at greater risk of catching the disease. Even before Covid, however, poorer Americans had higher levels of obesity and less access to quality health care and doctors. Once again, it is not clear how Republicans are at fault here, as not much evidence exists to show that expanding access to Medicaid improves health outcomes. Many of the issues causing these disproportionate life-expectancy declines in lower-income communities are related to obesity and other metabolic disorders. If anything, the left-leaning public-health community has worsened these problems with its concerns about stigmatizing obesity.
Republican states showed a lower uptake of the Covid vaccine, which may have increased those states’ Covid deaths; if so, however, this illustrates nothing so much as the toxicity of partisanship. After all, before Joe Biden’s election, Democrats were the vaccine skeptics. To address declining national life expectancy, we will have to transcend partisan politics. Blaming Republicans for killing people is part of the problem, not the solution.
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