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Generation of Lagging Life Expectancy Results from GOP Values

Patrick Henry rallied Virginians to go to war against the Crown by crying, “…give me liberty, or give me death!” Republican ideology seems to make liberty and death a package deal.

NPR reports that life expectancy in the United States, which already lagged other civilized countries by nearly four years before coronavirus, has plunged 2.7 years, while average life expectancy in other comparable nations dipped less than a year in 2020 and rebounded in 2021:

Ashley Ahn/NPR, life expectancy in U.S. and peer nations, 1980–2021, in Selena Simmons-Duffin, "'Live Free and Die?' The Sad State of U.S. Life Expectancy," NPR: Morning Edition, 2023.03.25.
Ashley Ahn/NPR, life expectancy in U.S. and peer nations, 1980–2021, in Selena Simmons-Duffin, “‘Live Free and Die?’ The Sad State of U.S. Life Expectancy,” NPR: Morning Edition, 2023.03.25.

Why are Americans, in the purportedly freest nation in the world, living shorter lives than folks in Europe, Australia, and Japan, not to mention the oppressed masses of Cuba and China?

The answer is varied. A big part of the difference between life and death in the U.S. and its peer countries is people dying or being killed before age 50. The “Shorter Lives” report specifically points to factors like teen pregnancy, drug overdoses, HIV, fatal car crashes, injuries, and violence.

“Two years difference in life expectancy probably comes from the fact that firearms are so available in the United States,” [University of Southern California gerontology professor Eileen] Crimmins says. “There’s the opioid epidemic, which is clearly ours – that was our drug companies and other countries didn’t have that because those drugs were more controlled. Some of the difference comes from the fact that we are more likely to drive more miles. We have more cars,” and ultimately, more fatal crashes [Simmons-Duffin, 2023.03.25].

Refusing to work together more and keep each other safe during the pandemic through science-based public policies and shouting “Freedom™!” at mask and vaccine mandates evidently didn’t help our cause. Coronavirus wiped out 25 years of life-expectancy progress in the U.S. But the graph above shows that the gap in life expectancy between the United States and other economically advanced nations has grown since the Reagan Administration.

The Shorter Lives report, published ten years ago, identified “five iconic American beliefs” that may help explain our lagging life expectancy:

Individual Freedom Strong beliefs in individual freedom, as expressed in the Declaration of Independence and Bill of Rights, remain powerful drivers in modern America (). As in other countries, Americans struggle with the natural tension between the state’s responsibility to safeguard public health () and the rights of people to freely make their own decisions about eating habits, tobacco or alcohol use, and other health-related risky behaviors (). Some personal freedoms carry special significance in the United States, such as the right to bear arms, a constitutional protection that does not exist in most other countries ().

Free Enterprise American society is committed to free-market capitalism and generally eschews restrictions on industries, especially when they impede economic activity or involve an expansion of governmental regulatory authorities. Many aspects of the political process, including the campaign finance system in the United States, give large donors and special interests a degree of influence over the formulation of policy than may exist in other countries (). Whether regulations are meant to protect public health, assist vulnerable populations, or meet other needs, a popular refrain in the United States is that effective solutions for social and economic problems are best achieved through the free market and more directly by families and their communities (see discussion on self-reliance, below). It is also true that a vibrant and growing economy is good for public health and for the health of the population, that anything that impedes economic growth and flexibility can have detrimental population health effects, and that strategies to boost employment and raise levels of income and wealth can yield important health benefits.

Self-Reliance In a nation founded by pioneers, many Americans believe in the responsibility of individuals, not the state, to solve personal problems: dependency on government welfare programs or “handouts” is discouraged. Thus, raising taxes for state-financed social or health programs is often unpopular with a large proportion of American voters. In contrast, there is a consensus in many other high-income countries around shared responsibility, solidarity, and the principle that a certain standard of living is a right of citizenship (; ); this consensus that may not be as pervasive in the United States.

Role of Religion Although the separation of church and state is a core principle in the United States, the United States is less secular than most other high-income countries (; ), and religious beliefs are often raised in public discourse. Sensitive public health policies, such as those related to contraception or adolescent sexuality, may not be as contentious in other countries (; ; ; cited by ).

Federalism The United States originated with a revolution against an overbearing government, and Americans continue to seek limits on the size and budget of government, including agencies responsible for social services, safety, and even health itself. The federalist principles adopted by the nation’s founders reserved limited authorities for the federal government and divided the remainder across the states, which in turn have delegated many authorities to counties and municipalities. Although this decentralized model is an ingenious strategy for separation of powers and is of growing appeal in other countries (), the resulting fragmentation complicates attempts to set national policy priorities that many smaller countries with more centralized governments can pursue more easily. It also creates an uneven distribution of resources that might not exist in countries with more centralized models and that often affect the neediest. For example, because authority for so many services rests with the states, the poorest Americans often live in states (e.g., Louisiana, Mississippi) with low tax revenue and small budgets for Medicaid, public schools, and social services [National Research Council and Institute of Medicine, Steven Woolf and Laudan Aron, editors, U.S. Health in International Perspective: Shorter Lives, Poorer Health, National Academies Press, 2013. Section II.8: Policies and Social Values].

Those values read like the Wheel of Fortune Kristi Noem spins each day to determine her next tweet. Dr. Ravi Sawhney, the former NIH official who helped start the Shorter Lives research project, proposes a policy platform that reads like the opposite of the Noem/GOP agenda and could help the U.S. catch back up with the longer lives of its peer nations:

Some of the policies he’s identified as helpful include universal, better coordinated health care, strong health and safety protections, broad access to education, and more investments to help kids get off to a healthy start. These policies are “paying off for them,” he says, and could for Americans, too [Simmons-Duffin, 2023.03.25].

Deep differences between people and communities often originate in value differences. I haven’t met anyone, here or abroad, who doesn’t value liberty, but the American expression of liberty seems tilted toward something like the libertarianism of my own misguided youth, when I thought I could secure the blessings of liberty to myself by my own efforts, without any reliance on or responsibility to the community around me. That rugged libertarianism turns out to be pretty flimsy when it comes to helping Americans live longer, enjoy their liberty, and pursue happiness. Canada, Germany, Australia, and Japan haven’t purchased their longer, healthier lives (Henry again) “at the price of chains and slavery“; they just pay a little more in taxes, stow their guns more responsibly, and take a little better care of each other. And somehow, Canadians, Germans, Australians, and Japanese still enjoy freedom of thought and expression and the rule of law.

19 Comments

  1. Richard Schriever 2023-03-29

    “…..since the Reagan Administration…..” and yet another bit of evidence toward Ronnie’s “sainthood” status.

    I have said for a long, long time now, Reagan = worst US President ever. Trump’s abhorrent personality and MAGAtry are not much in comparison to the long-term societal corrosion instituted by the continuing “trickle” of Reaganism and the Newt “world order” slowly soaking our nation.

  2. Mark Anderson 2023-03-29

    Why Cory, Republicans like weeding out those they can. It’s deep in their nature.

  3. Francis Schaffer 2023-03-29

    Well in South Dakota Covid-19 displaced suicide from the 9th leading cause of death to 10th.

  4. John 2023-03-29

    Sshhhh!! Let them keep digging, and killing their voters.

  5. grudznick 2023-03-29

    This is the continual fail of the Democrat Party in South Dakota. Look around at all the bloggings here on Mr. H’s blogging place. Most of you libbies just bitch and whine and throw hate about, and don’t offer a positive way forward. This is what is sinking the Democrat Party in South Dakota.

    I read today that they are looking for a new leader. Again. Again. Again. Is it the libbie hate that drives the failure, or the failure that drives the libbie hate? grudznick thinks this is a 22-catch canary conundrum.

    You fellows keep hating, grudznick will keep loving, and the better approach will just keep on winning, I am sure.
    (I exclude Mr. Barth, who breathes hard when walking downhill, from this generalization, as he is a lover for sure.)

  6. Donald Pay 2023-03-29

    Grudz, you are partly right, but when the smart people in South Dakota begin petitioning because they have gotten beyond that, it’s YOU who bitch and hate. Anything that comes from the people, you whine about. Your hate for real democracy is not lost on most of us here.

  7. grudznick 2023-03-30

    We are a constitutional federal republic, Mr. Pay. Not a democracy.

  8. Anne 2023-03-30

    Everybody with a functioning brain cell or two understands that a republic is a form of democracy.

  9. All Mammal 2023-03-30

    Oh, we do plenty more than nag, Mr. G. Word is bond. And we give you that grade A material so you can play devil’s advocate with your other chums. Besides, your love can’t help itself. Have a really, really nice day.

  10. larry kurtz 2023-03-30

    The SDDP has been hounding me for money yet they’re focused on Mrs. Noem’s bad behavior instead of targeting Howdy Doody Dusty. Mr. Johnson needs to be held accountable for coddling a would be dictator and building a war chest on the Big Lie, for his failures to support Medicaid, for voting against marriage, for not moving on immigration reform and for his culpability in driving talent from South Dakota. But he certainly knows which side of his bread gets buttered so the extreme white wing of the Republican Party owns him lock, stock and schlock. Johnson went from being a likable moderate to becoming just another tool of the oligarchs who hoard trillions in South Dakota’s banks and trusts because, hey, that’s where the money is.

  11. DS 2023-03-30

    NO, JOHN THUNE IT ISN’T “just premature to talk about it. ” (WHEN ASKED ABOUT A FEDERAL ASSAULT WEAPONS BAN).
    IN FACT IT IS TOO LATE. ANOTHER 6 ARE MASSACRED, 3 LITTLE CHILDREN AND 3 MUCH-LOVED ADULTS ALL RIDDLED WITH HIGH VELOCITY BULLETS DESIGNED TO RIP HUMAN FLESH, BONES, VEINS, ARTERIES AND INTERNAL ORGANS INTO A DEADLY GLOB WITH UNCONTROLLABLE MASSIVE BLOOD LOSS.
    IT IS TOO LATE FOR THE OTHER HUNDREDS OF INNOCENT KIDS MASSACRED AT SANDY HOOK OR UVALDE OR ANY OF THE OTHER HUNDREDS OF SCHOOLS.
    IT’S TOO LATE FOR YOU US SENATORS AND REPRESENTATIVES TO DO ANYTHING DEFINITIVE BECAUSE YOU ALL ARE EITHER BEHOLDING OR AFRAID OF THE NRA, OR YOU TRULY BELIEVE THEIR BS.
    IT’S TOO LATE FOR THE SURVIVORS, THE PARENTS, THE SIBLINGS OF THE MASSACRED. THEIR GRIEF IS EVER PRESENT.

  12. O 2023-03-30

    In terms of policy implications, since our life expectancy is declining, then it is time to roll back the GOP (steamtrained by the beloved Ronald Reagan) increased retirement age for Social Security benefits. The assumption was this great nation should raise the age of retirement because Americans were living longer; now that we are not, it ought to be time to roll those ages back downward.

  13. All Mammal 2023-03-30

    Midsummer funeral of child shot on the rez-

    Petá Zi Hoksila YELLOW FIRE BOY

    Dog days a’fleeting
    Standing room- no seating
    Shuffle in closer
    Press shoulder to shoulder
    We know why we are gathered here
    Summertimes the killing season
    ‘It’s hot out’ is a good enough reason
    We know why we are gathered here today, yes
    Dread heavy as lead without peace lain to rest
    We know. We dug the hole
    Knee high by the fourth of july
    Knee high is too young to die
    The heat in the tomb loosens the neckties
    Unconsciously the freed necks make it more clear
    We know why we are all here
    We hate being here and want to quarrel
    We want a physical pain and life sentence without parole
    Collective murder, death, suicide
    Two trite pallbearers assert our actions will be justified
    Baked leather would be more tender
    The dogs and the day and the bones never say surrender
    Strike up the requiem and join me in a bender
    We will be here forever getting gassed
    in the burning of the yowling, yellow dogged day no thing can outlast
    Thats why we are all here a’feeling useless
    Summertime’s livin is easy like slipping and skipping rope into nooses
    Lazily the pup’s shadow remains short for stretched hours
    We know why we stand here with necks like snapped stems of sunflowers
    We are gathered here in condemnation and know why
    Our congregation planted flat-footed in this skillet whilst we fry
    Too spiteful to the dirt to shed an itty bitty tear
    Without spite our high-noon fugal state wouldn’t have brought us all here
    Damn the thirsty hallowed ground
    She ate our kids and wound up round
    We are gathered here today dead and grey ashes and dust
    To pay
    our final respects before the pain and rage combust
    Our sincerest beseeching denied
    will burn the whole damned thing sky high
    Let it be done
    Let the dog days lie.
    DU

  14. e platypus onion 2023-03-30

    All the hate magats get is only what they deserve. Guns don’t kill people, magats do

  15. Donald Pay 2023-03-30

    O is correct. My retirement age increased by one year due to the changes during the Reagan Administration. I can’t recall being too concerned with it back then, but as I neared the age (65) at which I would have retired, I was a bit peeved.

  16. Francis Schaffer 2023-03-30

    Well let me try to provide solutions. As a ‘libbie’ some of my solutions for the ills are; universe health coverage, affordable housing, and universal basic income. As maternal stress is the best predictor of future addictive behavior these 3 family stressor need to be eliminated for our future. As a society, we need to rehabilitate instead of incarcerate. SD DOC annual budget is currently near $120 million. Now apparently there is talk of new prisons. Neither is an investment in civil society. Now how to pay for this? Remove all special income definitions from all tax codes using only the ordinary income definition and tax everyone as equals. I am certain this is insufficient an explanation of solutions, yet I tried.

  17. John 2023-04-01

    “That the US has a poor record on life expectancy is nothing new. For the best part of a decade, American lives have grown progressively shorter relative to peer countries. But beneath the surface, several striking details demand our attention and an urgent effort to reverse the trend.”

    “This means that the average American has the same chance of a long and healthy life as someone born in the most deprived town in England. If you then explore how life expectancy varies across the income distribution in both countries, the results are not pretty. This is especially alarming when you consider that the UK is far from top of the class when it comes to life expectancy in Europe.”
    https://www.ft.com/content/653bbb26-8a22-4db3-b43d-c34a0b774303

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