The red-blue divide in American politics extends beyond culture and mask-wearing habits, but also health. In fact, residents of Democratic-leaning counties are seeing fewer premature deaths than in counties that consistently vote Republican.
This is according to new research from Brigham and Women’s Hospital, which specifically found that over the past two decades, a widening gap in death rates has been observed between American red and blue counties. While medical experts emphasize that, overall, death rates have continued to improve (despite a slight drop in life expectancy that began around 2014 and dropped further during the pandemic), counties that voted Democrat in the presidential election from 2000 to 2016 had a faster increase. decline in premature deaths than their Republican counterparts.
In other words, the “death gap” between red and blue counties is growing.
The Doctor. Haider Warraich believes that the political entrenchment of access to healthcare is likely to blame.
Looking at the 10 most common causes of death, the study published Tuesday in the British Medical Journal found that between 2001 and 2019, the difference in death rate between Republican and Democratic counties increased by 600%. (Notably, the study was completed before the pandemic.) Deaths due to heart disease, cancer, chronic lung disease, unintentional injuries, and suicide largely drove this gap.
Comparing more than 3,000 US counties across all 50 states, the team found that death rates declined by 22% in Democratic-leaning counties but only 11% in Republican-leaning counties, according to the study.
Reflecting on the findings, Dr. Haider Warraich believes that the political entrenchment of access to healthcare is likely to blame.
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“In the country we live in today, health policy has become more entangled than ever before,” he told Salon. “Even before the pandemic, and certainly during the pandemic, the overlap between political ideology and affiliation and personal health as well as public health was clearer than ever before.”
With improvements in medicine as well as social and economic conditions, experts generally expect premature deaths to decline over time. Life expectancy would increase and death rates would decrease; in most wealthy nations, this is exactly the trend we see. But for decades, life expectancy has lagged behind in the United States, and now it lags behind other demographically similar nations such as Canada.
While Dr. Warraich emphasized the difficulty of analyzing exactly which mechanism caused discrepancies, what is clear is that Americans residing in counties where Republican candidates win have the worst health outcomes.
It now appears that as political polarization has come to dominate American life, so have disparities in regions entrenched in opposing ideologies. While Dr. Warraich emphasized the difficulty of analyzing exactly which mechanism caused discrepancies, what is clear is that Americans residing in counties where Republican candidates win have the worst health outcomes.
Of course, a comparison between a Democratic-leaning urban area and a Republican-leaning rural area runs the risk of blurring a pre-existing and ever-deepening disparity. To avoid this, the authors compared politically oppositional municipalities in comparable regions.
“Overall, Democratic-leaning areas — whether cities or suburbs — fared better than their Republican-leaning counterparts,” Warraich said.
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Even in rural areas, they found that this was often the case. In 2001, Democratic-leaning counties in rural areas had more deaths per capita than Republican-leaning counties, but that relationship has since reversed. Since 2009, improvements have stalled in counties that voted for Republican candidates.
Now, Republican-leaning counties not only have a higher death rate than Democratic-leaning counties, but they’ve also shown the least degree of improvement of any other area, whether Democrat or Republican; rural, suburban or urban.
While the study’s authors contend that directly attributing Republican politics to worse health outcomes is difficult, the study offers some clues as to what may be driving this growing gap, particularly in rural areas.
“We know that over the last 20 years, health policy has become deeply polarized in this country,” continued Dr. Warraich. “One of the critical points of this partnership was the Affordable Care Act, specifically the expansion of Medicaid.”
Previous studies have shown that the expansion of Medicaid has led to more affordable health care and better health outcomes, including lower death rates. States that expanded Medicaid also had fewer rural hospital closures. However, Medicaid’s expansion of the Affordable Care Act was deeply divided along party lines. Many states that normally vote for Republican candidates have not implemented the change despite the health benefits for their constituents.
That said, health outcomes are still declining for all groups. While the pandemic has certainly taken a toll on those gains, Dr. Warraich noted that he and his colleagues found improvements across race and gender lines, indicating that social, economic, and health policy changes are effective in improving health conditions.
“We must aspire to return to a time when the political bent of where you live has absolutely no bearing on how long you live,” he added. “For that to happen, we have to accept the reality that, in addition to the usual social drivers of health, politics has also become a significant factor in the state of American health. It’s something we can avoid, but we have to face the reality of that health is no longer independent of politics in this country.”
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