I don’t usually find important articles or editorials in my local paper, but this morning I found two. The first, “Causes Found for Higher Death Rates” by Noam Levey of the Tribune Washington Bureau says that recent studies show “higher-than-expected death rates” among middle-aged whites. This symptom of social deterioration – not found in other developed nations – is caused by “stagnant progress against heart disease and other common illnesses,” increased drug and alcohol abuse, and an increase in the number of suicides among whites in their 40s and 50s.
“The problem was worst in several states stretching from Appalachia south and west across the Deep South. Mortality rates were 60% to 76% higher than they would have been if the trends of the 1980s and 1990s had continued in West Virginia, Kentucky, Tennessee, Alabama, Mississippi, Arkansas and Oklahoma.
By contrast, the gap between expected and actual mortality rates was smallest in New York, New Jersey, California, Connecticut, Minnesota, Massachusetts and Illinois.
‘There is clearly something going on that is troubling,” said Samuel Preston, a University of Pennsylvania demographer who headed a 2011 National Academy of Sciences panel that looked at life expectancies in high-income countries. ‘It points to a serious national problem.’
Evidence has been emerging for years about worrying life expectancy trends in the United States, as women and men in some parts of the country died younger than their counterparts did a generation ago. The focus on middle-aged whites intensified when a pair of Princeton University economists – Nobel laureate Angus Deaton and Anne Case – published a blockbuster article last year in the Proceedings of the National Academy of Sciences showing that since 1999, death rates had increased specifically among non-Latino white Americans ages 45 to 54.
Researchers haven’t found a similar problem among African-Americans and Latinos, though a health gap between whites and nonwhites remains. Nor has the problem emerged among working class residents of Western Europe or other industrialized nations.
‘The question is: Is it the social safety net?’ Case said in an interview. ‘Are working class people more protected in Europe? Is it universal health care?’
To explain the reversal in decades of progress among whites, Deaton and Case pointed to a dramatic increase in deaths attributed to drug poisoning, suicide and alcohol-related liver disease, which killed twice as many working-age whites in 2014 as in 1999.
Commonwealth Fund researchers, working with the same data from the federal Centers for Disease Control and Prevention, looked beyond those causes, and also found a marked slowdown in what had been a steady improvement in death rates linked to illnesses including heart disease, diabetes, and respiratory disease. ‘Mortality rates for middle-age whites have stopped declining or actually increased across a broad range of health conditions, including most of the leading causes of death,’ the authors wrote.
The states showing the worst trends have high rates of poverty as well as some of the highest rates of smoking and obesity in the country. They also historically have had among the weakest health care systems, with high rates of people lacking insurance and having poor access to medical care.
The deterioration of the American political system over many years of political corruption, fixed elections, and politicians ignoring the wishes of their constituents – at least as reflected in nationwide polls – has led to both extremely low voter turnout and a latching on to anything that seems to promise change. Eugene Robinson, in an editorial in today’s Washington Post, focuses on the latter phenomenon, as evidenced in voter enthusiasm for only two of the current presidential candidates: Donald Trump and Bernie Sanders. Robinson, alarmed, describes Trump as “a populist tycoon, with zero experience in government, who vows to round up and expel 11 million people” and Sanders as “a self-declared socialist” completely out of the recent mainstream of the centrist Democratic Party.
“As individuals,” Robinson says, “Sanders and Trump are hardly cut from the same cloth; one rails against billionaires and one is a billionaire. Their supporters probably wouldn’t mix well at a cocktail party. But there’s a reason these are the only two candidates who regularly fill basketball arenas with passionate, standing-room-only crowds: both call for fundamental change. There are even specifics on which Trump and Sanders agree. Both denounce free-trade agreements, such as NAFTA and the new Trans-Pacific Partnership, saying they depress U.S. wages and send jobs to other countries. Sanders supports universal single-payer health care, which he describes as ‘Medicare for all.’ Trump wants to repeal the Affordable Care Act – a position every Republican candidate is required to take – but has also been a consistent supporter of universal care, though he doesn’t specify how he’d bring it about. Trump and Sanders are also both skeptical of the establishment consensus about America’s role as the world’s policeman. Sanders would use military force only as a last resort, while Trump would let Vladimir Putin take charge of cleaning up the Syria mess if he wants to.
Perhaps most significant of all, Trump and Sanders both portray traditional politicians as bought and paid for by powerful monied interests. Sanders rails against big banks, powerful corporations, and wealthy plutocrats who bend the system to their will. Trump speaks from personal experience, blithely telling audiences how he regularly wrote big checks to politicians in both parties to buy access and influence.
The system is rigged, these insurgents say. Your elected leaders are working for themselves and their puppet-masters. They couldn’t care less about you. Sanders’ solution is a grass-roots ‘political revolution.’ Trump, to the extent he offers concrete proposals, seems to promise the muscular use of presidential power. But both have touched a raw nerve, and our political parties had better pay attention.
As the caucuses and primaries begin, the RealClearPolitics poll averages show that 36% of Republicans favor Trump and an additional 10% support other candidates who’ve never held elective office. On the Democratic side, 37% of Democrats say they favor Sanders. These numbers show that there are huge numbers of Americans whose voices aren’t being heard, voters who are tired of half-measures and unkept promises.