Republicans aren’t just at war with each other in the U.S. House of Representatives: They’ve been quietly at war with their own constituents for decades. The Washington Post has a lengthy case study of what this has meant for one state taken over by Republicans: Ohio. One study the Post cites estimates that roughly “1 in 5 Ohioans will die before they turn 65…. a similar life expectancy to residents of Slovakia and Ecuador, relatively poor countries.”
The Post looks at Ashtabula County, Ohio, and compares it with its neighbor across the Pennsylvania border, Erie County, and the next county over, Chautauqua in New York state. The three counties have all experienced the same economic woes over the past several decades, as industrial jobs disappeared and wages fell. “But Ashtabula residents are much more likely to die young, especially from smoking, diabetes-related complications or motor vehicle accidents, than people living in its sister counties in Pennsylvania and New York, states that have adopted more stringent public health measures,” the Post found.
The primary difference: Democratic versus Republican lawmakers and leaders. Democratic states have enacted legislation to protect public health—including measures like seat-belt laws, high tobacco taxes, and more generous Medicaid and safety net benefits. Ohio and other Republican states have not. The Post cites a study by Ellen Meara, a health economics and policy professor at the Harvard T.H. Chan School of Public Health, in which she looked at geographic disparities in premature mortality over recent decades. It’s not just geography, she told the Post. It’s politics.
Meara’s paper doesn’t explicitly say that. Instead, she and her fellow authors say that “health disparities across states may arise from long-run changes in state policies or health ‘investments,’” including things like “anti-smoking policies, expansions of Medicaid, income support, and norms around health behaviors.” In other words, the kinds of investments blue states—like California, Pennsylvania, and New York—have made.
Three decades ago, California and Ohio had comparable health outcomes, ranking in the middle of all the states. Since then, the more proactive and progressive California has seen its premature-death rate fall significantly. Ohio has not. “By 2017, California had the nation’s second-lowest mortality rates, falling behind only Minnesota; Ohio ranked 41st,” the Post’s analysis found.
While Ohio is the specific case study for the Post, they found the divide has increased nationwide.
Today, people in the South and Midwest, regions largely controlled by Republican state legislators, have increasingly higher chances of dying prematurely compared with those in the more Democratic Northeast and West, according to The Post’s analysis of death rates.
Those disparities are bound to increase over the coming years. Some of these studies are still looking at pre-COVID-19 statistics. As Charles Gaba has been chronicling for the past few years, the death rate from COVID-19 is higher in Republican-leaning areas. Republicans have made the COVID-19 pandemic a political fight, like in Florida where the actual person in charge of public health calls the vaccine “anti-human” and is urging Floridians to avoid the newest vaccines.
Studies are soon also going to have to account for states that have banned abortion and criminalized reproductive health care. A study last year from the Commonwealth Fund determined that “maternal death rates were 62 percent higher in 2020 in abortion-restriction states than in abortion-access states (28.8 vs. 17.8 per 100,000 births).”
One of the factors behind that is on full display in parts of Idaho, where there are no practicing OB-GYN physicians any more—they’ve left the state over fear of prosecution. That makes giving birth a lot more dangerous. Making it even worse, the state is now going to prosecute emergency room doctors who provide abortions to stabilize a patient’s health.
Gun safety legislation—or the absence of it—is another key difference contributing to higher premature-death rates in red states. In 2021, the states with the lowest rate of gun deaths were Hawaii, Massachusetts, New Jersey, Rhode Island, and New York. Mississippi, Louisiana, Wyoming, Missouri, and Alabama had the highest gun-death rates.
In all of these states, the so-called “party of life” has consistently proven that what it’s really about is actively enabling premature death. They’ve proven that by refusing to save lives by expanding Medicaid, by warring against basic science, by keeping people hungry and vulnerable, and by criminalizing doctors. All in the name of so-called “family values,” “freedom,” and the “sanctity of life.”
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