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Home Publications Blogs Beat the Press Are Improving Health Care Outcomes a Red-Blue Divide?

Are Improving Health Care Outcomes a Red-Blue Divide?

Friday, 05 April 2013 05:18

I hate to be partisan here (seriously -- I criticize the Obama administration all the time), but this map showing declines (blue) in mortality rates for women and increases (red) looks a lot like voting patterns. There is a lot of red across the south and Republican Midwest. The blue tends to show up in Democratically dominated states like California and New York and to be most highly concentrated in the Democratic parts of Democratic or mixed states, such as the Chicago metro area in Illinois or the Detroit metro area in Michigan.

Of course there are many factors that determine life expectancy and some of them will not be easily affected by state policies, especially in the short-term. But the relationship shown in the map is striking. Needless to say, if the color pattern were reversed we would be hearing this as the lead news story for the next century.

Comments (16)Add Comment
written by Last Mover, April 05, 2013 7:42
Needless to say, if the color pattern were reversed we would be hearing this as the lead news story for the next century.

Exactly, explained of course that in states where more women own more guns, they live longer.
written by JP, April 05, 2013 7:58
At least for my state, Idaho, the only one that I can add any comment, the author's conclusion of socio-economic factors being the primary variable is accurate. We have two blue counties......one represented by the wealthy playground of the Sun Valley area and the 2nd county, although remote and isolated, has a high density of professional and government employees, the nuclear energy laboratory. The areas of "no change" are the populous areas with their own unique but relatively stable economic engines and higher employment.
AZ best in Nation ?
written by AlanInAz, April 05, 2013 8:26
Arizona seems to be the only state that has no red zones - quite amazing given the economic and political situation here.
Very important point
written by Jennifer, April 05, 2013 9:04
Even more important is the authors conclusion, that it is social-economic factors that ultimately determine mortality. If we really want to improve people's lives, specifically to keep them from dying, the focus should be policies that actually get money to people such as increased wages.
@last mover +1
written by jamzo, April 05, 2013 9:14

katherine newman talks about the connection between red state vs blue state tax policies and health status

Regressive Vs. Progressive Taxes: Do Southern Tax Policies Kill Poor People?

Katherine Newman, dean of the School of Arts and Sciences at Johns Hopkins University, says the tax system in the South is killing poor people — literally.

Newman is also the co-author of “Taxing the Poor: Doing Damage to the Truly Disadvantaged.”


Taxing the Poor: Doing Damage to the Truly Disadvantaged (Wildavsky Forum Series) [Paperback]
Katherine S. Newman (Author), Rourke O'Brien (Author)

This book looks at the way we tax the poor in the United States, particularly in the American South, where poor families are often subject to income taxes, and where regressive sales taxes apply even to food for home consumption. Katherine S. Newman and Rourke L. O'Brien argue that these policies contribute in unrecognized ways to poverty-related problems like obesity, early mortality, the high school dropout rates, teen pregnancy, and crime. They show how, decades before California's passage of Proposition 13, many southern states implemented legislation that makes it almost impossible to raise property or corporate taxes, a pattern now growing in the western states. Taxing the Poor demonstrates how sales taxes intended to replace the missing revenue--taxes that at first glance appear fair--actually punish the poor and exacerbate the very conditions that drove them into poverty in the first place.

Paperback: 264 pages
Publisher: University of California Press; 1 edition (February 27, 2011)
Language: English
ISBN-10: 0520269675
ISBN-13: 978-0520269675
written by skeptonomist, April 05, 2013 9:28
State politics is a bad explanation because of the low rates in Mexican border states - really border counties - regardless of state politics. What is common to those border counties and coastal New England and absent in the central belt (or vice versa)? It may be more than one thing.
Total population
written by David Green, April 05, 2013 10:24
I wouldn't want to diminish whatever significance these findings may have for social policy. Nevertheless, it's important to consider what percentage of the U.S. population resides in these "red" counties. I suspect it is less than 10%. I can't find any reference to it through the links.
written by David Green, April 05, 2013 10:54
The bottom 1300 counties in population begin at 22,000 and descend from there. Even if these 1300+ counties average 25,000, that 10% of total U.S. population. That's the "red" population referred to in this data.
The other missing point...
written by GRD, April 05, 2013 12:25
Dean, aren't you missing the point that this would be more discussed if it was men rather than women?
written by Bloix, April 05, 2013 2:42
Skeptonomist, you're not seeing "lower rates" in the border counties - you're seeing declining rates. The base mortality rate in New England and southern Texas is almost certainly very different. I expect that the reason for declining mortality rates along the border is that there are fewer immigrants and more people who have lived all or most of their lives in the US. I'll bet if you looked at the actual mortality rates for each county the border counties would show up as fairly high.
Exact Opposite of "Illegal Alien" Effect
written by Anonymous Jones, April 05, 2013 4:27
I've seen multiple misinterpretations of the data with the same point as skeptonomist. That's what's so *amazing* about the data. The border states should be overwhelmed by immigrants and attendant socioeconomic effects, but we are seeing the exact opposite.

Sorry, but the map looks very similar to other red-blue maps I've seen. Could be a coincidence, I guess.
border states
written by pjm, April 05, 2013 5:19
As most of you probably know, you can't interpret data without having a sense of its reliability (e.g. do the numbers come from state governments and which are particularly bad or under-resourced for doing this type of data collection, does working in certain types of immigrant communities make data collection more difficult, etc). FWIW.
Border States Addendum
written by JP, April 05, 2013 5:28
Based on a recent conversation I had with a business contact along the Texas border........Do not discount the positive results from living few miles from a drugstore that can fill your perscriptions for a fraction of what our drugs cost on the north side of the Rio Grande. While he is in no danger of having to make life choices between food or medicine, others in the area are and this boon of cheap medicine availablity transfers to the health of their whole family.
You may be giving California too much credit. Please consider the Hispanic Paradox
written by Rachel, April 05, 2013 6:56

Hispanics, and in particular Mexicans, despite lower incomes, tend to be healthier than whites. Heart disease rates are signicantly lower (age-adjusted ratio of 0.8, according to the Office of Minority Health), and there are lower rates for the big four cancers, breast prostate, colon, and lung. And the rate of smoking is quite significantly lower.

True, the diabetes rate is high among Hispanics, but one would expect the CHD rate to be proportionately higher, and it is not. (If I recall correctly, researchers from Scandanavia sometimes travel to the north of Mexico precisely because it's there, in Pima country, where they can study NIDDM in its pure form, uncomplicated by heart disease. In Scandanavia, of course, NIDDM and CHD are joined at the hip.)

So it's not at all clear that the health care system is more intelligently managed in California than elsewhere. For example, not long ago, one city in the SF Bay Area had the disgraceful distinction of having the second-most neglected African-American Medicare population in the country!!!!
written by skeptonomist, April 06, 2013 9:25
As Bloix says, the map shows changes, so the explanation will probably also involve change, and an obvious source of that is migration and change in the nature of the population. Age is an obvious candidate - an aging population will have higher mortality - although it is not obvious why this would affect females more than males, and it is hard to believe that age would not be controlled for, although it might be tricky. The article does not say what variables were controlled for, although health-care factors were specifically mentioned. This is where political influence would be manifested first, in public support for hospitals, etc. What other political decisions would affect health?
written by watermelonpunch, April 07, 2013 1:10
Many have said, "Health care is not a right."

Does any more need to be said in answer to the post title question?

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About Beat the Press

Dean Baker is co-director of the Center for Economic and Policy Research in Washington, D.C. He is the author of several books, his latest being The End of Loser Liberalism: Making Markets Progressive. Read more about Dean.