Death by Poverty

They're from an area that is a core of Trump support - Appalachia. And, while their Giant Orange Bloat promises them a future of milk and honey, they're dying in droves - of poverty.

Of course you won't find "poverty" listed on their death certificates. There's always some other, more proximate cause such as opiod overdose. But the real Grim Reaper is inequality and poverty.


Appalachians are dying faster than other Americans.

According to a new study, people in rural Appalachia suffer from rising infant mortality rates and falling life expectancy rates. As The Washington Post writes:

The country made gains on those health measures over the next two decades, but progress in Appalachia stalled. Between 2009 and 2013, the infant-mortality rate was 16 percent higher in Appalachia than in the rest of the country. People could expect to live 2.4 years less than their counterparts in the rest of the United States.

This is partly because of the opioid epidemic, and partly because many states in the Appalachian region refused to expand Medicaid. But Appalachia’s problems do not exist in isolation. Americans die because they’re poor.

None of this should come as any surprise. It's explored convincingly by two British epidemiologists, Kate Picket and Richard Wilkinson in their 2009 book, "The Spirit Level." Here's an excerpt from a review I wrote about their book in 2010:

The authors digest half a century of data from the industrialized democracies of Europe, North America and Asia and similar data from each of the United States. The nations and the states are ranked from least to most-unequal and against that are charted their respective performance on everything from mental health, drug use, physical health and life expectancy, obesity, educational performance, teen births, violence, imprisonment and punishment and social mobility. Whether it's a comparison of individual states or of various nations, the results are consistent. Societies with the greatest income inequality always have the poorest performance records. As wealth gap narrows, performance improves. As it widens, conditions worsen.

What's most impressive about Spirit Level is the depth of the research and the manner in which the authors foresee and pre-empt rebuttals about causation, ethnicity and historical influences. They examine and dispose of each of these at length relying not on professional opinion as much as half a century of observation and study.

The lesson of this book is that income inequality results in societal dysfunction. The authors show that this isn't merely a blight on society's poor but also has profoundly negative impacts on all social stratas save for the narrowest at the top. The likewise show that measures to curb income inequality benefit almost all social segments proportionally.