Red states are bad for your health

The value of health literacy extends far beyond the boundaries of COVID-19. Education leads to fact-based empowerment, and an educated healthcare consumer can be a potent change agent. Poor health literacy is one of the reasons why life expectancy is lower in Republican-led states, and the problem has been growing worse for decades. The highest rates for covid-19 deaths and murders are found mainly in red states.

Low levels of health literacy are a source of health disparities among disadvantaged communities and minorities. Of the nearly 77 million Americans who struggle with health-related reading tasks, 65% are minorities. The issue of health literacy and minority communities is not new. Still, it has been rediscovered because of COVID-19, precisely because of the problem of vaccine hesitancy driven by historical distrust of government-sponsored healthcare programs and a perceived lack of clinical trial diversity.

The health-care options in any given state are likely to depend on which party controls the statehouse. That dictates access, cost, and coverage, particularly for the roughly 17 million people who buy their insurance and the 29 million people who lack it entirely. In the book “Homeland Insecurity … American Children at Risk,” the author suggested that kids in red states are more likely to lack health insurance, live in poverty, and die early.

The fastest-growing states in terms of the population over the last decade, including Texas, Florida, and Georgia, (red states) consistently rank last regarding health and health care. This is because these states have large numbers of uninsured adults, high levels of premature death from treatable conditions, less investment in public health, too many people with mental illnesses unable to get the care they need, and residents facing mounting insurance costs that make health care less affordable than in many other parts of the country,according to the Commonwealth Fund.

Take Texas, which added 4 million people, the most of any state, over the past decade. Texas ranked 42nd overall in our measure of health system performance — primarily because of how hard it is for people in the state to get and afford the health care they need. It has the highest uninsured rate in the country, and fewer of its residents report having a regular source of health care — an important marker of how well the health system is working. Texas also has the most significant number of residents who said they skipped health care they needed because of cost, and health insurance costs take a more substantial share of people’s incomes in Texas than in almost any other state. Texas is also one of 14 states that still have not expanded Medicaid under the Affordable Care Act provisions, leaving millions of working people uninsured.

Florida, which grew by nearly 3 million people, has a similar story. It ranks 41st overall, and its residents face many of the same health care access and affordability challenges as people living in Texas, with many uninsured and high insurance costs. Another fast-growing state, Georgia, ranks 46th overall. Georgians face similar health care access problems as Texans and Floridians, but what stands out is its preventable mortality: Georgia has one of the highest rates of premature (before age 75) death from treatable conditions and one of the highest rates of infant mortality — ranking 42nd on both measures. All three of these states rank poorly in other areas of health care too.

Politics of red states are killing their residents. Conservative governors increasingly use preemption, the authority to override local governments, to block liberal health policies (e.g., indoor smoking bans),” he notes. States have preempted local regulations on nutrition (e.g., menu labeling, food deserts), and, as of 2013, 45 states had enacted statutes to limit local firearm regulations.

The difference between red and blue states might be related to gun laws, higher levels of poverty (where red states also predominate), low education levels (also worse in red states), cruddy health care (identical), or relatively low economic opportunity (again, red states dominate the worst states).

Whatever the specific reason, the governing philosophy of right-wing states (e.g., low spending; prioritization of cultural wedge issues; anti-elitism) leads to deadly results. Maybe it’s time they stop spending their political energy persecuting gay kids, banning books, outlawing abortion, and fanning culture wars. They have plenty of systemic problems they’ve failed to address while busying themselves with MAGA crusades. Red-state voters should see why their states have fallen so far behind in so many categories.