The Washington Post conducted a study trying to get to the bottom of why American life expectancy was shrinking. What they found was that red-state politics was killing people at an alarming rate. They studied three adjacent counties along Lake Erie: Ashtabula in red Ohio; Erie in purple Pennsylvania; and Chautauqua in blue New York. The 2020 death rate in the Ohio county was 650 per 100,000 people, compared to about 490 in Pennsylvania and 540 in New York. Link to the Washington Post article here.

Starting in the mid-1980s, Ohio's government has become increasingly dominated by Republicans, and it has reflected poorly on its residents' health.

Ohio sticks out — for all the wrong reasons. Roughly 1 in 5 Ohioans will die before they turn 65, according to [director of the Center for Aging and Policy Studies at Syracuse University Jennifer Karas] Montez's analysis using the state's 2019 death rates. The state, whose legislature has been increasingly dominated by Republicans, has plummeted nationally when it comes to life expectancy rates, moving from middle of the pack to the bottom fifth of states during the last 50 years, The Post found. Ohioans have a similar life expectancy to residents of Slovakia and Ecuador, relatively poor countries.

The Post found that a number of political choices, including less spending on health care, lower tobacco taxes and tobacco education spending, and more lax seat belt laws, have contributed to the Ohio county's poor life expectancy figures.

Of course, you can guess which county's residents died of Covid at a far higher rate than residents of the other two.

Many of the state's public health outcomes are a direct result of political decisions, [associate professor of health policy at Ohio University Dan] Skinner and other experts say, pointing to differences in Medicaid and safety net funding, as well as tobacco taxes and highway safety laws between Ohio and its neighbors. They note that Republicans' stranglehold on the legislature, after defying repeated court orders to redraw state voting maps, has protected those politicians from the consequences of their votes.

The article makes convincing cases for all these factors, but to use cigarette taxes as an example: Around 2000, all three states started increasing cigarette taxes. But by 2020, the tax rate per pack was $5.35 in New York, $2.60 in Pennsylvania, and only $1.60 in Ohio.

In 2000, all three counties had similar smoking-related death rates for ages 35-64 years old of about 200 per 100,000. By 2020, that rate had dropped to 150 in New York and Pennsylvania, but held steady at 200 in Ohio.

For years, Ohio's leaders rejected cigarette tax hikes, redirected money from tobacco control programs and took other steps that antismoking advocates warned would haunt them. And today, nearby states have shown more progress in curbing smoking. https://t.co/a3BR56zEEF pic.twitter.com/hADxKACuqh— The Washington Post () October 4, 2023

Ohio state legislators even prevent municipal governments from imposing their own, stricter laws on tobacco. Republicans are for local control, but only when it suits them.

[Ohio state House majority floor leader Bill] Seitz defended Ohio Republicans' efforts to limit cities' powers, saying it's in keeping with his party's philosophy: "We're for local control, but we're not for local out of control."
After all, he argued, lawmakers must balance safety with liberty. "Are we all going to be in a little bubble where no germs can infect us and no bad things can happen to us?" he asked.

Ohio Republicans proudly extoll their virtue of Freedom, but I really wonder whether residents of New York and Pennsylvania feel any less free. In fact, with less gerrymandering and thus more democracy, and more spending on positive health outcomes for themselves and their neighbors, I'd guess the New Yorkers and Pennsylvanians feel more free, and less trapped.

By the way, Seitz, who helps block tobacco tax increases, doesn't smoke. For a very good reason.

The 68-year-old Seitz, who smoked for 50 years before developing kidney cancer and having a kidney removed this summer, said he's unmoved by his own brush with the health system — even if it led him to finally kick the habit.
"I'm not going to turn into a smoke Nazi just because I used to smoke and I don't anymore," Seitz said.