Reunification
Following the 2016 U.S. presidential election, a Washington Post journalist observed a particular economic split between counties carried by Donald Trump and counties carried by Hillary Clinton. The 472 counties that Clinton won were mostly metropolitan, while the 2584 counties in Trump’s column were mostly non-metropolitan along with some suburban and exurban counties. Jim Tankersley cited a Brookings Institution analysis that established that “counties that Clinton won nationwide combined to generate 64 percent of America’s economic activity in 2015” and “counties that Trump won combined to generate 36 percent of the country’s economic activity.”
Since the election, other studies have discovered stark differences between Republican and Democratic strongholds along several variables. Brookings, along with the Wall Street Journal, documented an extreme pace of change in the economies of the two parties’ districts over the last decade. Median household income in 2008 had been $55,000 in Republican districts, slightly above the $54,000 in Democratic districts. By 2017 Democratic districts’ median household income had increased to $61,000 while Republican districts experienced a decrease to $53,000.
Educational attainment had also diverged between 2008 and 2017. For Democratic districts’ adults, 28.4% had at least a bachelor’s degree compared to 26.6% of Republican districts. By 2017 the gap had widened to 35.6% for Democratic districts to 27.8% for Republican districts. Productivity per worker rose from $118,000 to $139,000 for Democratic districts, and from $109,000 to $110,000 for republican districts.
The Journal of the American Medical Association (JAMA) published health data by state from 1990 to 2016. During that time frame life expectancy increased for all states. The data was produced to answer the question “How have the levels and trends of burden of diseases, injuries, and risk factors in the United States changed from 1990 to 2016 by state?” In terms of life expectancy at birth, the range by state varied in 2016 from a high of 81.3 years for Hawaii to a low of 74.7 years for Mississippi. States with the ten highest years of life expectancy, in descending order, were Hawaii, California, Connecticut, Minnesota, New York, Massachusetts, Colorado, New Jersey, Washington and Vermont. The ten states with the lowest life expectancy, in descending order, were Indiana, South Carolina, Tennessee, Arkansas, Kentucky, Oklahoma, Louisiana, Alabama, West Virginia and, at the lowest life expectancy, Mississippi.
The correlation between political orientation and life expectancy is unmistakable: all ten highest states, with the exception of Hawaii, voted Democratic in 2016. All ten lowest states voted Republican. The effect of public policy in addressing health issues may be further in evidence by each state’s decision to expand Medicaid under the affordable Care Act. All ten states with highest life expectancy have expanded Medicaid. Only half of the lowest life expectancy states (Arkansas, Indiana, Louisiana, Kentucky and West Virginia) have expanded Medicaid.
An article in the New York Times reporting on the JAMA study noted the decline in life expectancy over the most recent three years. The analysis of over a half century of data concluded that increased death rates among people in mid-life were mainly caused by so-called “deaths of despair” – suicides, drug overdoses and alcoholism. Again, state-level data in the JAMA study noted the prevalence of these causes of death in the same group of mostly southern states with low life expectancy.
Around the time of the 30th anniversary of the fall of the Berlin Wall, National Public Radio ran a series of podcasts that reviewed events since the reunification of Germany. West German taxpayers have spent more than $2 trillion in the East to improve living standards, including welfare, pensions, unemployment pay, public works projects and support for new businesses.
The podcast series went on to say that some economists compare Germany’s experience to the divisions that currently exist in the U.S. It asks, is there an opportunity for a “reunification” between areas that are thriving and areas that are falling behind? Can a U.S. version of reunification work to improve well-being for those falling behind? We don’t know. But we do know what holds people back: Lack of affordable health care for every citizen; grossly inadequate support for public education; economic development that doesn’t attack poverty directly; and poor physical and digital infrastructure. A multi-trillion-dollar program addressing these critical failures is worthy of consideration to achieve a U.S. reunification.