Facts about life expectancy (true and false)
By Scott Sumner
A recent Paul Krugman tweet got me thinking about life expectancy in the US:
I’m pretty sure those facts are not accurate, as average life expectancy (in 2016) in Trump states is much higher than 76. The source he cites gives quite different data, if my math is accurate:
Nonetheless, it does seem to be the case that life expectancy is higher in Clinton states, and has been rising more rapidly in Clinton states.
Krugman rightly criticizes conservative theories that try to explain this gap:
Conservative figures like William Barr, the attorney general, look at rising mortality in America and attribute it to the collapse of traditional values — a collapse they attribute, in turn, to the evil machinations of “militant secularists.” The secularist assault on traditional values, Barr claims, lies behind “soaring suicide rates,” rising violence and “a deadly drug epidemic.”
But European nations, which are far more secularist than we are, haven’t seen a comparable rise in deaths of despair and an American-style decline in life expectancy. And even within America these evils are concentrated in states that voted for Trump, and have largely bypassed the more secular blue states.
So something bad is definitely happening to American society. But the conservative diagnosis of that problem is wrong — dead wrong.
But progressives also lack simple explanations:
What explains the divergence? Public policy certainly plays some role, especially in recent years, as blue states expanded Medicaid and drastically reduced the number of uninsured, while most red states didn’t. The growing gap in educational levels has also surely played a role: Better-educated people tend to be healthier than the less educated.
Beyond that, there has been a striking divergence in behavior and lifestyle that must be affecting mortality. For example, the prevalence of obesity has soared all across America since 1990, but obesity rates are significantly higher in red states.
When you look at individual states, some interesting trends emerge. In 1990, life expectancy by state was tightly clumped between 73.1 in Mississippi and 78.5 in Hawaii. Then there was Washington DC (68.4) looking like a third world country. Suppose that in 1990 you had predicted that life expectancy in DC would be in the middle of the pack by 2016. I’d guess that people would have laughed at you.
If you look at cost of living-adjusted poverty rates, you’ll find two places that are much worse than anywhere else in America, DC and California. And yet California has the second highest life expectancy in the US, trailing only Hawaii. Progressives might point to California’s spending on health care, but I know of no evidence that that impacts life expectancy. More likely, race and lifestyle play a role. California has lots of Asians and Hispanics, who tend to live much longer than whites and blacks. And the whites that do live in California tend to have healthier lifestyles than those who live in Kentucky or West Virginia.
If America wishes to boost its life expectancy to European levels, the most effective way of doing so is to bring in 100 million immigrants from Asia and Latin America, not to spend more money on health care. We already spend far more than European nations—even our government health care spending equals or exceeds Europe’s (in per capita terms.)
Contrary to the claims of President Trump, immigration is the only way to make America great again. Mass immigration combined with China’s plunging birth rate would allow the US to retake the crown of the world’s biggest economy. It would significantly boost life expectancy. It would assure Silicon Valley’s continued dominance of the global information economy. It would help to secure America’s dominance of global arts and popular culture.
Nativism will make America look more like Kentucky, Mississippi and West Virginia, while mass immigration will make America look more like California, Texas, Florida and New York.
Immigrants built New York City. Both of them.