Red State Mortality Rates and Voters Who Vote against their own Economic Interests

I’ve been a public health official and epidemiologist for 32 years. As such, much of my work involves looking at and evaluating factors that influence human health, disease, and mortality. Recently I came across a map of age adjusted death rates by state (See page 4), and I was immediately struck by the fact that there appeared to be a very strong correlation between mortality rates and the political redness of the states. The correlation wasn’t by any means perfect, but it looked very strong. As a matter of fact, the 11 states with the highest mortality rates are all deep red states (AL, AR, GA, IN, KY, LA, MS, OK, SC, TN, WV). According to Nate Silver’s latest analysis, among those states, the most likely to vote for Obama this November is Indiana, and he rates the probability of that happening at exactly one half of one percent.

So I entered the numbers into my computer, using Nate Silver's October 17 probabilities of voting for Romney as an indication of the state’s redness, and used a standard statistical test (linear regression analysis) to evaluate the strength of the association between the state’s redness and age-adjusted mortality in 2009. The strength of the association was very strong indeed. The probability of seeing an association that strong by chance is less than one in ten thousand. The predictive value is so strong that of all the factors that could predict the mortality rate in a state, the state’s redness accounts for more than a quarter of the predictive power.

I thought that was phenomenal, so I assessed other potential variables in an attempt to find an explanation. The variable that I found that appeared to offer the best explanation was median family income of the state. Median family income was a substantially better predictor of state mortality rate than was the state’s redness. The association was strongly negative – the lower the median family income the higher the mortality rate (median family income held almost 40% of the power to predict a state’s mortality rate). This is a very well known relationship in the field of public health. A low median family income for a state means that a relatively large percent of families will be living in poverty. Poverty and near poverty is associated with poor nutrition, homelessness, relative lack of access to health care, and many other factors that predict high mortality. So it was no surprise to see a state’s median income strongly negatively associated with the state’s mortality rate.

But how would that explain the positive association between the state’s redness and its mortality rate? Well, it turns out that a state’s redness is also strongly and negatively associated with median family income. The more likely a state is to vote for Romney over Obama, the less is its median family income. And the state mortality rates vary a great deal. At one extreme is Hawaii, with an age-adjusted annual mortality rate of 620 deaths per 100,000 population. Hawaii is rated a 0.0% chance of voting for Romney. At the other extreme is West Virginia, with an age-adjusted mortality rate of 950 deaths per 100,000 population. West Virginia is rated a 99.8% chance of voting for Romney.

This all begs the question: Why are states with the lowest median family income, in general, the most likely to vote for Romney? Romney wants to reduce taxes on the rich even beyond the rates imposed by the George W. Bush administration. Romney wants to cut Social Security, which would have devastating effects on tens of millions of Americans. Romney was infamously quoted as showing contempt for 47% of the U.S. population, by implying that they are leeches who should not be entitled to the government benefits that they receive – which in many cases allow them to feed their families while they continue to look for a job. Shouldn’t all this cause low income voters to vote against Romney? Let’s take an in-depth look at the explanations behind the associations I’ve discussed in this post:


The association between a state’s redness and its mortality

I noted above that the causal explanation for the association between a state’s redness and its mortality rate is median family income. Low median family income is a very strong predictor of both a state’s mortality rate and its redness. It is primarily because of this that a state’s mortality rate and its redness are strongly correlated.

But there is also a more direct reason – that is, a direct relationship between a state’s redness and its mortality rate. A primary characteristic of a red state (or individual) is that these states and individuals have fallen for the Republican line that “big government” is intrinsically bad. Romney uses this simple-minded and fraudulent line all the time. He wants us to take it without question that anything government does can be better done by the private sector. They want us to forget that government is the elected representative of the people – i.e. government IS the people.

But the private sector in NOT intrinsically better than government. The private sector is here to make a profit. If in the course of making a profit, people benefit from their services, then fine. But benefiting the people is not their purpose. And without a representative government to exert some controls on the private sector, they will run all over the nation’s people in their quest for profit. This is exactly what has happened over the last several years. The American oligarchy (a term I use to describe the ultra-wealthy individuals, corporations, and interest groups who have gained control over much of our government) has used its massive amounts of money to buy the communications media by which so many Americans receive their political information. They’ve used their money to buy politicians to get elected to serve their own interests at our expense. When they can’t buy a politician they use their money to throw them out of government, as they did to Alan Grayson in 2010. They play us off against each other. More specifically, they have convinced millions of people to be against government programs that could greatly benefit them, on the premise that some undeserving people will benefit from those programs.

So it is that a preponderance of voters in red states regularly elect to local and state offices politicians who are dedicated to serving the desires of the American oligarchy at the expense of everyone else. They have fallen hook line and sinker for the idea that government is intrinsically bad. They believe that it is bad to elect government officials who want to regulate wealthy corporations in the public interest. They see “Obamacare” as bad simply because it represents government “interference” with the private sector – no other explanation needed. They believe that the private sector must take over Social Security in order to get it out of the hands of government. Corporations are let loose to pollute our air, water, and soil without government “interference”, and to manipulate our economy. These red state voters acquiesce too much to the idea that our social safety net programs are bad because they represent “big government”. They (along with their fellow citizens who aren’t fooled so easily but live amongst those who are) are now reaping the consequences for their naivety, in falling economic status, poor health and ultimately death.


The association between a state’s redness and its poor economic status

Now let’s come back to the question of why poor economic status of a state predicts a state’s redness. I think it’s very important to understand this – yet the explanation is far from obvious.

One important point is that we know from exit polls in 2000 and 2004 (and probably 2008 as well, but I haven’t looked at this issue for 2008) that lack of a college education is strongly associated with a tendency to vote red. That shouldn’t be surprising. The Republican Party often seems to hold education and educated people in contempt. Their contempt for education is reflected in their policies, which deny or scorn science-based findings such as climate change and evolution, and seek to make a college based education unattainable for ordinary people. Lack of a college education has to be one reason for the association between low family income and a state’s redness.

Most important, voters in these states have been convinced to vote against their own economic self-interests. The American oligarchy has led these people to believe that government has no right to interfere with their ability to do whatever they please. To do so would be “socialism”, they tell us, which everyone should know is bad. Worse yet, they’ve arranged for massive government subsidies and tax breaks that ordinary people don’t have access to. They even arranged for a multi-trillion dollar bailout of the fraudulent financial industry that got us into the economic mess that we’ve been in since 2008 – with very few strings attached. The bottom line is that voting red enables the wealthy to become even wealthier, at the expense of everyone else.

Thus voting red hurts people economically. An excellent example of the relationship between economic status and voting tendency is provided by events in Wisconsin in the past couple of years. Wisconsin is just a little to the blue side of purple. In the Republican tidal wave of 2010, Wisconsin tilted to the red side and voted in a far right wing governor and legislature. The newly elected right wing governor, Scott Walker, immediately set about the task of trying to destroy the presence of organized labor in the state – a move that gave Wisconsin the worst job loss in the nation compared to other states. At that point, the blue tendency in Wisconsin reasserted itself as voters put tremendous pressure on its governor and some of its most conservative legislators with recall movements. These efforts were successful enough to replace enough conservative Republican legislators with Democrats to block Governor Walker’s worst excesses – though the effort to recall Walker himself was prevented by the infusion of tons of money from Walker’s wealthy supporters.


Influencing people to vote in their own interest

If we are to be successful in reversing the constant drift to the right in our country, among other things (such as diminishing the influence of money in our political process, taking back our communications media from the wealthy corporations that now control it, and fixing our broken election system) we liberals/progressives need to be able to talk to people with conservative tendencies, to help them to better understand how political issues affect their own economic well being. A recent article by Josh Eidelson, a former labor organizer, addresses this point. In the article Eidelson discusses “Working America”, an organization that attempts to organize non-union working people to work and vote for their own economic self-interests. He describes the organization like this: