Ladies in Red, Face Life Expectancy with Dread

 

Ladies in Red, Face Life Expectancy with Dread

“For females born in some Southern states, life expectancy increased by less than three years from 1900 to 2000.” 

Dr. Theodore R. Holford, Yale PhD ’73, Yale School of Public Health (YSPH)

“That’s a staggering contrast when you consider that in states like New York and California, life expectancy rose by more than 20 years over the same period.” 

Susan Dwight Bliss Professor Emeritus of Biostatistics at YSPH.

It’s obviously more than a matter of political persuasion; it’s more about values and local priorities regarding state support of social programs and medical services. Where poverty reigns supreme and conservative values dominate, the “less is better” mantra of governance benefits those with higher earning power, where private access to healthcare and greater attention to personal medical issues are more prevalent… those “others” wanting or needing more are often on their own. So, if you live in Atlanta or Charlotte or Miami, where income levels are high, access to healthcare is there… although income may determine access to such medical facilities.

But today’s blog was inspired by a study by the Yale University School of Public Health, looking at improvements in life expectancy for women over the several decades… a study in contrast between poor Southern red states and the clearly richer northern and western blue states… all as frighteningly depicted in the above chart. Life expectancy in the United States, in general, is declining as most of the developed world is improving. But after the Dobbs Supreme Court ruling, reversing Roe vs Wade, women have fared increasingly worse in states where that ban is enforced.

“As of January 1, 2025, roughly 62.7 million women and girls lived under state abortion bans… Even before abortion was outlawed, the states that subsequently banned abortion had worse outcomes on key indicators of reproductive health, as reported in The State of Reproductive Health in the United States (January 2023). ‘Maternal Mortality in the United States After Abortion Bans,’ the fourth publication in Gender Equity Policy Institute’s series on Reproductive Health in the United States, presents GEPI’s analysis of 2019-2023 Centers for Disease Control and Prevention (CDC) data on maternal mortality to compare maternal health outcomes in the banned states, the supportive states, and the U.S. overall. The year 2023 is the most recent one for which annual data is publicly available from the CDC. Thirteen states enforced bans for the entirety of this year…

“Women who lived in states that ban abortion were significantly more likely to die during pregnancy, while giving birth, or soon after the birth of their child, compared to those who lived in states where abortion care was legal and accessible, our analysis shows. A mother’s risk of dying was nearly twice as high in the banned states. In some states, the risk was even higher. Mothers in Louisiana, for example, were three times as likely as mothers in supportive states to die during pregnancy, childbirth, or soon after giving birth.

“In the 24 states where abortion is legal and accessible (supportive states), mothers are more likely to survive pregnancy. Likewise, the trends on maternal mortality are moving in an encouraging direction. Maternal mortality went down 21 percent in these states post-Dobbs. A decline of 16 percent took place in the U.S. overall… This fall in maternal mortality—outside the banned states—is a positive development, especially given that the U.S. has one of the highest maternal mortality rates among wealthy advanced democracies.” Gender Equity Policy Institute, April 2005 using government data.

But as a report from the YSPH study released April 29th reveals, women’s health, even before Dobbs, very much depended on where women lived. [The study] “reveals striking disparities in life expectancy across U.S. states and the District of Columbia over the past century. The study provides new insights into how public health policies, social conditions, and environmental factors appear to have fundamentally shaped Americans’ longevity based on where they live.

“Analyzing more than 179 million deaths between 1969 and 2020, the multi-institutional research team traced life expectancy trends by birth cohort — a more precise measure for following the life experience of a population than traditional year-by-year summaries of mortality, which represent a mix of many generations… Their findings paint a sobering picture: while some states saw dramatic gains in life expectancy, others, particularly in the South, experienced little or no improvement over an entire century…

“The researchers found that states in the Northeast and West, along with the District of Columbia (D.C.), recorded the greatest gains. Notably, D.C. had the lowest life expectancy for the 1900 birth cohort but achieved an improvement of 30 years for females and 38 years for males by 2000 — a testament to urban policy shifts and changing demographics.

“By contrast, states like Mississippi, Alabama, and Kentucky saw minimal gains, particularly among women, suggesting that systemic factors — including socioeconomic disadvantages, limited access to health care, and weaker public health initiatives — have left lasting imprints on mortality.

“‘These trends in mortality and life expectancy reflect not only each state’s policy environment, but also their underlying demographics as well,’ said Dr. Jamie Tam, PhD, MPH, an assistant professor of health policy and management at YSPH and a study co-author. ‘It’s not surprising that states with fewer improvements to life expectancy also have higher rates of poverty for example.’… Without conscious policy changes, these gaps will likely persist or even widen.”

All this is in stark contract to a uniform backing by Congresspeople elected from red states who are drilling down on cuts to social programs like Medicaid, in order to accommodate major tax cuts for the richest people in the nation. Further, given that the US birth rates have fallen well below replacement numbers, the Trump administration is fighting to encourage “more babies,” while at the same time reducing federal support for early, primary and secondary education and undercutting support for the necessary and concomitant childcare, which has become both elusive and often prohibitively expensive after the administration’s enhanced immigration policies. Women’s healthcare and support for our nation’s children shouldn’t be a political issue… but it totally is. 

I’m Peter Dekom, and it is increasingly obvious that healthcare in general and our support to educate our children have fallen prey to culture wars and cutting taxes for the rich.