A new discovery about mortality, the causes and ages of death, was reported in The New York Times, The Atlantic magazine and The Boise Weekly. In a highly respected study by Dr. Angus Deaton, a Nobel Prize-winning economist from Princeton, the only group with an increasing death rate — that is, a group that is dying at younger and younger ages — is poor, middle-aged white people. This is a surprise because conventional wisdom tells us that the most at risk of an increasing mortality rate might be people of color, or those in deepest poverty.
This at-risk group is between 45 and 54, with a low income, high school education or less, dying at an increasing and alarming rate: 415 per 100,000.
Idaho has a population of just over 1.6 million people. That means that over 6,700 of our middle-aged, white citizens may die this year from suicide, opioid (pain killers) overdoses, and liver disease resulting from alcohol abuse. This has been said well by the above sources, but not how that applies to Idaho, nor what we can do about it.
First, the Idaho Legislature has so far refused to expand the $178 million Medicaid to the 78,000 people who would qualify, but instead spends millions (now proposed at $30 million) of state money on some of them. This amount could be totally paid for through the Affordable Care Act by expanding Medicaid and would cover medications, hospitalizations and needed procedures.
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Second, that would free up millions for education. Why education? Because the key characteristic of this at-risk white group, besides lower than average income, is that they are poorly educated. In fact, “the lower the education the higher the suicide rate and the opioid/alcohol problem.” The “increases in mortality rates (also) rose in parallel with their increasing reports of pain, poor health and distress,” said Dr. Deaton.
“This group tends to have a more pessimistic outlook about their financial futures,” than comparable blacks, Hispanics or Asians of the same age range, says Deaton. He goes on to say, “for a high school graduate their inflation-adjusted income fell by 19 percent” between 1994 and 2004. They complain mostly of chronic joint pain and sciatica. Work related injuries, inability to work, poor socialization skills, inadequate information about personal health care, no money for a doctor visit, no money for prescription drugs and no health insurance, all add to the depressing, pessimistic outlook. These are our sisters and brothers right here in Idaho!
In a nutshell, we are leaving $178 million of federal money on the table, and pay out state money for inadequate health care for the distressed. And who pays for this? You and me in poorly directed tax money, and part of our federal taxes. But the low-income, poorly educated, and especially the 6,700 white Idaho citizens, pay with their lives. And the elderly, the children, the mothers — as well as Latino, Native American and black Idaho sick people — pay with worse health outcomes.
Third, lets get the conversation started this legislative session about those Medicaid dollars and the great improvement in education that will come with increased funding. Let’s put that state money where we need it most — in education. Let’s help out the 6,700 who will die this year, the 78,000 without adequate Medicaid health care, and raise our educational outcomes through adequate funding. Let’s attract the best talent, retain the gifted teachers, raise the level of literacy and help save the 6,700 (18 per day). And all that without raising taxes.
Proverbs 29:18 states: “Without a vision, the people perish ... ”
Jon Brown is a Methodist minister-at-large and lives in Boise.