Too many deaths

At a board meeting yesterday, we were discussing the statistics for our community for the preceding month. Four deaths by suicide isn’t high enough to make us think it is unusual any more. In fact, our average is slightly higher than that number. After our conversation, as I was driving home, I felt increasingly alarmed at our attitude during our discussion. We may be becoming callous about the deaths of our neighbors. Death by suicide is so common that those of us who pay attention to our statistics have lost our sense of outrage. I don’t want to get to the point where I am no longer shocked by unnecessary death. I’m not saying that every death by suicide is preventable. I don’t think we possess the knowledge and resources to prevent every suicide death. But we ought to be able to make a difference and decrease the number of deaths.

I still run into people who believe that the United States has the world’s longest life expectancy. For those who haven’t looked at the data, it is easy to assume that our country is Number 1 on everything. But that simply isn’t true. For decades U.S. life expectancy has been below that of other advanced countries. And that gap is increasing dramatically. The widening “death gap” is the result in increased mortality among working-age American, largely due to what has been deemed “deaths of despair”: drug overdoses, suicides and alcohol. As the number of deaths from these causes rises, overall life expectancy for Americans has fallen every year for decades.

These deaths are not evenly distributed throughout the United States, however. A 2018 article in the Journal of the American Medical Association provided information on state by state changes in health and life expectancy. The divergence among states is striking. In 1990, Texas and Florida had higher life expectancy than New York and about the same as California. Today those two states are far behind. Life expectancy in New York and California continues to rise while it is falling in Texas and Florida. Our state, South Dakota, parallels Texas and Florida. Our health statistics were behind more populated regions of the country already and we have continued to see dramatic increases in deaths of working-age adults.

It is difficult to explain the divergence in the various states. Public policy is part of the picture. States that have expanded Medicaid and have taken action to decrease the number of uninsured people have seen increases in overall health. Our state has not taken any action to address those without insurance and remains near the top of states when it comes to the percentage of our population who are without insurance.

Being without insurance is not simply a matter of having less contact with health care providers, which is definitely true. It also means that we lead the nation in bankruptcies as a result of unpaid medical bills. The financial devastation of families due to the inability to pay for health care could be a factor in the increase in despair and a subsequent increase in death by addiction and suicide. Those connections, however, are largely speculative. Little or no solid research has been conducted into the reasons behind the disparity in states when it comes to increasing mortality.

Conservative leaders have argued that the rise in mortality is caused by the lack of traditional values. Attorney General William Barr has blamed what he calls “militant secularists.” He says that secularists attack traditional values and that is what lies behind soaring suicide rates, rising violence and a deadly drug epidemic. The statistics, however, don’t back him up, however. European nations, which are far more secularist than the United States have not see a comparable rise in deaths of despair and a decrease in life expectancy that the United States has experienced. And within the United States, the states that appear to be more urban and secular have better statistics than those with more traditional values. South Dakota is a conservative state. We are about as conservative politically as a state can get. Our legislature and our people have resisted attempts to increase secularism. Last year our state legislature mandated that every public school in the state display the national motto, “In God We Trust.” The law specifies the size of the letters and the locations where the motto is to be displayed. It is too soon to have comprehensive statistics, but so far there is no evidence that the displays have had any effect on rising teen suicide and drug-related deaths. South Dakota leads the nation in methamphetamine addiction among youth 12 to 17 years of age. We remain near the top when it comes to teen suicide.

Much attention has been given to South Dakota over state spending on an advertising campaign aimed at raising awareness of meth addiction. I’ve already focused on the campaign in a previous journal entry. Despite the lack of educational theory behind the slogan, “Meth. We’re on it.” and despite the lack of evidence that advertising has any impact on addition rates or treatment options, there is a grain of truth in the intended double meaning of the slogan. Addiction affects all of the citizens of our state, not just those who are using the drugs.

What frightens me about the spending of so much money on the advertising campaign is that I believe it is based in an inaccurate analysis of the case of the problem. It encourages people to continue in the belief that addiction, mental illness and suicide are somehow the result of a lack of moral education. These evils are rampant in our society and deeply seated in our state. They are not, however, signs of moral weakness or of a lack of religious training.

Our legislature has consistently taken actions that have not had any impact on the life expectancy of our people. They may be aware that we have a problem, but their analysis and response to that problem has been misguided at the least.

At the worst, it has been dead wrong.

Unfortunately, we’ve gotten all too used to the deaths.

Copyright (c) 2019 by Ted E. Huffman. I wrote this. If you would like to share it, please direct your friends to my web site. If you'd like permission to copy, please send me an email. Thanks!