Is your state government killing you?

2013-12-08T00:00:00Z Is your state government killing you?By Dennis D. Embry Special to the Arizona Daily Star Arizona Daily Star

Recent TV ads show Uncle Sam doing bad things in your doctors’ offices.

Maybe it is not the feds who are the threat to your life. Maybe the real threat is in your state and the choices its government makes about who gets health care.

It turns out where you live determines whether you die sooner or later.

Not long ago, I read an article about mortality rates by state and wondered, as a prevention scientist, what the relationship was between state governments with strong commitments to insuring their citizens compared with those without, not a bad question given all the hoopla about the Health Exchanges.

Using my computer’s spreadsheet application, I entered the names of the states plus the District of Columbia. Then I entered the percentages of the states’ citizens with health insurance in another column, and entered the death rates for states and for Washington, D.C., in the last column.

I did a statistical computation with the spreadsheet, a coefficient of correlation between percentage of the population and mortality rates. That number was -0.47, which multiplied times itself means that about 22 percent of your lifespan can be predicted just by picking states with more or less health insurance coverage for its population.

How big a deal is this? You could say that by choosing to live in a state with higher percentages of insured people, you will live another three to five years. The correlation is highly significant in statistical terms.

So what do all those other people having health insurance do to your health or my health?

Here just one example: With insurance, more people are likely to be protected against deadly infectious diseases. People with insurance seek preventive or early treatments. No insurance? People wait and wait. Thus, when you go to the hospital in states with many uninsured, you are more likely be infected by things like MRSA — a bacterium responsible for 99,000 deaths per year and higher health-care costs of $30 billion per year.

We might not be aware of how other people’s health affects us, but the data show it. Consider how politicians love to say, “The U.S. health-care system is best in world.” What is the bottom line measure of health? The polar opposite: death. We should have the best lifespan, right? Actually, we don’t.

The Institute of Medicine published an exhaustive analysis of mortality across 17 rich democracies. You can read it here: bit.ly/IOMLIVES

The report has bad news: American males die earlier at every age than those in other countries, and American females are the second-worst.

It’s not just countries with health insurance determining lifespans. If you live in the states with low levels of coverage, you will die three to five years sooner than in the states with high levels of health-care coverage.

Where might be a good place to live? Not Mississippi; it’s dead last in lifespan. About 37 percent of Mississippians do not have health insurance.

Want to live a longer life? Move to such states as Hawaii, Minnesota, Connecticut, Massachusetts, Vermont — places that typically have only about 5 to 10 percent uninsured, before the Affordable Care Act. Those states have elected to expand health-care at all levels.

Massachusetts, the site of original Tea Party, has the most insured, thanks to the health-care plan designed by former Gov. Mitt Romney.

And Arizona? We live about three years less than those folks. We’ve let about 21 percent of the people go uninsured in the past.

There might be glimmers of light and longer life. Many snowbirds come from places with higher rates of insurance and longer lifespans. Also, Arizona will add about 240,000 people to its Medicaid rolls in January, and more Arizonans will be taking advantage of affordable health care. It will be interesting to see if mortality and death rates improve over the next decade or so.

If you want to live longer and live in Arizona, get as many people to get health insurance as possible — besides eating well, getting some exercise, losing weight and engaging in other healthy habits.

Dennis D. Embry is a prevention scientist with multiple population-level prevention studies in the United States, Canada and New Zealand. He lives in Tucson. Contact him at dde@paxis.org

Copyright 2014 Arizona Daily Star. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.

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