life expectancy – COMMUNIST PARTY OF MAINE

_{^{Demonstrators carry a coffin over Brooklyn Bridge during a march against gun violence, 06.02.18, in NY. | Mary Altaffer – AP}}

Under U.S. capitalism, industrial production and consumerism expand. Greenhouse gases increase, the climate changes, and people die. U.S. imperialism leads to wars and potentially nuclear war.

U.S. life expectancy has fallen. According to government statistics released in December, 2022, life expectancy at birth (LEB) for 2021 was 76.4 years. LEB was 77.0 years in 2020 and 78.8 years in 2019. Public health officials claimed this “was the biggest two-year decline in life expectancy since 1921-1923.”

Mothers fare badly. In 2020,19.1 mothers in general and 55.3 Black mothers died per 100,000 live births. They died from illnesses related to childbearing, most of them preventable. In the Netherlands that year, the maternal mortality rate was 1.2 mothers per 100,000 live births. In 2018, 55 nations showed a rate more favorable than that of the United States.

Americans, mostly working-age adults, die from “diseases of despair” – substance abuse, accidental drug overdose, alcoholism, and suicide. They also died of Covid 19 infection, the U.S. rate of 332.81 Covid deaths per 100,000 population being the 16^th highest in the world.

During most of the pandemic, Black people died at two or more times the rate of infected white people. Now the cumulative death rates of each group are similar, with 355 deaths of whites and 369 deaths of Blacks per 100,000 population. Cumulative Covid deaths for American indigenous peoples register at 478 deaths per 100,000 population. Vaccine skepticism may account for increased vulnerability of whites.

The pandemic aside, Blacks and American Indians live far shorter lives than white people do. As of October 2022, LEB for Hispanics was 77.7 years; white people, 76.6 years; Blacks, 70.8 years; and American Indians, 65.2 years. In 2020, 65 nations showed longer LEB than did the United States.

Healthcare failings may have contributed to the high U.S death rates. Proposals for reform, especially for universal healthcare, center on its financing. The United States is the top healthcare spender among all nations.

Paying $12,914 per capita for healthcare in 2021, the United States outspent second-place spender Germany whose outlay was $7383 per capita. Total spending on health that year amounted to $4.3 trillion –18.3% of the U.S. GDP. The United States accounted for 42% of healthcare spending in the world in 2018.

Healthcare in the United States is a profit center. The pricing of drugs, medical equipment, medical insurance, and services provided by hospitals and outpatient facilities in general is exorbitant. Executives of medical supply and pharmaceutical companies, specialty physicians, and administrators of hospitals and healthcare networks receive enormous salaries.

Profitmaking hospital chains, health insurance companies, and pharmaceutical companies generate enough revenue to allow for stock buybacks and dividend payments. Over nine recent years 14 pharmaceutical companies spent $747 billion on stock buybacks. Payments to private insurance companies and private hospital networks are large enough to cover astronomically high administrative costs and profit-taking.

Some healthcare and health-promotion activities produce no revenue, or very little. They tend to receive relatively little support and skimpy funding.

The U.S. public health sector, charged with health education and illness prevention, is a low-priority item. Inadequate preparation and preventative measures largely accounted for the U.S. Covid-19 debacle.

Insurance companies dedicate effort to denying coverage for particular diagnostic and therapeutic interventions.

Multi-hospital, multi-service conglomerates are cutting back on health services in rural and economical depressed areas because of decreased “productivity.”

Many hospitals have recently dropped children’s hospital services as being less remunerative than care for hospitalized adults.

Small rural hospitals unable to pay bills have been closing down in droves throughout the nation, depriving area residents of care.

Specialty practitioners and hospitals often prioritize expensive medical procedures and high-technology diagnostic modes over care centering on provider – patient interaction and communication.

Many physicians during training opt for a specialty rather than a primary-care career, often because of income considerations. Primary care physicians now comprise only 20% of all U.S. physicians.

Diminished emphasis on a “medical home,” that hallmark of primary care, opens the door to inefficient, low-quality care.

Other capitalist countries have achieved long life expectancies. The average life expectancy for 2021 in eight European countries plus Australia and Japan was 82.4 years. Their average per- capita health spending was $6,003. Japan spent $4,666 per capita on healthcare; LEB was 84.5 years.

Those countries protect healthcare as a public good, mainly because labor unions and social democratic or labor political parties apply pressure. Universal access to care is the norm.

Universal care in the United States is but a dream. U.S. unions are weak and there is no working people’s political party. Some 25 million working age adults had no health insurance in 2021; insurance for 23% of them was inadequate. Too many have no care or fragmented care.

Reform efforts will continue in the United States, propelled perhaps by worsening life expectancy. But healthcare has its limitations. Steven Woolf, retired director of Virginia Commonwealth University’s Center on Society and Health, told an interviewer recently that better healthcare is “only a partial answer” to extending life expectancy, accounting “for about 10 to 20 percent of health outcomes.”

He explained: “Our health is really shaped by our living conditions, jobs, the wages we earn, our wealth accumulation, the education that enables us to get those jobs … The country that we live in is the richest in the world, but we have the highest level of income inequality. So, much of the resources that we need for a healthy population are not available to most of the population.”

Woolf is saying, in effect, that people die early because of inequalities, oppression, and organized greed. The United States appears as different from other rich capitalist counties. Social guarantees are fragile. The wealthy have few restraints on satisfying their wants. A besieged working class lacks voice and agency.

The prospect that reforms, alone, will restore justice and decent lives for working people is nil. They confront a voracious, extreme kind of capitalism. Its rulers tolerate, promote, and seek out collaborators for actions and policies leading to die-offs. Think climate catastrophe, wars, and nuclear war.

In response to impending disaster, Americans desiring better and more secure lives for everyone would adjust their forward vision. Working for reforms, they would aim at something new, which is top-to-bottom social and political change. New motivation, determination and hope would be a shot in the arm.

Revolutionary change is a worldwide project, and not to be left to one people – except in special circumstances. One such was pre-1917 Czarist Russia and another would be that anomaly among capitalist nations which is the death-dealing U.S. nation.

_{W.T. Whitney Jr. is a political journalist whose focus is on Latin America, health care, and anti-racism. A Cuba solidarity activist, he formerly worked as a pediatrician, lives in rural Maine. W.T. Whitney Jr. es un periodista político cuyo enfoque está en América Latina, la atención médica y el antirracismo. Activista solidario con Cuba, anteriormente trabajó como pediatra, vive en la zona rural de Maine.}

_{^{Photograph by Nathaniel St. Clair}}

Reporting by the U.S. news services frequently takes China to task for its strict preventative measures imposed to prevent Covid-19 infection. Reports point to economic instability and people’s distress supposedly generated by this uncompromising attitude. The slant of New York Times reporting, which skirts over Chinese lives saved, earned a sharp rebuke on September 9 from the fair.org website, a self-styled “national media watch group.”

Reporter Jim Naureckas imagines the lament of Times writers that, “China has had theenormous misfortune of avoiding mass death.” He is sarcastically contrasting lives saved in China with lives unnecessarily lost in the United States, where Covid-19 deaths now exceed one million. He reminds us that China now exceeds the United States in life expectancy.

U.S. reporting on the downhill turn of U.S. life expectancy is

fertile ground for the emergence of press bias that agrees with establishment leanings.

The U.S. government recently released statistics indicating that U.S. life expectancy at birth is now 76.1 years That’s a return to the life expectancy level of 1996. The 2021 figures, down from 77.0 years in 2020 and from 78.8 in 2019 represented the greatest multi-year life expectancy decline in 100 years. Life expectancy for men in 2021 was 73.2 years. That level signified an unprecedented male-female gap of almost six years.

U.S. press coverage of bad news on life expectancy barely mentions international comparisons and neglects the political and economic context of the drop in life expectancy.

Reports in the Washington Post, New York Times, and elsewhere have identified adverse biological or medical phenomena. They point to suicides, alcoholism and drug- overdose victims – “diseases of despair” – and spotty distribution of healthcare services. The reporting attributes the life-expectancy decline mostly to excess deaths from Covid-19 infection.

In explaining deaths during the pandemic, The New York Times and Washington Post focus on disaster befalling indigenous peoples in the United States. The combined male-female life expectancy of indigenous peoples as of 2021 registers at 65.2 years. Indigenous deaths rates have recently exceeded those of white people by a factor of 10.

These articles, and others throughout the period of the pandemic, have pointed to the particular risk Covid 19 infection poses for non-white populations. Press reports have cited Black and Hispanic mortality rates that are from two to four times higher than those for white people. Reports have leaned on public health data showing that “communities of color” had suffered from much chronic illness beforehand that compound difficulties in recovering from Covid-19 infection.

Reporters have described medical care for these chronic diseases as poorly accessible or of low-quality. They imply that racism is the factor that largely accounts for the increased Covid-19 death rates among ethnic minorities. If so, getting rid of racial oppression would be the best way to reduce human loss from the pandemic and restore decent life-expectancy figures.

The reports also cast blame for Covid-19 deaths on unhealthy living habits, environmental pollution, and access to guns. Recent articles attribute now deceasing death rates from Covid-19 among Black people to protective actions taken by people themselves (not government action). The Times article, seemingly alone, does mention “a fragmented, profit-driven health care system.”

Otherwise, inquiry into the nature of U.S. healthcare is missing. Unsurprisingly, there are no calls for universal access to healthcare, improved preventative care, additional first-contact care providers, removal of financial barriers, and higher quality of care. Lacking too is discussion of steps taken on behalf of education, housing, adequate nutrition, and safe retirement; all of these, taken together, promote good health.

Not much appears about the disjointed, inaccessible, unavailable care for illnesses, chronic or otherwise, that white people may experience together with Black people. The overall emphasis in the reporting is the special vulnerably of non-white people and, recently, the apparent role of racism in accounting for lowered life expectancy.

There is silence on social class. Seemingly alone among the major U.S. media, Newsweek highlighted the contrast between reduced U.S. life expectancy and Chinese and Cuban gains. The 2021 life expectancy of both countries, 78.2 years and 79 years, respectively, was higher that year than that of the United States

China and Cuba are socialist countries that redistributed wealth and opted for working-class political power. U.S. media and elected officials are reluctant to acknowledge successes of socialist countries, that by nature are oriented toward the good of working people.

Writing in 1991, Vicente Navarro, public policy and public health expert, notes that “class is rarely discussed in the scientific and mainstream media in the United States.” He adds that, “even if blacks and whites died at the same rates, most blacks would still have higher mortality rates.”

He elaborated in 2004:

“The United States is one of the very few countries that do not include class in its national health and vital statistics. It collects health and vital statistics by race and gender but not by class, even though, as I have shown, class mortality differentials are far larger than race or gender differentials. Class discrimination is the most frequent and least spoken of type of discrimination in the United States.”

Navarro’s remarks provide perspective to the biases in press coverage that are described here. Presumably press silence on developments in which working people have a stake does suit opinion-shapers for whom red-scare is a time-tested tool. Anti-Cuban sentiment and China bashing may play a role, but those postures too may stem from red-scare. Navarro has the last word: “The capitalist class is extremely powerful.”

The heroic journalist John Pilger once explained that, “Journalists can help people by telling the truth, or by as much truth as they can find, and acting not as agents of governments, of power, but of people.” He asked recently: “do we live in a Media Society where brainwashing is insidious and relentless, and perception is filtered according to the needs and lies of state and corporate power?”