Op-Ed

Economic inequality produces sickness and a politics of rage

Journal of the American Medical Association

Kentucky citizens need to be reminded of the out-of-state corporate plutocrats and their homegrown enablers making Kentucky one of the most unequal as well as most unhealthy states.

Independent studies of economic and physical well-being consistently rank Kentucky as one of the poorest and unhealthiest states. Kentuckians are literally dying of inequality.

Inequality, high poverty and ill health are closely connected. In 2016 Kentucky’s 18.5 percent poverty rate was one of the highest in the nation. Almost a third (30.8 percent) of African-Americans and just over one in four children living in poverty. Kentucky ranks second in the rate of abused children, double the national average.

We usually are among the top three states in industrial air pollution; one in 10 here suffer from asthma, and “we’re No. 1” in lung cancer and death from lower respiratory diseases. The state makes the top 10 in breast, colorectal and cervical cancers, diseases driven by smoking, obesity and lack of screening.

Deaths from drug abuse in West Virginia and Kentucky routinely make the top two; and more prescriptions are written for opioids than there are residents. Kentucky has the highest rate of homeless students, from families broken by deaths, divorce, prison, and in 2012-13 the highest percentage of children with incarcerated parents.

Conservatives say that with addiction, people make choices, and that has some truth. But it makes a difference where and with what resources choices are made: in a declining small town or a wealthy gated suburb; in a household experiencing food insecurity or from a menu in an expensive restaurant.

In a remarkable book, “The Spirit Level: Why Greater Equality Makes Societies Stronger,” Richard Wilkinson and Kate Pickett analyzed comparative data showing strong relationships between inequality and health and social problems.

They looked at mental illness, including drug and alcohol addiction; a lower life expectancy; lower educational performance; increased teenage births; violence and homicides; high imprisonment rates; and lower social mobility. Correlations are not causes, but the patterns they observed were not likely due to chance. Eastern Kentucky especially fits the profile of the afflictions rooted in inequality.

For the past year Kentucky’s Republican legislature and governor have carried out the agenda of billionaire colonizers led by the Koch brothers to increase a stark economic inequality that dramatically affects the quality of life and well-being.

Inequality and individual and social sickness can result in anger and resentment. President Donald Trump’s election has been called “the revenge of the forgotten class” because across rural America people living amidst decline, disease and despair chose a demagogue to lash out at dysfunctional, self-serving elites.

New data show that Trump did better than Mitt Romney four years earlier in counties in Appalachia, the industrial Midwest, and even New England with higher drug, alcohol and suicide rates. Counties with high economic distress and a large white working class went for Trump, and many experienced significant manufacturing job lossesin recent decades. Voters see social mobility disappearing and fear for their children.

Six of nine Ohio counties that flipped from Obama to Trump had overdose deaths well above the national average, as did 29 of 33 Pennsylvania counties. One analyst called this the “Oxy electorate,” although aware of all the other social and economic conditions at work. Many other causes led to Hillary Clinton’s defeat: sexism and media bias, Comey’s last minute interference, Russian hacking, Clinton’s failure to connect with the white working-class, and more.

Inequality breeds decline and physical and mental sickness in people and groups. It also breeds a politics of rage and despair. Kentuckians, above all, should know.

Ron Formisano of Lexington wrote“American Oligarchy: The Permanent Political Class.”

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