The NPR Politics Podcast - The American Trade-Off: Guns And Cars For A Much Shorter Lifespan

Episode Date: March 29, 2023

In 2013, researchers published a landmark study on why Americans of all incomes and demographics die years before their peers in comparable countries. In the decade since the report was published, that gap has only grown. We examine the policy choices behind Americans' shorter lives.This episode: political correspondent Susan Davis, national political correspondent Mara Liasson, and health correspondent Selena Simmons-Duffin.The podcast is produced by Elena Moore and Casey Morell. It is edited by Eric McDaniel. Our executive producer is Muthoni Muturi. Research and fact-checking by Devin Speak.Unlock access to this and other bonus content by supporting The NPR Politics Podcast+. Sign up via Apple Podcasts or at plus.npr.org. Giveaway: npr.org/politicsplusgiveaway Connect:Email the show at [e-mail] the NPR Politics Podcast Facebook Group.Subscribe to the NPR Politics Newsletter.Learn more about sponsor message choices: podcastchoices.com/adchoicesNPR Privacy Policy

Hi, y'all. I'm Erin. And I'm Brenna. And we're on vacation in Washington, D.C. Earlier tonight, we got to take a tour of the West Wing. And I got to sit in the NPR chair of the White House Press Briefing Room. This podcast was recorded at 1113 a.m. on Wednesday, March 29. Things may have changed by the time you hear this, but we'll still be riding the high of seeing the Oval Office. Okay, here's the show. I hope that they got to see some cherry blossoms.

We just got past peak bloom. It's a lovely time to be in town. Hey there, it's the NPR Politics Podcast. I'm Susan Davis. I cover politics. I'm Mar it's the NPR Politics Podcast. I'm Susan Davis. I cover politics. I'm Mara Liason, national political correspondent. And friend of the podcast, Selena Simmons-Duffin, who covers health for NPR, joins us today. Hi, Selena.

Hi, Sue. Hi, Mara. Hi there. Selena, there is a string of new data out that collectively adds up to this. Americans across all demographic groups are dying at younger ages than their counterparts in wealthy nations around the world. How significant is this divide between U.S. and other comparable countries? Well, if you look at the chart, Americans have a life expectancy of 76 years and a comparable country is about 82. And that might not sound like that much i think

sometimes when people hear those numbers they're like what am i gonna do in my late 70s you know but it's really significant i mean comparable countries haven't been 76 years for decades right so a lot of the recent drop off in life expectancy, it's dropped two years just because of the coronavirus pandemic that, you know, there have been unbelievable numbers of deaths in this country. The pandemic was global. The pandemic did have an effect in other countries, of course. But the drop just hasn't been anywhere in the same ballpark. And other countries, many of them rebounded in 2021 when vaccines were available, and the U.S. did not. It dropped again. So it is a significant gap. I think population researchers,

demographers who've been working on this for their careers are extremely alarmed and concerned, but also not surprised, I would say, because the U.S. has been lagging behind peer countries in life expectancy for many, many, many, many years. It's just the pandemic that caused this extremely dramatic drop recently. One thing I found so striking is that this idea that it is literally affecting all Americans, that it's not a rich-poor problem or a racial problem. I mean, it's just, it's the whole country. Right. I mean, I did a story recently about this report that came out in 2013, and the title of it was Shorter Lives, Poorer Health. And the researchers who worked on this report really pointed out that there are disparities, of course, and they're horrible.

And if you pull out certain subgroups of the population, sometimes the statistics are even more concerning. But all countries have disparities population, if you have insurance and you're wealthy and you exercise and you eat well and you're not overweight and you don't smoke, the top portion of America's population does worse than the top portion of populations in our peer countries. You can't buy your way out of this problem, basically, is what the researchers were trying to say. And that's why they did this really kind of universal framing. Say, like, let's just look at America and let's look at these other countries and do the comparison that way. Selena, this report has been out for some time. What made you want to dig in on the issue now? It had been 10 years since this report came out, and it made a splash at the time. People were really like, really? Wow. Oh, my gosh. And so I wanted to check in and see what progress had been made, if any, because in the years since the report came out, all of the trends they were documenting have really just gotten worse. Mara, all of these problems individually, I think,

are things that politicians have talked about or focused on. Opioid addiction, access to health care, the pandemic, things that affect children like firearms or car crashes. But I don't know of anyone sort of connecting the bigger, broader picture here in our politics of like the health of this nation is not well. Actually, you know who does talk about it in a completely different way is Donald Trump. American carnage. Everything is going down the tubes. Only he can fix it. I mean, there is no doubt that the despair or all of these negative trends are affecting people. They are affecting politics. I think it's why you get populism of the left and the right. When people feel that they don't have a chance, they're more likely to abuse drugs, and that leads to deaths of despair. There was a poll, this is kind of adjacent, but there was a poll recently in the Wall Street Journal, and it was really extraordinary. 25 years ago, people were asked about what things they thought were important, patriotism, religious faith, tolerance for others, a college degree, public schools, having children,

community involvement. Every single one of those things dropped in terms of the number of people saying they were important to them from 25 years ago. The only thing that went up was having money. Wow. And it's similar. I mean, we're in a very negative, pessimistic moment in this country for real reasons. It does make me think about like structurally when we've been talking about polls, Mara, like how baked in disapproval ratings are for any president or the right track, wrong track. I mean, this country has been in a very pessimistic mood for a long time. And I'm not sure I really connected the dot between these factors and that. I think I've always looked at it through a purely political lens, but like life is hard. Life is hard. And also because we don't have the social safety net and the healthcare system that other countries like us have, also it's just harder to be in the middle class. I mean, put aside the inflation that we've had recently, healthcare, education, and housing, which to me

are the three tickets to a middle-class lifestyle, have been inflating. The cost of them has been going up for decades. It has nothing to do with the current overall inflation. Selina, can we talk about, it's interesting to me to go a little bit deeper on some of these factors at play, which might seem obvious to some, but it's worth sort of reminding folks. I mean, cars, cars alone are a factor for life expectancy in the U.S. That was surprising to me. I think people, Americans are kind of used to hearing, oh, we eat badly, we don't exercise enough, and that's why we're less healthy. But yeah, car crashes, fatal car crashes are way higher in this country than in our peer countries. Do Americans just drive more? Yeah, Americans have

more cars and do drive more. But I also think that there's things about how the cities are built. When the cities really are designed to drive, you're going to drive. I think that that's another thing that, as you say, like connecting the dots, like car crashes are not a thing that are going to jump to your mind maybe when you're thinking about Americans and living healthy lives. And I think this is a little bit hard to wrap your mind around because of that, because it touches so many different aspects of life. And it's really hard to point your finger and say, this is the thing, like we need to fix this. The author of the Shorter Lives Report, the chair of the panel that put

that together in 2013, I spoke to him. His name is Stephen Wolfe. He's a professor emeritus at Virginia Commonwealth University. And when I was asking him, what were the factors that you found in your research that contributed to this gap? This is what he told me. We are more likely to own guns. There's higher rates of drug abuse. We found higher child poverty rates, the highest levels of income inequality, systemic racism, social isolation, and I could go on. I don't want to have too long an answer, but you get the point. I mean, he actually spoke for three minutes. It boggles the mind and it can, I think, be a little bit hard in the context of maybe politics when you want to be targeted.

Yeah, you want the solution. You want the one thing that you can fix. You want the one thing and you want something tangible, like a face you can connect to. And talking about life expectancy can be quite abstract. All right, let's take a quick break and we'll talk more about this when we get back. And we're back. One of the most jarring statistics in all of this to me is this, that guns are now the number one cause of death of children in the United States, more than cancer, more than car crashes. There was a reminder of this reality just this week

with the school shooting in Nashville that left three nine-year-old children dead. Selena, you mentioned you have little kids. I have little kids. I think that literally every parent of little children in this country are horrified by this data. What is driving it? And is it just as simple that guns are really easy to access in this country? Yeah, I mean, one of the authors of this report that I spoke with, Eileen Crimmins, who's at USC in L.A., she said that she thinks about two years of the gap in our life expectancy and our peer countries is the availability of guns. It's just they're really easy to get. And it's not a whole lot more complicated than that. I mean, some of these problems are really, really complicated.

And, you know, unhealthy food, you know, health care, like they're really super complicated. And access to guns seems like in some ways pretty straightforward. And we do have models in other countries for how gun control has had an impact on mass shootings and also just gun deaths that aren't in the news. And a lot of children's gun deaths are not mass shootings. They're guns in homes. They're accidental deaths. It's not, you know, mass shootings are actually a small outlier for the cause of children's death. Right. Mara, and yet, you know, here we are again. Guns are one of the most intractable issues

in politics. President Biden this week reiterated a call for a ban on high-capacity firearms. I think we both know that's not going to go anywhere. No, that's not going to go anywhere. And what's really interesting is you've got one party who wants more gun safety, they would say, gun control measures, and the other party that's making it easier to own guns. Florida is either about to pass or just passed a law that said you don't need a license to carry a loaded concealed firearm. So this is just not going to happen. But I do think it is a political issue. There was gun safety legislation passed last year in Congress. It was pretty modest, but it was better than nothing. But yeah, this is something that really divides the parties. And when you talk to Republicans now, not only are a lot of them for what they call

constitutional carry, less gun regulation, but they also say guns are out there. There's nothing we can do. We've also seen this political realignment of, you know, where more working class voters have become more aligned with the Republican Party. And these are also voters that tend to benefit more from a stronger social safety net. But that has not traditionally been a strong position for the Republican Party. And I wonder if you see the potential here for maybe some political realignment on these issues, I think specifically like Medicaid expansion, right? Like a lot of conservative states have

started to actually expand Medicaid because these are their people now. There's no doubt that I think there's potential and I'm watching for it. And there are Republicans like Marco Rubio in the Senate who are talking about having a more pro-family agenda as in least for now, I think the Republican theory of the case is that for those low-income voters, culture is a good substitute for a social safety net. So, you know, culture war issues are going to be the thing that keeps those voters loyal to them. But over time, I think there is potential for a realignment on issues around guns, around health care, around all sorts of things that make it easier to raise a family. Selina, in the bigger picture here, I mean, you know, this is kind of depressing. This is dark data. I mean, we're talking about children's deaths, deaths of despair, poor access to health care. I mean, the picture is bleak.

But you also mentioned that there are people at NIH and other places that are also looking at solutions. I mean, where in the public health space are the ideas for how to turn this trajectory around? Oh, I think it's kind of complicated for the health agencies like NIH, which has $40 billion every year to try to help Americans do research that helps Americans live healthier lives. It's not going so great. It's not going great, right? And CDC, which compiles these numbers every year, they don't want to talk about this, is my impression.

I mean, I asked HHS, NIH, CDC for comment. I got some PDFs and written statements back. And to be fair, some health officials have said this is much bigger than health research. Like we can't research our way out of these really, you know, intense societal and political beliefs like you guys were just talking about. I don't think that's an excuse, though, for not taking a hard look at the policies that have worked in other countries to help people live longer and healthier and seeing how they can be Americanized and implemented here. Yeah, I still get the sense that from a political lens and from, you know, Capitol Hill perspectives, that this is still seen as sort of individual

issues. Like there's a gun debate, there's a health care debate. There's a car safety, consumer product safety debate. You know, there's a climate change debate. Like all of these are seen as silos and there isn't a lot of in the policy space people connecting lines across these very vastly different issues. It's too big and too complex. And I don't think that our politicians or our policy debates sort of lend themselves to these kinds of things. I think you're probably right. But it's not that complicated, right? Like it's just being healthy and living long. You know, in some ways, if you broaden it out, it becomes a little less complicated and intractable. And it just becomes like this really basic thing

that any country would want for its population. All right. Well, that is it for us today. Selina Simmons-Duffin, as always, thank you for coming on the pod. Thanks for having me. I'm Susan Davis. I cover politics. I'm Mara Liason, national political correspondent. And thanks for listening to the NPR Politics Podcast.