Health care is a big deal. But we have to consider other factors too. Because it's the quality, balance, and interaction of ingredients that make the cake. Eggless batter won't have that velvety richness. Bad flour tastes stale. Insufficient sugar will produce cake that doesn't even taste like cake. Fat, moisture, oven temperature, cooking time--it all matters.
And so it is with the quality and texture of our lives. Within the context of our shared social worlds, it's the interplay and qualities of our physical health, our economic well-being, and our education that render our lives what they are. It's not one or the other, it's all three. And it's not all three in the abstract, it's the distribution of these qualities across communities that concerns the body politic. Who gets how much of what around here?
As a Jewish person observing the holiest days in our tradition, I stood among my community last week as we collectively posed questions about the coming year: Who shall live, and who shall die? Who shall perish by thirst, and who by hunger? Who will see ripe age, and who shall not? Who shall be secure, and who shall be driven?
We pose these awesome questions, and many others equally scary, but the answers are not in God's hands; they are in ours. We actually know a great deal about the relationship between the distribution of human and material resources and, say, illness and longevity. The fact is: What we do here and now determines who will see ripe age, and who shall not.
Enter one of my favorite sources of data: http://www.measureofamerica.org/maps/
The non-partisan social science group that created this resource has developed what they call an "American Human Development Index." This composite measure shows the relationship among education, personal earnings, and health--assessed across multiple indicators--through a single score. On a national range from the low end of 3.84 (West Virginia) to the high end of 6.30 (Connecticut), Missouri has scored 4.68, 15th from the bottom. That's 15th worst.
But that number alone doesn't tell our story. Our state's story is in the breakdown of that 4.68. Because the southeast region of the state, the 8th Congressional District, scores 3.24, which is far worse than West Virginia's score. Our 2nd District scores a 6.24, which is nearly as good as Massachusetts' state score.
Or look at life expectancy at birth: The average person in the 8th District can expect to live to 75.1 (a little less than the average life expectancy in West Virginia). In the 2nd District, that age is 79.4 (a little bit better than the life expectancy in Wisconsin).
Health, income, and education. Who shall live, and who shall die?
I'll get to education in another column, but right now let's look at median personal incomes, the wages and salaries earned by individuals 16 and older, working full and part-time.
In Missouri as a whole, the median personal earnings are $26,800, 19th from the poorest. But of course we all know -- as with health care and life expectancy -- this is not a true picture. The true picture is the contrast between our 8th district and our 2nd, our poorest and our wealthiest. Here we go: the median personal earnings in the 8th District is $21,102. In the 2nd, it's $36,405. (By comparison, in Connecticut's 4th Congressional District, this figure is $42,099.) In Missouri's 8th, 20 percent of the community is living in poverty, compared with 5.2 percent in the 2nd. As for percentages of people reliant on foodstamps? In the 8th it's 19 percent. In the 2nd, 3.5 percent.
Really, what we have here is around 650,000 of us Missourians living, on average, in what amounts to Connecticut, and 650,000 living, on average, in a kind of West Virginia that shares a few features with the poorest border towns of New Mexico. (If we disaggregated the 2nd District data we would probably see a pretty significant range across zip codes.)
I am not the first to say something like this. And I am not the first to ask whether "we" are OK with this. But I do wonder who "we" are, given who "we" say "we" are.
Are "we" those who truly consider ourselves our brothers' keeper? Are those who vote for proponents of "trickle down" economic theories and practices-- whether true believers or cynical plutocrats -- considering the lay of our land over time?
Let me quote Albert Vorspan and David Saperstein, from a passage published in 1998, a decade before the economic collapse of 2008:
"In 1959, before the birth of the modern social welfare program, 22 percent of the American people lived in poverty. By 1965, it was down to 17 percent; in the 1970s, as a result of the Social Security and Great Society programs, the rate hovered in the 11- to 12- percent range."
Beginning in 1981, with the ascent of Ronald Reagan and the trickle-down crowd, these trends began to reverse. Things got worse for the worse off. And when reforms were needed in the system, when adjustments might have been made to improve the programs, the 1996 Welfare Reform Act (enacted under Bill Clinton and the centrist crowd) instead cut $55 billion in federal government spending on human needs programs over the next six years.
As in public education (where policies and practices were actually starting to lesson the achievement gap through the late 1960s and 1970s), ever since the late 1990s we have, as a nation, been slowly grinding away at the poorest and most vulnerable communities among us across all of the most essential and interrelated factors that enable a person to live life with dignity: health, education, and a decent personal income. It turns out that those of us who were children between 1965 and 1980 were marinating in what would prove to be among the most slogging-towards-decency episodes of the last century. This is a strange thought when I recall the teachers' strikes, the garbage workers' strikes, the crime, the beloved wreck that was Central Park, and the near bankruptcy of the New York City I grew up in. Turns out those were the good old days!
Grassroots Democrats tend to complain a lot about (poor or middle class) people who vote against their personal, pocketbook interests and thereby help send to Jefferson City and Washington D.C. representatives who represent the interests of rich people.
Republicans tend not to talk so much about (upper middle class and rich) people who vote against their personal, pocketbook interests in order to try to send to Jefferson City and Washington, D.C. representatives who, it is hoped, will tax, regulate, and generally try to design a social landscape less dystopian and inequitable than the one we have now.
Lots of us have enough, much more than enough. Many more of us have nothing even close to enough. Not enough decent food, not enough clean water, not enough peace and safety, not enough access to good health care, not enough high-quality schooling, not enough money.
I was 16 when I watched Jimmy Carter, wearing a sweater, tell people that natural resources were growing scarce, that the Middle East was unstable, and that we had better turn down our thermostats. It was the truth, and he got clobbered for it. But the truth is the truth. As JoAnn Wypijewski recently wrote following her experience covering the Republican convention in Tampa: "The wars are lost, the soldiers are killing themselves, the children are stupid, labor is idle or underpriced, the masses are indebted or poor, the rich are vulgar and grabbing all they can while they can." Bleak and extreme words, I know. But at the very least, we can stop pretending they're not rooted in truth, nor driven by data.
There are no solutions to our nation's problems that do not somehow, in some way, redistribute some of the treasure from the few who have much (including the transnational corporations) to the many who have little. Fair wages, access to health care, and meaningful schooling do not represent the fruits of a socialist plot. And any candidate who suggests otherwise is not speaking the truth.
Stay tuned for our next guest expert, a person who will work the numbers a little more. And if you feel like poking around the Missouri-specific data for yourself, here's the link: