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Comment on Life expectancy in the U.S. varies greatly by region

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I saw all the doom and gloom tweets, but didn't realize most of the cause boils down to policy decisions. Call your elected officials and tell them you don't want to die an avoidable early death.

I mean, what else could be the cause? One way or another, it'll come down to some insane policy decision or other.

And this "states vs federal" power struggle in America (not my country) basically guarantees that there will be variance across states. The division of powers made sense in the old days, but in today's day and age it's crazy that there are not more standards set across the board at the federal level.

It's not my battle to fight, but it is depressing to see America squander so many opportunities to make things better.

The problem with federal standards is getting everyone to agree. If state standards aren’t allowed and California wants tougher environmental standards on California land, but Texas doesn’t, you force a showdown, a loser, and simmering resentment for decades.

100% agree with the first sentence.

If state standards aren’t allowed and California wants tougher environmental standards on California land, but Texas doesn’t, you force a showdown, a loser, and simmering resentment for decades.

Federal standards are in the interest of all citizens, whether or not they frustrate some state politician or not shouldn't even count as an objection.

I don't care if the Texas government is happy, but I do care if the people in Texas are healthy. Maybe that's just me though.

First, I’m sure it’s hard to imagine, but California could lose said showdown and find themselves obstructed from protecting even only California. Second, it’s not just some lone politician that would care. The whole Roe v. Wade thing should have made clear that half of the country had been seething to overturn it for decades. Our whole system is built on consent of the governed; Federal mandate is therefore tricky if one large state is in overwhelming support of an issue while another is overwhelmingly opposed.

Many US states are size equivalent to entire EU countries. There’s no need to let the EU control those countries directly, same goes for states.

Going one level higher up the chain doesn’t gain anything other than further separating people from policy makers.

However, US states are vastly more interconnected than EU countries. We all (well, mostly) speak the same language, we all use the same currency and always have used the same currency, you can walk or drive across the borders of any states with nobody checking or caring, and indeed states don't need to take individual responsibility for protecting their borders militarily. You can live and work in any state you want and move to or work in a different state at any time. The US military is mostly nationalized. The state-based National Guard does exist, but it's quite small and weak compared to the Army, Navy, Air Force, Marines. And the National Guard doesn't have nuclear weapons! Imagine if individual US states controlled nukes...

Even though there's definitely a strong state by state correlation, I thought it was interesting that a number of states (like South Dakota and Wyoming) had such a wide range of outcomes. Not sure of that's just randomness due to smaller population sizes or what

Those are reservations. MT, ND, MN, WI too https://en.m.wikipedia.org/wiki/Indian_reservation

Well, that's a very depressing answer to the mystery. Thanks though!

Smaller populations, more rural populations -- see also: rural vs urban divide -- and, as another poster mentioned, Native American reservations, which are often some of the poorest areas in the US.

What changed between the old days and now to make running many independent(ish) experiments in government stop making sense?

The 13 colonies were not "experiments". They were preexisting local governments that needed to come to agreement on forming a new nation after overthrowing the rule of the British King. The compromises made in the US Constitution were the price for that agreement at the time.

The problem is that people in the 21st century still feel bound by an 18th century agreement. I guess the alternative is another civil war, so that might be why the agreement lasts, no matter how shaky and dubious.

Sure seems to me like any time the technocrat/commentariat/coastal crowd point out the various problems with the American South, it's always with this patronizing schadenfreude vibe.

"Haha guys look at the poor dumb hicks who don't know what's best for them"

Having half my extended family in the rural South, they don't often do much to offset that impression. There are nice ones and mean ones, but none of them really have their lives together and there's obvious stuff they could be doing, like cutting sugar consumption in half (so many diabetics). One of my uncles died of complications from willfully unmanaged diabetes. His foot was literally rotting off one toe at a time, he was in direct pain and he still pounded can after can of Mountain Dew and ignored anyone who tried to advise him otherwise, including his own wife and son. My nicer uncle is half-functional due to neck injuries he sustained in a car crash, but he just pushes through things and doesn't look after his health, and just makes things worse for himself despite his good intentions.

That seems to be the identity of the modern south, various flavors of denial and defiance. Those who defy the stereotype tend to leave, or cluster in/around the better developed urban areas. I've met a lot of awesome people who immigrated from the south, but not many living there outside of a major metro.

Thank you for illustrating my point. Yeesh.

I am from the South and I concur with that poster, I’m not sure why takes like these are invalid due to having left. If a place has a lot of problems, you would expect people to leave it and then freely tell other people about the problems after getting more exposure to the world outside of it.

The South has educational problems, lack of opportunities, a lot of poverty, health problems, and different cultural values when compared with the rest of the country. This is a fact, it’s not a “yikes” to state this.

It’s not entirely willful, but it’s also not a completely unavoidable state of affairs either. A lot of it is cultural - when you’re in that environment, it’s normal to you. But at the same time, the people making up the culture as a whole are not helpless individuals incapable of understanding things like diabetes or obesity

How so? Is it patronizing to say the Bears had the worst record in the NFL last season? The proof is in the pudding.

My experiences are just anecdotal evidence that supports the objective stats.

Respect is earned, and sometimes, when lots of people tell you you're wrong, it's useful to have the humility to consider they might be right.

What’s the other explanation? I presume it’s not the enormous amount of asymmetric financial assistance that pours into the south every single year from the “patronizing” coastal elites?

The South ties its wagon to the wrong horse year in and year out. No one forces them to do that.

Fixating on the patronizing tone is exactly the type of error that gets these outcomes.

I presume it’s not the enormous amount of asymmetric financial assistance that pours into the south every single year from the “patronizing” coastal elites?

No, this is largely a myth. [0]

[0]: https://mises.org/wire/no-red-state-economies-dont-depend-gr...

It is interesting that so many states are tagged blue when I would have tagged them red or purple at most. According to Wikipedia (https://en.wikipedia.org/wiki/List_of_United_States_state_le...) there are 19 democratic states and 28 republican states. Your source almost splits the country into two halves which is misleading.

I believe "red state" and "blue state" is commonly referring to which party's candidate won the state in the last presidential election.

QED

Is your claim that the patronizing tone is the source of or a possible solution to the South’s problems?

Or is this a, “because the coasts are patronizing, we don’t need to discuss these issues.”

Seems like the latter to me but I’d be interested to hear if it’s the former.

“You made your bed, now lay in it” is neither constructive nor effective in changing minds.

True. What is effective, though?

Cultures do change themselves over time, but it may be painfully slow, and sometimes they don't change.

I'm not condescending or judging. We're all human biologically, and culture is not a simple matter of individual responsibility, it's a collective and historical phenomenon. Individuals may be able to rise above their culture, but in some cases the path can be longer and steeper. Would I be the same person if I were born in a different place? If I were born in a different time? Of course not. We've all been shaped by our culture.

In any case, it's difficult to help when relevant help is rejected, e.g., ACA subsidies. Moreover, there's an underlying conflict of values and even religion that pervades the politics, seeping into seemingly unrelated issues such as health and economics, and undermining the possibility of agreement or compromise. It's difficult to be kind, sympathetic, understanding, patient with someone when that someone goes out of their way to try to take away civil rights that you care deeply about. At a certain point, you need to fall back to self-preservation.

And that isn’t being said here. Frustration with a person’s family is one comment, discussions of the cultural problems on the south in another (denial/defiance), but regardless of someone’s tone thousands of miles away the problem is still there and the source of it is not the tone or words used by individuals from far away.

No one is saying that. This would be a good retort if anyone was proposing that the South actually lay in its own bed.

I have never heard any proposal from the patronizing coastal elites to cut off funding for Southern welfare states.

“The South ties its wagon to the wrong horse year in and year out. No one forces them to do that.”

. . .

"Haha guys look at the poor dumb hicks who don't know what's best for them"

We can factually and objectively demonstrate how the south is lagging. This isn't some moralistic "lol those dumb hayseeds wear shitty clothes", there is a measurable, concrete divide in things like healthcare and scholastic outcomes.

People are dying early, considerably so. dying Child mortality is notable higher. Standardized test scores are just lower, and by non-trivial numbers.

I have direct experience with non-coastal people doing things bad for their health because somebody told them it was bad for their health, not because they think the person who told them was wrong, but because they want to show that they can exercise their right to be stupid anyway. Everything from eating things they didn't really like just because they were unhealthy to modifying their cars to be dirtier. This was a frequent enough occurrence to be noticeable.

I more or less agree... But, does it make it any less true?

No it absolutely does not change the facts - but I’d be willing to bet people are more likely to change their minds (about policy, politics, their way of life) if folks didn’t look down their noses at them.

Of course everyone knows this, but grace and empathy is much harder than condescension and schadenfreude.

It goes both ways though. "Woke" has now become almost exclusively pejorative. And they're pulling "Communist" out of retirement lately, despite the fact that Russia and China are both capitalist now. What about the contempt for gay people? The contempt for "hippies" in 1960s?

I doubt that anyone is innocent of condescension.

Here's an article about "No-Respect Politics" from 20 years ago: https://www.washingtonpost.com/archive/opinions/2002/07/26/n...

Evidently you missed the part about grace and empathy?

"But they started it" "They do it too" "They are meaner"

'They they they' is the problem.

"But they started it" "They do it too" "They are meaner"

You're using quotes, but I said none of those things.

'They they they' is the problem.

The problem is as vaidhy suggested. You said grace and empathy is much harder than condescension and schadenfreude, but it becomes even harder when grace and empathy are met in return with condescension and schadenfreude. If you're acting in good faith, how much can you stand to be humiliated? It takes two sides to come to the table. Trust must be built mutually. Otherwise it's like talking to a brick wall.

Grace and empathy only go so long. You cannot be tolerant of the intolerant over and over again. There needs to be some amount of reciprocity.

I’m not really sure how this relates to the problem. People may be awful or cruel sometimes, but that doesn’t force civic leaders or individuals into making bad policy/personal decisions.

Furthermore, a lot of this is an explicit problem. Poverty is high in the south and poverty correlates strongly with less access to healthcare, or healthcare avoidance to avoid the cost.

Viewing every woe as a policy issue is actually very technologist/authoritarian.

The South obviously has a unhealthy diet, but the inner cities are dramatically poorer than blue state cities with even more crime to match (St. Louis in particular). It's not a blue/red thing. It's more income and culture driven.

The biggest problem with the American south: https://www.pbs.org/wgbh/nova/article/how-a-worm-gave-the-so...

I had a co-worker whose neighbor died recently not all that much after his 40th birthday from some combination of smoking, occupational exposure to construction debris/chemicals, and long covid. He was on the list for a lung transplant for a bit, but no one seemed to believe that gave him any chance, and it did not. Perhaps if he had not smoked, worn proper PPE when needed, and gotten a covid vaccine, he would be alive today. It seems that his downwardly mobile southern culture failed him quite completely, but I do agree that if you had told him that, you'd probably be thought of as a patronizing.

When everyone sh*ts on your culture 24/7/365 for decades and decades, it gets pretty hard to separate the condescension from the genuinely good advice.

Consider what are the predominant themes were in white southern culture 60 years ago. They never really let go of it.

I guess they’re getting what they deserve then, eh?

Certainly not. I think they have cynically manipulated by politicians taking advantage of some amount of real cultural disapproval. They cultivate the grievances and push them even more extremes.

Politicians are just people. They're not space aliens like Kang and Kodos. Politicians are citizens and came from the same place as everyone else. They're just as much a product of the local culture as everyone else in their locality.

Sure. Politics is a group dynamic. And in this case it has a clear tendency towards an extreme that is self harming. But almost none of the individuals are driving towards that intentionally.

But almost none of the individuals are driving towards that intentionally.

I disagree with that.

Indeed, when their own TV network calls them "dumb, cousin-fucking terrorists"[0], you'd think they'd have a hard time trusting them, but it doesn't seem that way. Still, I'd think don't smoke and take your vaccines would be relatively uncontroversial basic public health information these days, but I guess not.

[0]https://twitter.com/Eric_Alterman/status/1634971075334508544

“Their own TV network”

I don’t know many Louisianans working at FOX NEWS HQ in NYC…

Yes, they'd never be allowed to work there for reasons mentioned in my previous comment. However, you may find that they view it as their side in opposition to the mainstream media. But of course you know that and are simply playing a game of your own (and I suppose I'm indulging in it a bit myself).

Exactly, I'll tell them I want restrictions on guns, more speed limit enforcement, universal healthcar....oh you were trying to be sarcastic

Call your elected officials and tell them you don't want to die an avoidable early death.

I'm pretty sure they know that already.

I don't think you have noticed. But politics has devolved into being anti-woke rather than making adult policy decisions.

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