Conservative state policies generally associated with higher mortality

State policies in eight different policy areas, including gun safety, labor and tobacco, are associated with working-age mortality in the United States, according to a new study published this week in the journal free access PLOS ONE by Jennifer Karas Montez of Syracuse University, USA, and colleagues. They note that more conservative state policies were generally associated with higher mortality.

Americans die younger than people in most other high-income countries, and life expectancy in the United States differs significantly by geographic area. In 2019, it ranged from 74.4 in Mississippi to 80.9 in Hawaii.

In the new work, the researchers used data from the National Vital Statistics System 1999-2019 to calculate state-level age-adjusted mortality rates for deaths from all causes and diseases. (CVD), alcohol, suicide and drug poisoning in adults. 25 to 64. They merged this data with annual state-level data on eight policy areas, where each state’s policies were scored on a conservative-to-liberal continuum from 0 to 1.

The analysis found that more liberal policies on the environment, gun safety, labor, economic taxes, and tobacco taxes were associated with lower mortality in each state. However, for marijuana, more conservative policies were associated with lower mortality. Particularly strong associations were found between gun safety policies and suicide mortality among men; between labor policies and alcohol-induced mortality; and between economic and fiscal policies on tobacco and mortality from cardiovascular disease. Simulations suggested that changing all policies in all states to an all-liberal orientation could have saved 171,030 lives in 2019, while changing them to an all-conservative orientation would have cost 217,635 lives.

The authors conclude that the emergence of more conservative state policies in several areas and changes in the share of the population living in states with these policies partly explain the high and rising mortality among working-age Americans and the disadvantage overall US mortality. United States compared to other high-income countries.

The authors add, “U.S. state policies over the past several decades may have contributed to the high and rising death rates of working-age adults. Changing state policies could prevent thousands of deaths each year from cardiovascular disease, suicide, alcohol and drug poisoning.

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In your coverage, please use this URL to provide access to the article available for free in PLOS ONE: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0275466

Quote: Montez JK, Mehri N, Monnat SM, Beckfield J, Chapman D, Grumbach JM, et al. (2022) US State Policy Contexts and Working-Age Adult Mortality. PLoS ONE 17(10): e0275466. https://doi.org/10.1371/journal.pone.0275466

Author countries: UNITED STATES

Funding: This article was supported by a grant from the National Institute on Aging to JKM (grant R01AG05581). www.nih.nia.gov. The funder had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.