Changes in US state policies since the 1970s, particularly after 2010, have played an important role in the stagnation and recent decline in US life expectancy. Some US state policies appear to be key levers for improving life expectancy, such as policies on tobacco, labor, immigration, civil rights, and the environment. US life expectancy is estimated to be 2.8 years longer among women and 2.1 years longer among men if all US states enjoyed the health advantages of states with more liberal policies, which would put US life expectancy on par with other high‐income countries. Context Life expectancy in the United States has increased little in previous decades, declined in recent years, and become more unequal across US states. Those trends were accompanied by substantial changes in the US policy environment, particularly at the state level. State policies affect nearly every aspect of people's lives, including economic well‐being, social relationships, education, housing, lifestyles, and access to medical care. This study examines the extent to which the state policy environment may have contributed to the troubling trends in US life expectancy. Methods We merged annual data on life expectancy for US states from 1970 to 2014 with annual data on 18 state‐level policy domains such as tobacco, environment, tax, and labor. Using the 45 years of data and controlling for differences in the characteristics of states and their populations, we modeled the association between state policies and life expectancy, and assessed how changes in those policies may have contributed to trends in US life expectancy from 1970 through 2014. Findings Results show that changes in life expectancy during 1970‐2014 were associated with changes in state policies on a conservative‐liberal continuum, where more liberal policies expand economic regulations and protect marginalized groups. States that implemented more conservative policies were more likely to experience a reduction in life expectancy. We estimated that the shallow upward trend in US life expectancy from 2010 to 2014 would have been 25% steeper for women and 13% steeper for men had state policies not changed as they did. We also estimated that US life expectancy would be 2.8 years longer among women and 2.1 years longer among men if all states enjoyed the health advantages of states with more liberal policies. Conclusions Understanding and reversing the troubling trends and growing inequalities in US life expectancy requires attention to US state policy contexts, their dynamic changes in recent decades, and the forces behind those changes. Changes in US political and policy contexts since the 1970s may undergird the deterioration of Americans’ health and longevity.
Political scientists often characterize state and local governments as marginal and highly constrained in policymaking. However, I suggest that in recent decades state governments have moved from the margins to the center of partisan battles over the direction of U.S. public policy. Across 16 issue areas, I investigate interstate policy variation, policy differences across states, and policy polarization, the changing relationship between party control of state government and policy outcomes. Since the 1970s, interstate variation has increased such that an individual’s tax burden, right to obtain an abortion, and other relationships to government are increasingly determined by her state of residence. Policy polarization increases dramatically after 2000 in 14 of the 16 areas. I show that party control increasingly predicts socioeconomic outcomes in the polarized area of health care, but not in the nonpolarized area of criminal justice.
Awareness of the benefits related to school drinking water provision and funding may help communities achieve excellence in drinking water access.
Scholars and political observers point to declining labor unions, on the one hand, and rising white identity politics, on the other, as profound changes in American politics. However, there has been little attention given to the potential feedback between these forces. In this article, we investigate the role of union membership in shaping white racial attitudes. We draw upon research in history and American political development to generate a theory of interracial labor politics, in which union membership reduces racial resentment. Cross‐sectional analyses consistently show that white union members have lower racial resentment and greater support for policies that benefit African Americans. More importantly, our panel analysis suggests that gaining union membership between 2010 and 2016 reduced racial resentment among white workers. The findings highlight the important role of labor unions in mass politics and, more broadly, the importance of organizational membership for political attitudes and behavior.
The Trump presidency generated concern about democratic backsliding and renewed interest in measuring the national democratic performance of the United States. However, the US has a decentralized form of federalism that administers democratic institutions at the state level. Using 51 indicators of electoral democracy from 2000 to 2018, I develop a measure of subnational democratic performance, the State Democracy Index. I then test theories of democratic expansion and backsliding based in party competition, polarization, demographic change, and the group interests of national party coalitions. Difference-in-differences results suggest a minimal role for all factors except Republican control of state government, which dramatically reduces states’ democratic performance during this period. This result calls into question theories focused on changes within states. The racial, geographic, and economic incentives of groups in national party coalitions may instead determine the health of democracy in the states.
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