#380: Dying Before Our Time?

Americans are likelier than people in other wealthy nations to think they are in good health. But they would be wrong…

In recent years, I have asserted that both scandal and mismanagement by the Catholic hierarchy have led to the loss of influence for Catholic Social Teaching. Thus one of the great sources of public wisdom in our culture ends up getting ignored or even dismissed. But no matter how badly the custodians of this tradition perform their duties, we American Catholics ignore that wisdom at our peril.

Now comes evidence that ignoring the lessons of Catholic Social Teaching is costing people their lives. A recently released study by the National Research Council and the Institute of Medicine (U.S. Health in International Perspectives: Shorter Lives, Poorer Health ) attempts to determine why the U.S. ranks last in life expectancy among all wealthy nations. (see http://www.nap.edu/openbook.php?record_id=13497&page=1)

The Gospel of John makes it clear that Christian faith and a full life are closely linked, when Jesus says, “I came that they may have life, and have it abundantly.”

Catholic Social Teaching includes “Health Care” (one key to a full life) on its list of human rights. As one commentator explained: “Human fulfillment requires health, work, education, access, leisure, resources, security and many other things, which we define as human rights.”

But this massive study expands the reality behind these principles. Part 1 begins with this basic fact:

The United States ranks at or near the bottom on multiple measures of mortality and morbidity, in all age groups up to age 75, in males and females alike, and in virtually all other subgroups of the population. 
                                          
Then Part 2 it asks why. And Part 3 explores ideas for changing our course.

Last week’s wide media coverage of the report focused on its account of firearms deaths--the most newsworthy item, of course, in the wake of the Newtown tragedy.

But this 424-page study is bigger than that. It is a landmark that offers for the first time a comprehensive answer to why Americans suffer a health disadvantage. For Catholics who believe good public health is a human right, this analysis touches not only on social justice, but on life and death.

The evidence shows that the U.S. health disadvantage is pervasive across people’s lifespan, gender, class, and even race: “Americans face shorter lives and greater illness at all ages.” In a word, we are sicker and we die sooner--even if we don’t know it.

The breadth of our health inferiority is stunning:

When compared with the average for other high-income countries, the United States fares worse in nine health domains: adverse birth outcomes; injuries, accidents, and homicides; adolescent pregnancy and sexually transmitted infections; HIV and AIDS; drug-related mortality; obesity and diabetes; heart disease; chronic lung disease; and disability.

Think a good medical care system is enough to guarantee “healthcare”? Think again! This pervasive disadvantage is determined by far more than our Medical Care System. The study outlines four more key areas that affect our health:

Life-styles and behaviors, social and economic circumstances, environmental influences, and public policies can also play key roles in shaping individual and community health. And a number of these factors may be critical to understanding why some high income countries experience significantly better health outcomes than the United States.

When all five are added up, the tally is bleak. This raises the question of whether our “American way of life” is killing us.

It is true that “ObamaCare” should expand the number of insured Americans, but its broad impact is to be determined.

As for personal behaviors, the study finds that 40% of all U.S. deaths are linked to tobacco, diet, inactivity, or drinking. I wonder: why are these behaviors more dangerous in the U.S. than elsewhere?

Certain important unhealthy or injurious behaviors are more common in the United States than peer countries, including high-caloric intake, drug misuse, unsafe driving practices, high-risk sex, and the use of firearms. Poverty, unemployment, and income inequality are more prevalent than in comparable countries, education has not kept pace with other countries, and social mobility is more limited.

On firearms, the data is appalling.

There is little evidence, the study says, that violent acts a more frequent here than elsewhere. Yet they cause more deaths. 48% of violent U.S. deaths (homicide, accidents, suicide) involve firearms. US citizens own 35 to 50% of all the civilian owned firearms in the world--four times as many semiautomatic and automatic weapons as the U.S. Army! Globally, 80% of the firearms deaths occur in the U.S. The U.S. homicide rate is 20 times higher than our peer countries, and 43 times higher for people aged 15-24. (Note: that’s not 20 % and 43% higher, it’s 2000% and 4300% higher).

The U.S. firearms suicide rate is 5.8 times higher than elsewhere and unintentional firearm deaths are 5.2 times higher. All these grim numbers produce a chilling conclusion:

The prevalence of firearms in the United States looms large as an explanation for higher death rates from violence, suicidal impulses, and accidental shootings.

As for social factors in the U.S. health inferiority, the study collected data on income and wealth, on education, on the occupation, and on racial and ethnic identity. Observing that, relative to other wealthy countries, the U.S. possesses a “weak social safety net,” the study finds that our decline in health and life expectancy since 1975 coincides with a 40-year decline in social conditions, and concludes we need to explain the connection:

Life expectancy and other health outcomes…in the United States began to lose pace with other high-income countries in the late 1970s, a trend that has continued to the present. During this same time…there has been a potentially important co-occurrence of worsening social conditions in the United States, notably a rise in income inequality, poverty, child poverty, single-parent households, divorce, and incarceration--all more pronounced than other rich nations.

These unsettling trends present a potentially important explanation for the U.S. Health disadvantage… An examination of these underlying causes can shed light on why the United States appears to be losing ground.

On policy, the study reviewed the nine key health factors from Part One and concluded that each factor has policy implications:

Policy is also relevant to the unfavorable social, economic, an environmental conditions identified of this report as potential contributors to the U.S. Health disadvantage. A variety of policies can contribute to high poverty rates, unemployment call-up, inadequate educational achievement, lost social mobility, and the absence of safety net programs to protect children and families from the consequences of these problems. However, identifying and implementing policy solutions is a formidable challenge.

This means that policy reform is key to longer life for Americans. Not just government policy, but also the policies of corporations and communities and nonprofit agencies and even churches. Those peer countries are ahead of us for a reason: they have instituted social systems aimed at the common good--aimed at a longer, healthier life for all their people. And they are succeeding:

In countries with the most favorable health outcomes, resource investments and infrastructure often reflect a strong societal commitment to the health and welfare of the entire population…Choices about political governance structures, and the social and economic conditions they reflect and shape, matter to overall levels of health.

The sad truth is that our health inferiority does not mean we have failed to achieve what they have achieved. Rather, the truth is this: we have not even tried! The study is clear about the consequences of doing nothing:

The consequences of not attending to the growing U.S. health disadvantage and reversing current trends are predictable: the United States will probably continue to fall further behind comparable countries on health outcomes and mortality. In addition to the personal toll this will take, the drain on life and health may ultimately affect the economy and the prosperity of the United States as other countries reap the benefits of healthier populations and more productive workforces. With so much at stake, especially for America’s youth, the United States cannot afford to ignore its growing health disadvantage. 

We Catholics claim to serve life. We inherit a moral tradition that requires an option to promote the common good. We belong to an institution that believes we all have a human right to the best health and fullest life possible.

From this viewpoint, too many of us have allowed this basic right of ours to be violated by inaction at all levels. Worse than that: we haven’t even noticed it happening. As if we were victims of mass anesthesia, we have slept through the decline in our health and our lifespan, dreaming that all was well. This study sounds a loud alarm that offers no snoozing. It is time we wake up and face the nation that is allowing its people to die before their time--before our time.

© Bernard F. Swain PhD 2013

#371 Manipulating the Catholic Vote

Now that Catholics represent a critical swing-voting group, some Catholics cannot resist exploiting faith to push their political agenda.

We hear a lot of complaints about “cafeteria Catholics.” But every election cycle brings another kind of Catholic into public view: the kind ready to exploit our faith for political gain.  I call them “Self-serve Catholics”.

In our time, this has mainly happened on the conservative side of the political spectrum.  The original Self-serve Catholics were Goldwater Republicans, chronically irked by the steadfast support of Catholics (80%) for John F. Kennedy.  Such Catholics were delighted when Lyndon Johnson’s civil rights leadership (1964, 1965) undermined the “Dixiecrats” (conservative southern Democrats) and turned the south over to the Republicans.  They were equally delighted when Roe v. Wade (1973) polarized the Catholic vote.  Catholics had been block Democratic voters since the days of Al Smith (1928), but by 1980 many were “Reagan Democrats” and over the last 30 years Catholics have become the largest swing vote in the nation.

The results delighted Self-servers: from 1968 to 2004, every President elected came from the south or California, far from the traditional Catholic liberal bedrocks of northeast urban centers.  And in 2004, even Catholic candidate John Kerry managed to get only 47% of the Catholic vote, largely because a caucus of conservative American bishops labeled him a bad Catholic.

But then, in 2008, Barack Obama regained the Catholic majority, and became the first northern liberal elected since John Kennedy.  This has left Self-servers doubling their efforts to regain conservative control of the Catholic vote.

I have repeatedly demonstrated that neither major party platform conforms to Catholic Social Teaching (CST), so neither party can lay claim to the Catholic vote as a right.  But Self-serve Catholics, undaunted by facts, continue trying to manipulate the Catholic vote using two main tactics.  First, they argue that only one issue should determine Catholic votes.  Second, they demonize one party (the Democrats) as immoral, anti-Catholic, even godless.

1. Single Issue Crusades.  In the 1960s, Self-serve Catholics struggled to find a Catholic litmus test for Democrats to fail: prayer in schools, sex education, birth control.  But after Roe v. Wade, the struggle shifted to attacking anyone who did not agree that legal prohibition of abortion was the best way to stop abortions.  In the last 10 years, gay rights and especially same-sex marriage have become new “single issue” options, but this year Self-serve Catholics have gone back to birth control, like this argument by columnist George Weigel:

Over the past four years, the Federal government has made unprecedented efforts to erode religious freedom.  The gravest assault was the “contraceptive mandate” issued earlier this year by the U.S. Dept of Health and Human Services: an offense to conscientious Catholic employers who believe what the church believes about the morality of human love and the ethics of the right to life, and a frontal attack on the institutional integrity of the Church.  For with the HHS mandate, the Federal government seeks nothing less than to turn the Catholic Church’s charitable and medical facilities into state agencies that facilitate practices the Catholic Church believes are gravely evil.

I have already explained why “offense to conscience” is a bogus argument against the HHS mandate (see CrossCurrents #350).  In America, the issue of religious freedom is already guaranteed by the First Amendment—and enforcing it is the responsibility of our courts, not our elected officials.  In fact, the matter is already in court.  If the courts decide this mandate does infringe on the Church’s religious freedom, then the mandate will go.  If not, the mandate will remain and Self-serve Catholics will continue to fight it, but they will lose any legitimate claim that it violates our rights.  Either way, the outcome has nothing to do with elections.

But facts are no deterrent to Self-serve Catholics.

2. Demonizing Democrats. George Weigel leads the crusade with relatively moderate rhetoric that nonetheless crosses the line.  He says “The Catholic Church is under assault of the United States today.” He argues that this assault violates the principle that “the state respect the sanctuary of conscience, so that the Church’s people are not required by law to do things the Church teaches are immoral.”

I confessed this dangerous-sounding language baffles me.  I picture federal police force-feeding birth control pills to Catholics citizens.  I wonder: precisely what immoral action will the government require people to do?  Will it require anyone to use contraceptives?  No.  Will it require anyone to buy them?  No.  Will it require Catholics to prescribe them?  No.  Will it require Catholics to pay for them?  Possibly, indirectly, by subsidizing the coverage of contraceptives by insurance companies--but then, we Catholics already subsidize the pharmaceutical companies that sell contraceptives all the time.  I have already explained why participating in the marketing of contraceptives cannot reasonably be called immoral (see CrossCurrents #350).  Yet Self-servers like Weigel persist in charging their political adversaries with immoral assault.

Such talk inspires others Self-servers to more inflammatory rhetoric.  Consider these examples, taken from the “Letters to the Editor” section of the very same issue of the Catholic newspaper in which Weigel’s column appeared.

One reader wrote:

We are already witnessing an attack on our freedom of religion by government edict…As Catholics it is our responsibility to fight against this evil…We should gather…in our churches for prayers to end the assault on our morality by the present administration in Washington and replace it with people with values like our own.

The writer is perfectly justified, of course, in wanting leaders with values like his own.  But he is not justified in invoking his Catholic faith to demonize political opponents as “evil.” Once again, there was no recognition that freedom of religion is already a constitutional right, to be protected by the courts, not politicians.

Another self serving reader made his demonizing even more personal:

The Obama administration’s war on religious freedom launched another attack with help from inside the Church.  Aided by every Catholic heretic in the Massachusetts congressional delegation, the Democrats are attempting to force religious institutions, especially the Catholic Church, to provide immoral medical procedures in violation of God’s law… They’re trying to limit our practice of our faith and to exclude us from the public arena. Our love for Jesus Christ tells us that we cannot allow this. We must resist and disobey these immoral laws and regulations.

Notice two things here.  First, the reference to “Catholic heretics” is an explicit claim that Catholics with contrary opinions on policy somehow violate their faith.  Second, these heretics are “attempting to force” the Church to participate in immorality.  In other words, these are not only bad Catholics, but they commit deliberate, premeditated evil on others.  And finally, in that writer’s view, not only do they “support immoral actions” but they even “refuse to recant publicly”!

There is no attempt by any of these writers to debate the issues at stake.  To them, the moral questions are black and white, the policy implications are self evident and beyond dispute, and the deliberate malice of their opponents renders all dialogue futile.  These assumptions trump both the facts and our faith.

And there is more.  Amid these demonizing attacks there is no corresponding description of “people with values like our own.” Since the context of these attacks is the election, we can presume the writers mean Republicans.  In other words, these electoral appeals presume that Republican policies are Catholic-friendly.  This begs the question: do Republicans have “values like our own“?

To me, this means asking whether Republican values conform to Catholic Social Teaching (CST).  Posing this question exposes the hypocrisy of Self-serve Catholics. The truth is that CST teaching clashes with Republican values and policies on many issues.  Let me cite two examples: “big government” and “human rights.”

Big Government.  Clearly a major policy priority for Republicans is the promotion of smaller government, less regulation, less taxation, less public spending.  This is built on the classic belief “that which governs least governs best,” and is rooted in a narrow concept of “freedom” as personal economy.  That is, we are free to the extent the government does not intrude in our lives.

I have already explained (CrossCurrents #83) that freedom means much more in our Catholic tradition, but the simpler objection is this: CST teaching places no value on the size of government.  It focuses instead on the role government plays in promoting “the common good” - - which is the prime value of CST.  If the common good is served by a larger government, CST supports that. CST even recommends using taxation to fight inequality by redistributing wealth. Do Republicans?

Human Rights.  Politics aside, most Americans agree that securing human rights for the citizenry is the job of government.  But many Americans, even American Catholics--and especially Self-servers--embrace a list of human rights that is much shorter than the human rights recognized by CST.  This allows them to assume--wrongly--that the Republican Party is Catholic-friendly.

How often do Republicans acknowledge that “illegals” are actually exercising the human right to migrate, as Catholicism does?

How often do Republicans acknowledge that healthcare is a human right, to be guaranteed by government, as Catholicism does?

How often do Republicans call housing, education, and employment human rights, as Catholicism does?

In my view, both parties, Democratic and Republican, fail to consistently support CST.  Yet I feel no need to demonize either party, or to claim they’re attacking me or my faith.  For me, it is enough to say that CST sets a standard they both fail to reach.

But that is not enough for Self-serve Catholics.  They insist on demonizing Democrats as deliberately imposing evil, while blithely giving Republicans a pass on their own failures.  What else can I think but this: these Self-serve Catholics begin with a particular political bias, filter their Catholic faith through that bias, and then invoke that distorted version of Catholicism to attack their political opponents and advance their own political agenda?  And how can I not think that such an exploitation of our faith is self-serving?

I am open to dialogue with those who want to explain how demonizing Democrats, while absolving Republicans, is a reasonable application of our faith.  But until that happens, I will stand by this: these Catholics offend me with their Self-serving political exploitation of our faith.

© Bernard F. Swain PhD 2012