Sunday, November 23, 2003

Losing Hope

From the Boston Globe comes a story about lost lives and futures in a place where “a boy born…has a life expectancy lower than that of babies in 34 of the world’s developing nations, among them some of the most impoverished — Tajikistan, Colombia, the Dominican Republic, Mongolia, and Vietnam.” They’re not talking about Iraq. They’re talking about McDowell County, West Virginia.

“It’s amazing that these places exist in the United States,” said Christopher J. L. Murray, lead author of a 1998 mortality study of US counties by Harvard School of Public Health and the Centers for Disease Control. “These are people who have the same set of diseases and risk factors that much of the rest of the world — some two to three billion poor people — worry about.”

There are other American outposts of needless death, death at too young an age. The Sioux tribes of South Dakota, whose alcohol-related accidents have plunged male life expectancy to 61 years. Or the African Americans of the Mississippi Delta region, who are plagued by high rates of homicide, AIDS, and drug abuse. Or those living in the urban neighborhoods of Washington, D.C., Baltimore, St. Louis, and the Bronx, who die young even as their neighbors, in some of the country’s wealthiest neighborhoods, live the longest.

There is a common thread linking the residents of these very different places: They have almost no economic base, or political pull.

In effect, they are a kind of ongoing social experiment in how long people can live in a state of chronic poverty, and dispiritedness, before their bodies give way and their health falls apart.

“If you don’t treat anybody or offer lifestyle interventions, life expectancy — without high infant mortality — probably is in the low 60s in the United States. That’s what you are seeing in those places,” said Thomas Graziano, a native West Virginian who specializes in cardiovascular diseases at Brigham & Women’s Hospital in Boston. “So it’s not that they are dying young. They are dying without interventions.”

“What burns me up is that we’re in Iraq building sewer and water systems, and health systems,” said Danny Brown, an assistant to funeral director Widener. “Are these people in Washington ever going to look at this county here?”

For what it’s worth, West Virginia voted for Bush in 2000.