Although opponents of former president Donald Trump have found many grounds to criticize him on, among his most glaring presidential flaws in the eyes of the public was his response to the COVID-19 pandemic.
This is partially because of his penchant for sharing COVID-19 misinformation, which is partially what led researchers from Cornell University to identify him as the largest driver of what they described as the “infodemic.” But Trump’s critics found an even more direct reason for their ire when he admitted to journalist Bob Woodward that he intentionally downplayed the virus’ highly infectious and potentially deadly reality.
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To this, his supporters often suggest that it’s unfair to blame Trump for COVID-19 deaths since they’re occurring worldwide and would have done so in the United States whether he was president at the time or not.
However, a new report from The Lancet argues that it is possible to measure how many fatalities he was responsible for and set out to do precisely that.
As the name might suggest, Trump and his policies factored heavily into the considerations of the Lancet Commission on Public Policy and Health in the Trump Era.
However, the report they published on February 10 argues that these policies serve to deepen a trend that has existed in America’s political and economic framework since 1980.
The refer to this trend as the “missing Americans,” which refers to American deaths — typically in those younger than 65 — that are out of proportion with the mortality rates of the other nations that make up the G7. These are Canada, the United Kingdom, Japan, Italy, Germany, and France.
The Lancet commission identified 461,000 of these missing Americans in 2018.
And it is by a similar metric that the commission found that 40% of the estimated 483,205 Americans the nation lost since the emergence of the pandemic could have been prevented.
And while this speaks to the overall gulf in mortality rate between the United States and its fellow G7 nations, the commission pointed to a variety of Trump’s policies and decisions that contributed to this particular difference.
In terms of the most direct impact the commission identified Trump as having on COVID-19 fatalities, they cited his public downplaying of the severity of the coronavirus, his lack of a national strategy against the virus’ spread, and the shortage of personal protective equipment and testing materials that resulted from that lack of a strategy.
Also mentioned were his long-time decisions to discourage mask wearing, rush to re-open schools, and hold indoor public events that he expected thousands to attend.
However, the Lancet commission also found that even policies that wouldn’t appear relevant to these deaths during the pandemic played their on role in increasing American mortality.
They describe him as undermining health coverage and weakening food assistance programs, which are fairly obvious barriers to efforts by Americans in need to sustain their lives.
But even Trump’s policies shifted funding from social programs to tax breaks for corporations and military spending saw their own effects as similar austerity measures in late-Weimar Germany and modern Britain have historically been associated with spiking mortality rates in cities most affected by these measures.
As the Lancet commission saw it, it’s no coincidence that counties where more than 60% of citizens voted for Trump saw a two-and-a-half year dip in life expectancy compared to counties where he secured less than 40% of the vote.
The main category for deaths resulting from these economic policies are known as “deaths of despair,” which tend to describe suicides and substance abuse-related fatalities.
As these deaths of despair have risen significantly over the same time period that the U.S. has adopted neoliberal policies that saw persistent spikes in incarcerations, welfare eligibility restrictions, and the widening of income and wealth inequalities, it’s not hard to see why the Lancet commission would find it inaccurate to drop this “missing Americans” trend purely on Trump’s lap.
More directly related to public health are the effects of a 20% decrease in the front-line public health workforce due to funding cuts and the fact that 30 million Americans have no health insurance — and this is the figure that came after the passage of the Affordable Care Act — and that even those with insurance often can’t afford care.
With these conditions in mind, the Lancet Commission characterizes Trump’s failure to prevent 40% of the nation’s COVID-19 deaths as the exacerbation of a system that was already vulnerable to the pandemic.
Another concerning finding is that this gulf in mortality rates between the United States and other G7 countries is disproportionately seen among Black, Indigenous, and People of Color.
According to the Lancet commission, this was also true before the COVID-19 pandemic as mortality before the age of 65 was 59% higher among Native Americans and 42% higher among Black citizens than among white Americans. They also found that Native American women were 2.3 times more likely to have a pregnancy-related death and Black women 3.2 times more likely to have one than white women.
Once again, this has only become worse since the pandemic emerged as Black Americans are 1.2 to 3.6 times more likely to experience the fatal effects of COVID-19 than white people and both Black and Latinx individuals have seen their life expectancy rates decrease at a disproportionate rate compared to white Americans.
So while Trump’s policies and other decisions were linked to 40% of the COVID-19 deaths America has seen thus far, this “missing Americans” phenomenon is unlikely to significantly improve after his absence — particularly among BIPOC people — if the systemic conditions that worsened during his administration aren’t sufficiently addressed by future governments.
h/t: The Lancet
