Where you live in America can have a major effect on how young you die | Colin Woodward

The truth of life expectancy in America is that places with comparable profiles — similar advantages and similar problems — have widely different average life outcomes depending on what part of the country they belong to.

POLITICO Magazine Friday Read

America’s Surprising Partisan Divide on Life Expectancy

Centuries-old settlement patterns — and the attitudes they spawned about government — are to blame for differences in longevity between red southern states and bluer parts of the country.

POLITICO illustration/Photos by iStock

By COLIN WOODARD

09/01/2023 04:30 AM EDT

The Identities of the ‘American Nations’

In the book American Nations I argued that there has never been one America but rather several Americas, most of them developing from one or another of the rival colonial projects that formed on the eastern and southwestern rims of what is now the United States. These regional cultures — “nations,” if you will — had their own ethnographic, religious and political characteristics, distinct ideas about the balance between individual liberty and the common good and what the United States should become.

There is a more detailed summary here, but the nine large regions — with populations ranging from 13 and 63 million — are:

Yankeedom (pop. 55.8 million)
Founded by Puritans who sought to perfect earthly society through social engineering, individual denial for common good, and the assimilation of outsiders. The common good — ensured by popular government — took precedence over individual liberty when the two were in conflict.

New Netherland (pop. 18.8 million)
Dutch-founded and retains characteristics of 17th century Amsterdam: a global commercial trading culture, materialistic, multicultural and committed to tolerance and the freedom of inquiry and conscience.

Tidewater (pop. 12.6 million)
Founded by lesser sons of landed gentry seeking to recreate the semi-feudal manorial society of English countryside. Conservative with strong respect for authority and tradition, this culture is rapidly eroding because of its small physical size and the massive federal presence around D.C. and Hampton Roads.

Greater Appalachia (pop. 59 million)
Settlers overwhelmingly from war-ravaged Northern Ireland, Northern England and Scottish lowlands were deeply committed to personal sovereignty and intensely suspicious of external authority.

The Midlands (pop. 37.7 million)
Founded by English Quakers, who believed in humans’ inherent goodness and welcomed people of many nations and creeds. Pluralistic and organized around the middle class; ethnic and ideological purity never a priority; government seen as an unwelcome intrusion.

Deep South (pop. 43.5 million)
Established by English Barbadian slave lords who championed classical republicanism modeled on slave states of the ancient world, where democracy was the privilege of the few and subjugation and enslavement the natural lot of the many.

El Norte (pop. 33.3 million)
Borderlands of Spanish-American empire, so far from Mexico City and Madrid that it developed its own characteristics: independent, self-sufficient, adaptable and work-centered. Often sought to break away from Mexico to become independent buffer state, annexed into U.S. instead.

Left Coast (pop. 17.9 million)
Founded by New Englanders (who came by ship) and farmers, prospectors and fur traders from the lower Midwest (by wagon), it’s a fecund hybrid of Yankee utopianism and the Appalachian emphasis on self-expression and exploration.

Far West (pop. 28.7 million)
Extreme environment stopped eastern cultures in their path, so settlement largely controlled by distant corporations or federal government via deployment of railroads, dams, irrigation and mines; exploited as an internal colony, with lasting resentments.

I shared these maps with cardiologist Donald Lloyd-Jones, a past president of the American Heart Association who chairs the preventive medicine department at Northwestern University in Chicago, who said they didn’t surprise him at all. “There’s a reason why the Southeastern portion of this country is called the Stroke Belt: It’s because the rates of stroke per capita are substantially higher there and mirrored by rates of cardiovascular disease, diabetes, obesity and other risk factors.”

“The places on your map where you see orange and red have structural and systemic issues that limit people’s ability to have socioeconomic opportunity, access health care, or achieve maximum levels of education,” Lloyd-Jones added. “All of these policies affect your health and these disparities in longevity absolutely reflect social and structural and historical policies in those regions.”

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At Nationhood Lab we wondered if all of this is might just be a reflection of wealth. Some American regions have always had higher standards of living than others because their cultures prioritize the common good over individual liberty, social equality over economic freedom and quality services more than low taxes. The Deep South was founded by English slave lords from Barbados who didn’t care about shared prosperity; The Puritan founders of Yankeedom — who thought God had chosen them to create a more perfect society — very much did, and it made the average person materially a lot better off, both then and now. Maybe the differences between the regions would go away if you compared just rich counties to one another or just the poor ones?

Nope.