🕵️♀️ THE SLOW-MOTION CULL OF MAGA COUNTRY A Gonzo Dispatch from the Dying Hollers Filed from Delray Beach at 3:59 PM EDT, with the market bleeding out and the body count rising — as it does every day, every hour, in the great red gut of America Let me tell you something, friends, and I want you to pour yourself a stiff one before I do, because this is the kind of data that makes a rational man want to go buy a pickup truck and drive it straight into the nearest Joel Osteen prosperity-gospel megachurch at 90 miles an hour with the stereo blasting “Fortunate Son.” Snow, bless his epidemiologist’s heart, asked the right question up there — is it the babies or the grown men doing the dying? — and the answer, as it turns out, is yes. It’s both. It’s everybody. It’s a goddamn all-ages buffet of preventable death down there in the Bible Belt, and the catering is sponsored by the Republican State Legislature and a Philip Morris lobbyist named Chet. The Raw Numbers — Because the Numbers Never Lie, Even When Mississippi Does Mississippi — ancestral home of voter suppression, catfish, and the lowest life expectancy in the United States of America at 70.9 years. West Virginia: 71.0. Alabama: 72.0. Kentucky: 72.3. Louisiana: 72.2. Now look at Hawaii at 79.9, Massachusetts at 79.6, Connecticut at 79.2. That is a nine-year gap between the state that voted hardest for the guy in the red hat and the state where people wear sandals and read books. Nine years. That’s a middle-school education. That’s a mortgage refi cycle. That’s the difference between watching your grandkids graduate and being a photograph on a mantle next to a ceramic rooster. And it’s getting worse. The gap between best and worst state was under five years in 1984. Now it’s seven-plus and widening like a Mississippi sinkhole. Yale’s researchers found that for men born after 1950 in many Southern states, life expectancy gains essentially plateaued — they got less than two years of additional life across the entire back half of the 20th century, while the rest of the industrialized world kept adding years like Tom Brady adds Super Bowl rings. Progress just stopped below the Mason-Dixon. Someone pulled the plug and nobody noticed because they were too busy arguing about bathrooms and Confederate statues. Snow’s Question: Is It the Babies or the Grown Men? It’s the babies. Mississippi’s infant mortality rate: 8.94 per 1,000 live births. Arkansas: 8.22. Alabama: 7.64. Louisiana: 7.14. Oklahoma: 7.12. Now the blue states: New Hampshire 2.93. Vermont 3.16. Massachusetts 3.28. New Jersey 3.69. A Black baby in Mississippi is statistically worse off than one born in a country we spent 20 years bombing. The Black-white infant mortality gap, incidentally, has widened — Black infants died at 92% higher rates than white infants in the 1950s, and now they die at 115% higher rates. We have gone backwards! In the era of genome editing and mRNA vaccines and CRISPR and Neuralink, a Black mother in Jackson is burying her baby at a higher relative rate than her great-grandmother did during the Eisenhower administration. That is not a policy failure, friends — that is a policy choice! But it’s also the grown men. The National Bureau of Economic Research crunched it and found geographic inequality in midlife mortality jumped 70% between 1992 and 2016. West Virginia’s midlife mortality rate is nearly double Minnesota’s. In seven southern states — West Virginia, Mississippi, Oklahoma, Tennessee, Kentucky, Alabama, Arkansas — excess midlife mortality exceeds 200 deaths per 100,000 above where the trend line said they should be. In West Virginia, mortality is higher than at any time since 1980. These aren’t five-year-olds. These are 45-year-old coal country Trump voters keeling over from fentanyl, cirrhosis, suicide, untreated diabetes, obesity-driven heart disease, and the soul-crushing medical debt of a $400 insulin prescription they can’t afford because their governor turned down free Medicaid money to own the libs. And here’s the kicker that ought to be tattooed on the forehead of every state rep who voted against Medicaid expansion: “deaths of despair” only account for about one-sixth of the midlife death gap. The rest is just… everything else. Heart disease. Cancer. Diabetes. Stroke. All the boring, treatable, manageable stuff that a functioning healthcare system catches at a check-up. The South isn’t dying of despair — it’s dying of neglect, administered by men in Brooks Brothers suits who tell their constituents that Obamacare is communism while their own gold-plated federal health plan covers their third hip replacement. The Smoking Gun: Medicaid Expansion Here is where the partisan hatchet does its cleanest work. The Lancet’s study: Medicaid expansion was associated with 11.8 fewer deaths per 100,000 adults per year. Fewer cardiovascular deaths. Fewer respiratory deaths. Fewer cancer deaths. Fewer infection deaths. Just fewer deaths, full stop. And the peer-reviewed “Mortality of Politics” paper in 2024 came out and said the quiet part loud: if red states had vaccination rates equivalent to blue states, 72,000 COVID deaths could have been avoided. Seventy-two thousand people. That’s 24 September 11ths of dead grandmas in MAGA hats, sacrificed on the altar of Tucker Carlson’s prime-time hour and Joe Rogan’s ivermectin horse-paste hallucinations. And who were the hold-outs? Mississippi. Alabama. Florida — yes, Phil, your own adopted swamp, governed by the sentient gym-sock in boots who used hospital ICU beds as campaign props. Texas. Tennessee. Wyoming. Ten states still refuse Medicaid expansion as I type this, and in each one the coffins stack up like cordwood while their senators go on Fox News and complain about pronouns. The Atlanta Phenomenon — Phil’s Point, Now With Footnotes Phil noticed the blue dot in the red sea — progressive Atlanta in Georgia, blue pockets in Texas, blue South Florida. This is real. Politico’s investigation of the “American Nations” cultural regions found the poorest quartile of counties on the Left Coast has a 2.4-year advantage in life expectancy over the richest quartile of counties in the Deep South. Read that sentence twice. Being poor in blue California beats being rich in red Mississippi, lifespan-wise. You could be a broke surfer eating ramen in a Eureka trailer park and still outlive the plantation-heir attorney sipping 18-year Pappy on his veranda in Natchez. That’s not income. That’s not race. That’s not “culture of poverty” or whatever Charles Murray codeword is fashionable this quarter. That is policy! Clean air, clean water, seat belt laws, gun laws, tobacco taxes, minimum wages, Medicaid, paid leave, abortion access, labor protections — every one of them correlates with longer life, and every one of them gets strangled in its crib the moment it crosses the Georgia state line. The Character Assassinations (A Brief, Non-Exhaustive List) Greg Abbott, governor of the state with 2,263 dead babies a year, who would rather ship migrants to Martha’s Vineyard on Instagram-ready charter buses than acce...
