Saturday, April 29, 2023

Life Expectancy Differences Between Democrats and Republicans

Readers of Baby-Boomer-Retirement have repeatedly shown interest in understanding what they can do in order to live a longer, healthier and less stressful life.  Since most Baby Boomers are now in their 60s and 70s, this interest is quite understandable.  No one wants to see their lives, or the lives of their loved ones, cut shorter than necessary.

As a result, it was with great interest that I learned that among the causes of a shorter lifespan, one factor which is often overlooked is your political party, as well as the prevailing political leanings in the state and community where you live.  In fact, as you can see in the map shown in the healthcare section of this post, there is an almost 20 year difference in average lifespan between people living in heavily Republican areas and heavily Democratic leaning areas.  

Of course, all of us know a favorite Republican aunt who lived to the ripe old age of 102, or that Democratic cousin who died at 45. However, despite these outliers, on average a Democrat living in a Democratic county in a Democratic state is likely to live to be significantly older and healthier than a Republican living in a Republican county in a Republican state.

On Average, Republicans Have Shorter Lifespans Than Democrats

The United States has been divided into two major political parties, the Republicans and the Democrats, for decades. These parties often have contrasting views on various political issues including gun violence, healthcare, environmental factors, education, and more, and it may surprise you to know that those issues can contribute to the differences in longevity. Below are some of the reasons why this may be true.

Gun Violence

Gun violence is a significant problem in the United States. The Centers for Disease Control and Prevention (CDC) reports that firearms are the second leading cause of injury-related deaths in the country, with an average of 40,000 deaths annually. It is the leading cause of death for children and teens. 

Republicans generally have a more lenient attitude towards gun control than Democrats, which plays a part in the shorter lifespans in areas where they are in control. Studies have shown that states with more permissive gun laws have higher rates of firearm-related deaths, including a study by the American Public Health Association which found that states with more permissive gun laws had a higher rate of firearm homicide than states with stricter gun laws.

Data compiled by:


Access to healthcare is a fundamental factor in determining an individual's health outcomes. Republicans generally oppose policies which would increase access to healthcare, such as the Affordable Care Act (ACA). In contrast, Democrats support policies which aim to improve healthcare access. 

Research has shown that lack of healthcare access is associated with higher mortality rates. A study by the National Bureau of Economic Research found that individuals who gained access to Medicaid through the ACA had a 6% lower mortality rate than those who remained uninsured. Many people also benefited by the Medicaid expansion during the Covid pandemic.  When the Medicaid expansion expires post-Covid, especially in the Southern states, people without healthcare are more likely to die at a younger age.

Another problem is that in some parts of the U.S., local hospitals, particularly maternity hospitals, have closed, which increases the risk of death in pregnant women and their babies.

In addition, differences in attitudes towards vaccines, science, and access to healthcare also contributed to a higher death rate during the pandemic in Republican communities, compared to Democratic leaning communities.  

All this adds up to a terrifying reality. The map above shows that people in the darkest blue counties have an average age at death of 86.8 years, while those who live in the darkest red communities have an average age at death of 66.8 years, which is a 20 year difference in the average age at death, all based on the political values of the county where you live. 

Environmental Factors

Environmental factors can also impact an individual's lifespan. Republicans have generally been skeptical of environmental policies which aim to reduce carbon emissions and protect the environment. In contrast, Democrats support these policies, especially in the states where they live. 

Research has shown that exposure to air pollution and other environmental factors can lead to a wide variety of health problems, including respiratory diseases and cancer. A study by the International Journal of Environmental Research and Public Health found that exposure to air pollution was associated with a higher risk of lung cancer. 

Of course, some highly polluted cities, such as Los Angeles and New York, are in Democratic leaning areas, while many Republicans live in rural, Midwestern areas which may seem to have less air pollution from industry and cars. On the other hand, people in rural areas are more likely to be subjected to exposure to farm pollution, such as chemicals dropped from crop dusters, which can also be deadly.  Despite the higher air pollution in certain Democratic cities, the states of California and New York still have the second and third highest life expectancies in the U.S.  (Hawaii has the highest).  Any health damage caused by pollution may be offset by the other health advantages available to the residents of Democratic states.


Education is an important factor in an individual's socioeconomic status and overall health outcomes. Democrats generally support policies which attempt to increase access to education, such as affordable college tuition and student loan forgiveness. In contrast, Republicans are more skeptical of policies designed to increase equal educational opportunities for all. 

The problem with lower educational opportunities in some states is that research shows that higher levels of education are associated with lower mortality rates. A study by the American Journal of Public Health found that individuals with a college degree had a 28% lower mortality rate than those without a high school degree. Improving educational opportunities, and making higher education more affordable, is one way to improve the lifespan of the citizens of a state.

Income Inequality

Income inequality is another factor which can impact an individual's lifespan. Republicans generally support policies which favor the wealthy, such as tax cuts for the wealthy and deregulation of the financial sector. In contrast, Democrats support policies which aim to reduce income inequality, such as progressive taxation, increasing the minimum wage and supporting programs such as Social Security and financial safety nets for the poorest Americans.

Researchers have found that income inequality is associated with higher mortality rates, including a study by the Journal of Epidemiology and Community Health which discovered that income inequality was associated with a shorter lifespan. Many Republican leaning Southern states in the U.S., including Mississippi, Alabama, Louisiana, West Virginia and Arkansas, are among the poorest states and also tend to be places where people do not live as long. Essentially, poverty kills.


Stress is another factor which can impact an individual's lifespan and this is something which can affect both Republicans and Democrats, although they often have different sources of stress. Republicans who live in areas where there is a lot of poverty may experience more stress due to economic insecurity, while certain groups of Democrats may experience more stress due to discrimination and social inequality. 

Studies have shown that chronic stress can lead to a variety of health problems, including cardiovascular disease and depression. A study by the Journal of Occupational Health Psychology found that job stress was associated with an increased risk of cardiovascular disease.  It is hard to assess how different types of stress can affect lifespan, but regardless of where you live, your life expectancy will probably be longer if you feel less stressed.   


In conclusion, where you live and your political affiliation may affect how long you will live. This is due to a wide variety of factors, including gun violence, healthcare access, environmental factors in your community, access to higher education in your state, the income inequality or discrimination you experience, and your overall stress.  Of course, where you live is not the ONLY factor which will determine how long you will live.  Your longevity will also be determined by your genes, how well you take care of yourself, whether you smoke, get exercise, eat right, and other issues.  However, just knowing that there is a 20 year longevity difference in the United States between the most strongly Republican and Democratic counties is certainly something to consider when thinking about where you want to live and raise a family.

Since this topic may be controversial to some readers, you can find a full list of the citations for this research at the end of this article, and explore the research which interests you the most.  By reading the background material, you may even find ways to reduce the impact of these issues on your personal life.  

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“America Under Fire: An Analysis of Gun Violence in the United States and the Link to Weak Gun Laws.” Center for American Progress, 2016.

“2021 Gun Law State Scorecard.” Giffords Law Center, 2021.

Kaufman, Elinore J., et al. “Rural–Urban Differences in Firearm Ownership and Storage Practices Among Adult Owners in Alaska.” Journal of Rural Health, vol. 35, no. 2, 2019, pp. 213–21.

Centers for Disease Control and Prevention. National Center for Injury Prevention and Control. WISQARS Leading Causes of Death Reports. Available from:

Kalesan B, Mobily ME, Keiser O, Fagan JA, Galea S. Firearm legislation and firearm mortality in the USA: a cross-sectional, state-level study. The Lancet. 2016; 387(10030):1847-55.

Webster DW, Vernick JS, Zeoli AM, Manganello JA. Association between youth-focused firearm laws and youth suicides. JAMA. 2004; 292(5):594-601.

Sommers BD, Epstein AM. The Affordable Care Act and mortality in US adults. New England Journal of Medicine. 2017; 376(10):1-9.

Gruber J, Sommers BD. The Affordable Care Act’s effects on Americans’ health. Brookings Papers on Economic Activity. 2018; 2018(1):1-84.

Brauer M, Hoek G, van Vliet P, et al. Air pollution from particulate matter emissions in the European Union decreases life expectancy by almost a year. Proceedings of the National Academy of Sciences. 2019; 116(52):26211-6.

Lipsett MJ. Air pollution and cardiovascular disease. Environmental Health Perspectives. 1997; 105(Suppl 1):23-8.

Elo IT. Social class differentials in health and mortality: patterns and explanations in comparative perspective. Annual Review of Sociology. 2009; 35(1):553-72.

Hayward MD, Gorman BK. The long arm of childhood: the influence of early-life social conditions on men's mortality. Demography. 2004; 41(1):87-107.

Wilkinson RG, Pickett KE. Income inequality and population health: a review and explanation of the evidence. Social Science & Medicine. 2006; 62(7):1768-84.

Marmot MG, Wilkinson RG. Social determinants of health. Oxford University Press; 2005.

Epel ES, McEwen B, Seeman T, et al. Stress and body shape: stress-induced cortisol secretion is consistently greater among women with central fat. Psychosomatic Medicine. 2000; 62(5):623-32.

McEwen BS. Protective and damaging effects of stress mediators. New England Journal of Medicine. 1998; 338(3):171-9.

Landsbergis PA, Dobson M, Koutsouras G, Schnall P. Job strain and ambulatory blood pressure: a meta-analysis and systematic review. American Journal of Public Health. 2013; 103(3):e61-e71.

Saturday, April 15, 2023

Sick on a Cruise Ship? What You Need to Know Before You Go

A few years ago, a couple we know were on their dream cruise to Peru. Unfortunately, when they neared Panama, the husband had a massive heart attack and he and his wife were put ashore in Panama, where they had to stay for nearly a month until he was well enough to travel back to California.  He survived his heart attack, but they never made it to Peru.

Recently, I read an article by a woman who was fully vaccinated and boosted, but still got Covid on a cruise to Alaska in August, 2022, when most people were talking about Covid in the past tense.  She spent most of her cruise in a lonely room, away from her family, in the quarantine section of the ship, and then had to spend another five days in a hotel in Seattle before she was well enough to travel back to her home in the United States.

In both of these situations, the people learned important lessons which everyone needs to know before taking a cruise, so they can avoid having a cruise turn into a medical and financial disaster.  Here are some of the tips they passed along:

Buy Travel Insurance

Dealing with a travel insurance claim can be time-consuming and irritating, from what friends have told me.  However, it certainly is better than having to take a big financial hit without it.  Our friend who had the heart attack and ended up in Panama instead of Peru was certainly glad that they had the foresight to purchase insurance which covered many, but not all, of their expenses.  

Make sure your travel insurance also has a CFAR (which means "cancel for any reason") provision.  Things happen, often at the last minute, and you want to have the flexibility to cancel or postpone a trip if you or someone in your family is not feeling well.

Ask Your Credit Card Company About Their Travel Protections

One of your current credit cards may offer some type of travel insurance, at least to cover things like travel delays and cancellations.  Make sure you have their written policy information with you on your trip. 

Check Your Airline's Travel Cancellation Policy

Whenever possible, book your flights on an airline which will allow you to cancel or reschedule your flights without a flight change fee.  It may not solve all your problems if you get stuck in a foreign country where that airline does not fly, but in some cases it could save you money if you just need to change your return flight.

Check Your Cruise Line's Onboard Medical Resources

Most cruise ships will have some medical facilities and personnel onboard.  It would be wise to check out what they offer before you leave, especially if you have a chronic illness which may need to be treated in an emergency.  Of course, you will be charged for their services.

The types of equipment you should expect to have onboard your ship include defibrillators, ventilators, cardiac monitors, oxygen tanks, x-ray machines and lab equipment. (Most cruise ships also have a small morgue onboard.)

You can get a general idea about what onboard medical care will cost on this website:

Some of the typical expenses are listed below:

Doctor consultation            $125.00

Nurse consultation                  75.00

Doctor medical evacuation escort   $1200.00

Defibrillation                        $500.00

You will find a much more in-depth and detailed list of costs at the website mentioned above.  

I have known of people who continued their dialysis on cruise ships, but have heard it is extremely expensive and NOT reimbursed by insurance.

In addition, call your cruise line to find out what they charge for common procedures, the number of medical personnel who will be on your cruise, and the facilities they have.  

They will probably NOT accept your insurance, including travel insurance.  You will have to file a claim with your medical or travel insurance company when you return home.  Meanwhile, you will be expected to pay your bill for any care you received onboard before you leave the cruise ship.  Make sure you travel with a credit card that gives you a large line of credit, just in case you need it. 

Check Your Cruise Line's Covid Compensation Policy

Some of the cruise lines still cover the cost of certain expenses if you are diagnosed with Covid on their ship.  For example, they may provide your quarantine stateroom with free Wi-Fi. They may also pay for a hotel stay for a few days at the end of the cruise.  However, with most countries declaring that the Covid pandemic is behind us, fewer and fewer cruise lines are likely to offer these services. 

If you develop other medical problems on a cruise, they may cover some extra expenses, and help you make the necessary arrangements to leave the ship if you have a heart attack or another serious health scare while traveling with them.  Make sure you inform them of any serious illness you develop during your cruise, and find out what they can do to help you.  

Try to Avoid Getting Sick

Of course, all of these financial considerations will be unnecessary if you are able to avoid getting sick in the first place.  While you cannot avoid every situation, taking a vacation does not mean that all normal health concerns are taking a vacation, too. You are still subject to the laws of nature.  Watch what you eat and drink, and don't overdo it.  Get enough sleep.  Avoid sunburns.  Make sure your vaccinations, including flu and Covid vaccines, are up-to-date before you travel.  Wear a face mask in crowded, indoor situations. Wash and/or sanitize your hands frequently. Continue to take your prescription medications at the proper times.  In other words, use good hygiene and common sense!

Prepare for an Extended Stay

Although we all like to travel as light as possible, if you are going to be gone on an extended cruise it could be wise to bring along extra clothing in different weights, in case you are stuck in a hotel far from home for an extended period of time.  You want to make sure you have comfortable clothing whether it is hot or chilly.  You can't prepare for everything, but bringing along an extra jacket, extra underwear, and a few practical items of additional clothing could make any delays easier to bear.

Prepare to Self-Treat Some Illnesses

Cruise lines may charge for a visit to their infirmary, which are often poorly stocked, so you want to bring along a few medical supplies of your own, and they shouldn't take up much space in your luggage.  Fill a zip-lock back with some Covid tests, a thermometer, a pulse oximeter (Ad) to measure your blood oxygen levels, cough medicine, cough drops, ibuprofen and/or acetaminophen, and a few basic First Aid supplies like band-aides and antibiotic cream for minor injuries.  The onboard medical facility is likely to charge you for these supplies and it will be far cheaper to bring them from home.

If you do test positive for Covid, or develop another serious illness, make sure you notify the cruise ship's infirmary, because they may be able to help you get to land or find you safer accommodations onboard the ship, so you do not expose other people.  They may also provide you with room service meals at no extra expense.

Also make sure you travel with an extra large supply of your prescription medications, in case you are delayed on your trip longer than expected.  A cruise ship will not have a fully stocked pharmacy if you forget your blood pressure medication, for example.  Bring along any medications you might need during an extended stay.

Prepare to be Bored

Whether it is because you are stuck in the quarantine section of a ship, alone in a hotel room far from home, or simply forced to deal with bad weather during your trip, you want to bring along a few, non-tech ways to entertain yourself.  Depending on what activities you enjoy, you might want to pack a deck of cards for playing solitaire, a paperback novel or two, and even a small puzzle.  Basically, you want to bring along anything that will keep you from going crazy if you are stuck in a hospital or quarantine room and cannot easily or affordably access the internet. 

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Enjoyed this post? Never miss out on future posts by following us.  You will receive one weekly email containing the most current post. 

If you are interested in learning more about financial planning, Social Security, Medicare, where to retire, common medical issues as you age, travel and more, use the tabs or pull down menu at the top of the page to find links to hundreds of additional helpful articles.

Disclosure: This blog may contain affiliate links. If you decide to make a purchase from an Amazon ad, I'll make a small commission at no extra cost to you.

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Photo credits: Pixabay and the author's Etsy store.