Very likely the reader is wearily familiar with one of the memes that American right-wingers endlessly repeat. It's called the "great replacement": the claim that shadowy but apparently omnipotent elites are deliberately replacing the old stock (meaning white) American population with immigrants from predominantly non-white or non-Christian countries.
The notion had its beginnings decades ago in the mental swamps of Southern segregationist politicians and has been recycled in various iterations through white supremacist groups. Donald Trump's election and the popularization of the phrase (in more or less coded language) by professional jackasses like Tucker Carlson made it into another of the Republican base's innumerable slogans.
The idea is bunk, of course, and easily understood as yet another of the many myths designed to play into right-wingers' persecution complex. But it is also possible to understand it as a folk-psychological projection of something that is indeed happening in the strongly Republican regions of the country inhabited by what Sarah Palin called "real Americans." It's not so much the great replacement as the great die-off, and Republicans are both its chief promoters and its principal victims.
The phenomenon first received attention in 2015, thanks to a paper by Anne Case and Nobel Prize laureate Angus Deaton. They detailed first the stagnation and then the absolute decline in life expectancy among non-Hispanic white populations, particularly in white rural areas of the U.S. They charted a significant rise in "deaths of despair" like suicide or drugs (particularly synthetic opioids) or obesity-related illness among the white working class.
This phenomenon cannot entirely be explained by the relative economic disadvantage of those who live in rural areas as compared to cities. Black and Hispanic populations, whether rural or urban, also experience economic disadvantage, but rates of midlife mortality among those groups continue to decline significantly, while they keep rising among white people with no college education.
Much has been written in recent years about the demographic collapse Russia is experiencing. In 2021, that nation lost nearly one million in population, following many years of decrease, a pattern that began in the 1980s. Russia's population is now smaller than Bangladesh and its per-capita income lower than that of the Maldives. Male life expectancy has also fallen below that of Bangladesh, a nation with a relatively recent history of dire poverty and famine. In 2022, with Russia confronting combat deaths, economic sanctions and the exodus of at least 900,000 people, most of them young and educated, the demographic decline may have accelerated into free-fall.
Russia's case is considered singular in the developed world, yet there are swaths of rural America that are beginning to replicate it. Owsley County, Kentucky, has a life expectancy similar to that of Russia; from 1980 to 2014, the county's cancer death rate increased by 45.6 percent, the largest increase in the nation. In 2020, Donald Trump received 88 percent of the Owsley County vote. This correlation between early death and heavily Republican voting patterns may be one of the biggest stories of the decade.
Russia's demographic collapse is seen as singular in the developed world — its population declined by nearly a million in 2021 — but swaths of rural America are beginning to replicate it.
With the onset of the COVID pandemic in 2020, the longevity disparity increased between regions in the United States, a gap that also correlates strongly with partisan political leanings. Statistical research has consistently shown higher COVID death rates in Republican jurisdictions than in Democratic ones and that gap increased after the rollout of COVID vaccines. A study by Lancet Regional Health-Americas found that the more conservative the voting records of members of Congress and state legislators were in a district, the higher the rate of age-adjusted COVID mortality was, even after compensating for race, education, income and vaccination rates.
This partisan difference in death rates also applies to traffic deaths. Some of this might be explained by the fact that Republican areas tend to be rural, which means lots of high-speed driving on two-lane roads, worse engineering and maintenance of those roads, and longer trips from an accident scene to the nearest emergency room, which may be an hour or more away. But one sociologist who studies the attitudes of red-state conservatives suggests an additional factor: "a kind of cowboy mentality, a kind of deregulatory, anything goes culture" that may result in collective carelessness. The gap in seatbelt use would tend to support this hypothesis.
If we recall the Republican-generated uproar over Michelle Obama's campaign to encourage schoolchildren to eat healthy food, we might predict that spinach and KFC have become totems of the culture wars. Sure enough, there is also a correlation between political leaning and obesity, a condition strongly associated with early death. There is also a striking correlation between areas that supported Donald Trump and the presence of fast-food chain restaurants.
Could it be that poorer areas simply cannot sustain more expensive restaurants that serve healthier fare? That's possible, but the ubiquity of fast-food outlets in red states or red regions may also be connected with the fact that many Republican-dominated states have passed laws prohibiting civil suits against fast-food franchises over obesity. One doesn't have to be a Republican to believe that dietary preferences are largely a matter of personal responsibility that generally precludes third-party liability. Still, this is one more case, as with firearms, where Republican politicians immunize an industry (and its potential donors) from lawsuits. How many of us would feel queasy if auto manufacturers were similarly protected from lawsuits over the injuries and deaths caused by their products?
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This year, Scientific American summarized the result of all these factors: a striking differential in overall death rates in Republican versus Democratic counties, a gap that has been widening for 20 years and shows no sign of leveling out. The article suggests that policy choices are a factor.
It is easy enough to rationalize this disparity by pointing to external factors, such as poorer quality and less available health care in the rural communities where Republicans are more likely to live, along with less developed infrastructure (such as roads) in general. But here as well, those conditions at least partly result from decades of political choices made by Republican voters in electing state and local officials.
During the pandemic, Florida Gov. Ron DeSantis prohibited localities from implementing masking and social distancing ordinances. The fact that DeSantis was overwhelmingly re-elected this year demonstrates that a majority of his state's voters approved of his policy and believed the resulting additional deaths were "worth it" (whatever "it" is").
Social scientists are likely to shy away from drawing admonitory conclusions about behaviors that link to partisan values. But there is enough evidence to infer that the blue-red gap in the death rate is determined mostly by political attitudes, not external economic factors.
If someone is conditioned by Fox News or an angry voice on talk radio to believe that public health measures for COVID are useless or harmful, that person is more likely to die of COVID. If someone embraces "personal freedom" with so much enthusiasm as to defy common-sense safety precautions, that person is more likely to drive without a seat belt or engage in risky behaviors — hinting at the redneck joke that begins, "Hold my beer…." If that person repeatedly elects politicians who demonize government as evil, he shouldn't expect to get treated at a fully-equipped rural hospital.
Possibly there is also a less direct but deeper explanation for the white Republican die-off. This group has been systematically fed a steady diet of fear, rage, resentment and loss, which may well condition a fatalistic mental state that has real-world consequences. The great die-off is, at bottom, a form of self-sacrifice to an angry pagan idol that can never be propitiated.
I have argued before that the Republican Party has become a death cult, and one can see evidence in the diatribes of conservatism's faux-intellectual wing. In 2016, right-wing operative Michael Anton, writing under the pretentious pseudonym Publius Decius Mus, wrote "The Flight 93 Election," a hysterical comparison of a low-turnout presidential contest between a toxic bully and a lecturing scold to Armageddon, in which true conservatives were the doomed passengers of a hijacked plane rushing the cockpit.
During the COVID pandemic, First Things, a website that seeks and invariably finds theological justification for its crank political views, published a piece in a similarly apocalyptic vein. R.R. Reno, its editor, wrote "Say No to Death's Dominion." Contrary to its title, he argues that death should be embraced, and that those who save lives through medical science are in league with Satan.
This echoes the theology of the religious right, which has turned its back on science, progress and humanitarianism because the Rapture may come at any moment. It is but a short step from viewing life as a vale of tears to calling modern medicine junk science and mandatory seat belt use an oppression by the Safety Nazis. Given that evangelicals are the largest segment of the Republican base, it is hardly surprising that Republican areas should suffer from higher rates of preventable death.
Republicans have become a death cult, fed a steady diet of fear, rage, resentment and loss, which conditions a fatalistic mental state with real-world consequences. The great die-off is a self-sacrifice to an angry pagan god that cannot be propitiated.
Paranoid crackpots have been scribbling since the dawn of written language; why have they become so influential now, to the point where they are dragging down American life expectancy? Post-World War II American conservatism always had an apocalyptic, doomsaying strain; one need only think of Whittaker Chambers or James Burnham, whose works were replete with cataclysms and existential catastrophes. Even William F. Buckley Jr., the putative founder of modern conservatism and a supposedly sunnier, more optimistic philosophy, said that the mission of conservatism was to "stand athwart history yelling stop." But to do so also means yelling "stop" to science, enlightenment and the amelioration of human suffering.
What has changed is that the American conservative ecosystem, once a counterculture that people could ignore for days at a time, has been suitably dumbed down, amplified and infused with the ill-gotten loot of sinister billionaires to the point where it has become a media-entertainment complex fully on par with Hollywood and the pre-existing mainstream media. Crackpots who were once compelled to howl in the wilderness are now the savants of this propaganda empire. "The Turner Diaries," the novel that inspired Oklahoma City bomber Timothy McVeigh, is far more influential today than when it was published in 1978.
Consistent with this development, the Republican Party has evolved into an anti-party. Its agenda largely consists of stunts, trolling, performative cruelty and gaslighting. Such legislation as it bothers with is mostly designed to negate laws already on the books; its amendments are poison pills intended to doom substantive legislation.
The GOP has become a religious-ideological mashup embodying the worst features of post-World War II conservatism and religious right know-nothingism. As for the religious part, many religions emphasize "transcendence," the existence of a purer, better world than the merely material one we temporarily inhabit. Buckley was fond of using the word in hammering home conservatism's spiritual superiority.
But what we see in the contemporary Republican Party, and in the results it has wrought in places where it is entrenched, is not transcendence but its philosophical cousin: nihilism. It is advocating needless death, either to own the libs or to find salvation, and its followers are embracing it, just as they embrace political violence, in a kind of slow-motion Jonestown. If political parties were labeled with consumer information in the manner the FDA mandates that cigarettes be labeled, the GOP would be branded in bold letters: "WARNING: THIS PRODUCT WILL KILL YOU."
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