American health will suffer if Donald Trump is reelected. Depending on factors like location and demographics, each state will experience unique health outcomes as a result of the 2020 election. This piece explores the future of Florida’s health; next week’s blog will take a look at the health stakes for Ohio.
As a populous and diverse state, Florida has its share of health equity issues. A fifth of the state’s residents are over age 65; the majority of seniors rely on Medicaid and are prone to chronic health issues. South Florida has significant minority populations, who tend to have poorer health and lower rates of insurance than whites in the state. As Florida residents contend with both the COVID-19 pandemic and increasingly extreme weather events, the potential reelection of Donald Trump threatens to worsen health disparities in the state.
Over 16,000 Floridians have already died from COVID, which has disproportionate health impacts on both seniors and minorities. There are thousands of new cases in the state each day, yet the state governor is following Trump’s lead on the issue of masks. Trump’s botched management of the pandemic has resulted in widespread unemployment, leaving thousands lacking healthcare coverage and food security. Additionally, Trump’s decision to remove the U.S. from the WHO means that Americans won’t have access to their vaccine. Joe Biden would protect vulnerable populations by establishing a clear and cohesive response plan, rejoining the WHO, and encouraging state leaders to require masks.
Many of Florida’s most vulnerable populations have experienced significant health benefits from the Affordable Care Act (ACA), the future of which likely depends on the election outcome. Because of the ACA, 1.5 million Floridians have been able to get health insurance: 12.9% of Floridians were uninsured in 2018, down from 26% in 2010. The number of uninsured Floridians could be further reduced if the ACA is protected and improved upon, as Biden proposes; Biden will not force all Americans to get universal healthcare. Expanding Medicaid under the ACA would insure another million Florida residents, and produce robust economic benefits.
On the other hand, repealing the ACA (as Trump wants to) would have catastrophic effects on health equity in Florida. One million Latinos would be at risk of losing health insurance, and four million seniors would experience reduced healthcare access; and further, immunizations and screenings would no longer be covered. Since Trump’s presidency began, there have been more uninsured children in Florida, likely because of his anti-immigrant rhetoric and his attacks on Medicaid.
Access to quality healthcare is a social determinant of health (SDOH) because it’s a factor that directly impacts a person’s wellbeing. Relatedly, income is another SDOH. Over three million Florida residents live in poverty. Poverty directly influences affordability of care, food insecurity, and transportation (all of which are health-related concerns in the Orlando community). By keeping the ACA intact and making it better, Biden will continue to make healthcare more affordable. He also has a long-term plan to invest in home and community care initiatives (with a particular focus on the disabled and elderly), which will reduce costs and improve healthcare accessibility.
The ACA covers smoking cessation treatments, which is notable since smoking kills 28,600 Floridians each year. Smokers tend to be of low socioeconomic status and usually pick up the habit from people that they know. Similarly, chronic diseases can be influenced by social networks. Obesity, diabetes, heart disease, and cancer often develop over a lifetime of engaging in risky behaviors (smoking, drinking, poor diet, lack of activity). Many chronic diseases are more fatal to minorities than white people. Social community, stressors associated with poverty, and education are all potential SDOH that contribute to health disparities. Additionally, people who experience discrimination in medical contexts might not trust doctors or their advice, and avoid healthcare services even when they’re available.
Climate conditions can also impact health. The Earth’s rising temperature and sea level will increase the frequency and severity of hurricanes, thunderstorms (and thereby tornadoes), fires, and droughts in Florida. Extreme weather events can cause immediate death or injury, along with many longer-term health consequences, like diminished healthcare access, worsened pre-existing mental health conditions, and PTSD.
Floods can contaminate water wells (as was the case in Duval County, FL after Hurricane Matthew hit), and drinking contaminated water is especially dangerous for vulnerable populations. Climate change will also make heat waves more intense, which will worsen chronic heart and lung diseases.
Further, natural disasters exacerbate health inequities. Extreme weather events have disproportionate health impacts on already vulnerable populations: lack of funds, transportation, or insurance make it much harder to recover from a disaster. If a storm causes power outages, people without generators are more likely to get food poisoning. Newer luxury homes along Florida’s coast are more equipped to resist flooding than older buildings. People who work outdoors or don’t have air conditioning experience more heat-related health issues.
Worsening climate change magnifies health disparities. Donald Trump doesn’t believe that climate change is caused by burning fossil fuels, and has spent his administration deregulating the fossil industry, allowing them to pollute more. Contrastingly, Joe Biden wants to shift America’s energy sources away from fossil fuels in a way that will create jobs and bolster the economy. Biden would rejoin the U.S. in the international Paris Climate Agreement, as this is crucial in mitigating the effects of climate change since America produces the second-most amount of carbon in the world.
Ultimately, Joe Biden will improve healthcare costs, quality, and coverage rates for Floridians. He will improve the ACA and address SDOH, especially for the elderly and disabled. He’ll take action to slow the effects of climate change. Biden will reenter the U.S. into the WHO and push for national social control measures to manage the COVID-19 pandemic. As a vaccine isn’t expected to be readily available until mid-2021 at the earliest, it’s essential that we elect a president who will prioritize the health of his people in the midst of such an unprecedented threat.