Updated: Oct 29, 2020
Four more years of Trump would have catastrophic effects on American health disparities. Depending on factors like location and demographics, each state will experience unique health outcomes as a result of the upcoming election. This piece examines how the health of Pennsylvania residents could be impacted by the 2020 election; next week’s blog will take a closer look at the future of Florida’s health.
Millions of Pennsylvanians will experience health consequences if Donald Trump is reelected.
Residents of Pennsylvania report being most concerned about mental health, healthcare access, chronic disease, obesity, and drug use. Many of these health issues are greatly influenced by social determinants of health (SDOH)—that is, environmental and social factors that impact wellbeing. Plenty of the chronic conditions that affect Pennsylvanians are dangerous: the state sees more hospitalizations due to diabetes, asthma, COPD, and heart failure than the national average. Black Pennsylvanians are disproportionately affected by these chronic conditions.
Before the Affordable Care Act (ACA), small hospitals struggled financially because of the high number of rural patients who received Medicare and/or Medicaid. The ACA provides these hospitals with reimbursements to help them provide vulnerable populations with the healthcare they deserve. The ACA has also helped nearly one million Pennsylvania residents access Medicaid.
Until recent job losses from COVID-19, the number of uninsured Pennsylvanians was dropping steadily. Continued improvement of the ACA under Joe Biden would strengthen hospitals and coverage for the most vulnerable. On the other hand, Donald Trump has made it harder for people to access Medicaid throughout his presidency and encourages repeal of the ACA (though he has no plan for its replacement). Without it, one million Pennsylvanians will lose coverage, seniors will pay more for prescription drugs, and preventive services will no longer be covered (including screenings, which are critical to reducing cancer fatalities, the second leading cause of death in Pennsylvania).
Many of the health issues that plague Pennsylvanians are closely linked with SDOH. Wellbeing is directly impacted by diet, physical activity, and lifestyle habits, which in turn are influenced by things like income, transportation, neighborhood environment, and social relationships. Education and lack of healthcare coverage are also potential barriers. For example, Pennsylvania has more cigarette smokers than the national average; smokers are more likely to be lower-income, and Medicaid expansion under the ACA requires coverage of smoking cessation programs.
Joe Biden wants to address the complex challenges that exacerbate health disparities, and his healthcare plan takes SDOH into account. He plans to launch home-based initiatives to improve healthcare access for disadvantaged populations. Biden’s $450 million plan will help hospitals and family caregivers provide health services and will also provide meals, transportation, home modifications, and day programs to elderly and disabled people. The Trump administration recently acknowledged that SDOH contribute to health disparities in America, yet Donald Trump has done nothing throughout his presidency to address SDOH.
Further, location can be an important SDOH—and over 3.5 million Pennsylvanians live in rural regions. Climate change makes extreme weather events more frequent and severe, including snowstorms. Harsh winter conditions in Pennsylvania limit healthcare access for many residents, who tend to be older, impoverished, and prone to health issues, as delayed care causes problems to worsen. Winter weather and physical distance may also reduce the availability of healthy food for rural residents.
Heat waves make heart and lung illnesses worse, especially for physically vulnerable populations and Black communities. As climate change worsens, Pennsylvania can expect to see more snowstorms and summer heat waves. Biden wants to address climate change in a “middle road” approach that encourages job and economic growth. As a climate science denier, Trump has no interest in mitigating the dangerous effects of climate change.
Many Pennsylvania residents worry that Biden will ban fracking in the state; he won’t. It’s true that Biden doesn’t want any new fracking ventures on public land, but he understands what a crucial role the industry plays in Pennsylvania’s economy. He wants to improve the efficiency and safety of fracking—which is greatly needed, as gas-fired power plants threaten low-income rural populations with carcinogenic pollution.
Over 4,400 Pennsylvanians died from drug overdoses in 2018, and since the onset of COVID, fatal overdoses have been on the rise in Pennsylvania. Biden wants to ensure that people have access to treatment through the ACA, hold Big Pharma responsible, and stop the inflow of fentanyl and heroin into the U.S. Trump has put some funding toward fighting the opioid crisis and has a plan to reduce drug use, but referring to Joe Biden’s recovering son as a “crackhead” demonstrates Trump’s lack of empathy and understanding for addicts and their loved ones.
With COVID-19 cases on the rise (especially in the state’s urban regions), unemployment leaves many without healthcare coverage or food security. Trump’s handling of the pandemic has already cost lives (over 8,500 Pennsylvanians), and his decision to remove the U.S. from the World Health Organization (WHO) means Americans won’t have timely access to a vaccine. Joe Biden would protect vulnerable populations by rejoining the WHO and encouraging state leaders to require masks.
Ultimately, the election of Joe Biden will result in a healthier, more equitable Pennsylvania.