During the drama of the impeachment hearings and the run up to Iowa Democratic caucuses, both the Trump administration and Congress missed two stunning yet unheralded scientific studies last month. Each study describes health or environmental findings that could present “black swan” political implications — unforeseen events with severe consequences.
First, the Journal of the American Medical Association (JAMA) reported that life expectancy in the United States declined for the third consecutive year — Americans are simply not living as long as they did even a few years ago. The JAMA study found that middle-aged adults are dying as a result of drug overdoses, alcohol abuse, suicides, and organ system diseases across all racial groups. Specifically, New England and the Ohio Valley have witnessed the largest relative increases in midlife mortality rates. From 2010-2017 JAMA estimates that there were 33,307 excessive deaths of middle-aged adults. Worse yet, globally, the U.S. ranks 43rd in life expectancy and is falling further behind other rich nations. America is becoming a middle tier country on one of the core metrics of human development.
Second, the United Nations offered a grim assessment of global progress towards reducing carbon emissions and curbing the worse consequences of climate change. The UN observed last month that temperatures are on pace to rise as much as 5.8 degrees Fahrenheit by the end of the century. At this rate, there will be life-altering effects. Coral reefs will dissolve in increasingly acidic oceans. Some coastal cities will be inundated by rising seas. In parts of South Asia, the Arabian Peninsula and the Horn of Africa, intense heat and humidity will be incompatible with human life. Climate stress is likely to lead to deepening conflict and increased grievances of citizens against their governments.
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Just in 2020, the UN’s emergency response chief anticipates that 168 million people will need help and protection in crises around the world requiring nearly $29 billion in humanitarian aid.
The trajectory for chaos and displacement is likely to worsen as climate shock deepens.
These studies present far-reaching consequences for the United States and suggest that real gains in human development are reversible. This “de-development” or the reversal of 20th Century health gains is not likely to make headlines in the 2020 elections. In the generation ahead, declining health outcomes for the most vulnerable people and communities will deepen political gaps in the United States and fuel disruptive conflict globally.
How serious are these trends? The United States has not experienced a sustained decline in expected life span at birth in a century, a trend not seen since the mass death of World War I and the flu pandemic. Midlife mortality is not equally distributed, the top 1 percent of male income earners live 15 years longer than men at the bottom 1 percent. For women, life expectancy differs by 10 years. Midlife mortality is the result of systemic failures that are reversing human development particularly in poorer communities.
Equally as troubling, the U.S. maternal mortality rate has more than doubled from 10.3 per 100,000 live births in 1991 to 23.8 in 2014. In contrast to the significant global improvement, the U.S. is the only developed country experiencing worsening maternal mortality rates. Declining life expectancy, massive and increasing differences in longevity based on income, and increasing maternal mortality rates demonstrate that American health outcomes are fragile despite the U.S. being the largest economy in the world.
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The 21st Century has experienced de-development through the lens of two brutal examples. Witness the impact of war in Syria and the consequences of widespread displacement and destruction. Venezuela, once a thriving nation, is on track to be the largest refugee crisis in 2020, fueled by authoritarian leadership which has overseen the collapse of the entire economy and drove millions into poverty.
Climate changes will serve as an accelerant to de-development and could place hundreds of millions of more people at grave risk.
Simply, climate shock threatens the reversal of progress made in the second half of the 20th century to improve the human condition. Poor communities in Bangladesh, Yemen, Somalia — as well as the Mississippi Delta and Puerto Rico — will carry the greatest level of social and economic disruption.
Scenes such as the New Orleans Superdome after Hurricane Katrina will be commonplace. Today’s 168 million displaced could very well be the floor for global displacement. As de-development deepens, grievances against local and central governments will grow, fueling nativistic instincts among political leaders and radicalization among marginalized communities. Geo-political conflict seems inevitable, particularly as the post-World War II order begins to erode. No doubt China and Russia will seek to leverage disruption to their advantage while undermining American institutions and interests.
Political dysfunction in the federal government today does not lend itself to long-term strategic planning about black swan challenges to people, communities, or American global leadership in the next decade. Yet, the costs of worsening health outcomes arising from economic marginalization or, in the years ahead, from climate shock will present historic geo-political risks.
In the absence of serious administration or congressional leadership, strategy, innovation and solutions will have to come from states and local governments, private sector leaders, and global research universities.
The shocks are inevitable; preparation is a national choice.
R. David Harden is managing director of the Georgetown Strategy Group and former assistant administrator at USAID’s Bureau for Democracy, Conflict, and Humanitarian Assistance. He was a minister counselor in the Senior Foreign Service. In May of 2019, President Trump
Donald John TrumpRepublicans aim to avoid war with White House over impeachment strategy New York Times editorial board calls for Trump’s impeachment Trump rips Michigan Rep. Dingell after Fox News appearance: ‘Really pathetic!’ MORE awarded Mr. Harden the Distinguished Service Award, the highest award in the Foreign Service, for “sustained extraordinary accomplishment in the conduct of the foreign policy.”
