A New Toy for Wonks: Interactive Death Map

Virginia death map

Mortality rates, all causes, 2014. Source: U.S. Health Map.

Virginia has mortality rates roughly in line with the national average, although there are wide variations within the state, as can be seen in part in this image captured from the U.S. Health Map published by the Institute for Health Metrics and Evaluation. Not surprisingly, the highest mortality rates are found in the impoverished Southwest and Southside regions.

The very highest mortality rates within the Old Dominion are located in the far Southwest. Excepting a handful of localities in the Dakotas (which I suspect are home to Indian reservations) the highest mortality rates in the country are in the Central Appalachia. This is coal mining country, and it should come as no surprise that the population there has the nation’s highest rate of respiratory-related fatalities, no doubt reflecting the prevalence of black lung disease.

Virginia’s coal-mining counties share many economic and cultural attributes with their super high-mortality neighbors across the border in Kentucky and West Virginia. I’m not sure why the mortality rates on the Virginia side of the border are notably lower (though still high by comparison with the rest of the state). The rate of chronic respiratory disease is just as high in  Virginia’s coal-mining counties. Mental and substance abuse disorders are almost as high.

But mortality from cardiovascular disease is measurably lower. Why would that be? Is poverty is less endemic? Is there a better (or less bad) health care system? Whatever the reason, it bears analysis.

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16 responses to “A New Toy for Wonks: Interactive Death Map

  1. “Toys for Wonks” is a bit on the rude side when discussing death, especially in Appalachia.

    For a look at what the coal industry did for a century and a half in West Virginia, check out “Blood on the Mountain,” a documentary that opens in DC on Friday, Dec. 16. It has already played in New York, Los Angeles and Houston.

    Yours truly, who wrote a book about coal, contributed to the film as a talking head and consultant. I will be part of a panel discussion after the 7:15 p.m. showing Friday. One focus of our talk will be Congress’s inaction on keeping retired coal miners on benefits after their companies were sold off and went bankrupt.

    I wouldn’t describe this as a “Toy for Wonks.” It is real. And you might not have a sympathetic audience. Here are details:

    https://www.facebook.com/notes/blood-on-the-mountain/washington-dc-1216-panel-discussion/1203869982994800

    • Off topic just a bit, Peter, but I read your totally disingenuous article in the Chesterfield Observer about the meals tax. Well…I should probably rephrase, since you have the option of blaming your co-author Mr. McConnell for the “error”.

      You talk about how the Henrico meals tax was promised to be dedicated to Henrico schools. You fail to mention that tax money is fungible; that, just as with the lottery, “dedicating” a particular tax to a particular piece of government spending is totally meaningless. If my meals tax dollar is dedicated to the schools, it simply means that fewer of the other tax dollars collected have to be allocated to the schools. I’m going to doubt that your intention was to deceive the fair readers of the Observer. That leaves two possibilities: you simply don’t understand the facts of economic life, or you merely didn’t catch your co-author’s error. Either way, you should probably correct the impression that was left for Observer readers.

      • Crazy – I was under the impression that the meals tax was to pay for bonds to upgrade schools – a capital expense over and above their existing operational/maintenance expenses.

        no?

        • As my friends across the union bargaining table used to say, “You have failed to miss the point.”

          Dollars are fungible. Saying you will dedicate this new tax to upgrade bonds, or municipal buildings, or police cruisers or neckties does not obviate the fact that you are simply moving dollars from one pocket to another.

          Let’s say you have tax revenue equal to 1 million. And let’s say your expenditures are the same. You absolutely must upgrade your schools with a $50,000 expenditure because they are falling apart. You can take the $50,000 from the expenditures budget you already have, but that means you would have to make hard decisions about priorities and reduce expenditures on other things (We’ll leave aside the notion of deficit spending for a moment). Enter a new tax, the meals tax, which provides $50,000. Voila!! You have dedicated the meals tax to upgrading schools, right? Wrong! All you have really done is allowed the government to continue spending on the other things while arguing to the public that it has dedicated this new tax on schools. Would the public have bought in to an argument that the new tax will allow the government to continue spending on senior’s pickleball and the like? Of course not.

          • re: ” Let’s say you have tax revenue equal to 1 million. And let’s say your expenditures are the same. You absolutely must upgrade your schools with a $50,000 expenditure because they are falling apart. You can take the $50,000 from the expenditures budget you already have, but that means you would have to make hard decisions about priorities and reduce expenditures on other things ”

            yup – but you’re not going to pay for something big like new/upgraded schools with a one-time budget adjustment and you’re not likely going to make those cuts from the school operational/maintenance budget either.

            with capital projects, you’re normally talking about hundreds of millions of dollars of ADDITIONAL costs that cannot be paid for with one year of “prioritization” and that’s why most jurisdictions borrow the money and why good jurisdictions strive for a AAA rating – which requires quite a substantial effort at budget and finance to start with. The bar is so high that maybe 7 localities in all of Virginia are fiscally responsible enough to qualify for AAA – Henrico being one.

            That means that they ALREADY have done a pretty good job of prioritization and hard choices.

            yes – money is fungible – but if you commit to NEW capital projects – and loans for them – how do you pay them back without cutting other things?

            Do you think an elected govt can lobby for an increased tax for a specific purpose then once it passes – not spend it on their purpose and not have consequences at the ballot box – as well as the credit rating folks?

  2. I won’t be able to attend – but wish Peter well and hope that it will be on C-Span or YouTube at some point – and thank Peter for all the hard work that had to be done to write the book. Thanks!

    On the death rate in Appalachia – I think Bacon might be barking up a slightly wrong tree – the higher death rate exists in places that don’t mine coal – and likely includes a lot of others – all of whom lack access to good health care.

    here’s an interesting one also:

    • Larry, does the gun related homicide information include suicides? My understanding is that these types of suicides are significant in number and may be growing, while gun related homicides are lower and decreasing over time.

      • TMT – pretty sure they do – and comprise maybe 1/2 the total.

        but you might be surprised by geographic distribution – which is different from overall gun deaths in the prior map:

        • Here’s another map TMT – this one shows a geographic distribution similar to the health and gun death maps that extends beyond Appalachia coal mining country.

          FYI – SSD is a benefit paid to people who HAVE worked and paid into Social Security by SSI – despite it’s similar name is welfare.

          ” Supplemental Security Income (SSI) is a Federal income supplement program funded by general tax revenues (not Social Security taxes):

          blue ball It is designed to help aged, blind, and disabled people, who have little or no income;

          It provides cash to meet basic needs for food, clothing, and shelter.”

  3. Wonder what in the world is going on in Union County, Florida?

  4. I am always getting beaten up for something!
    C’;m,on you guys. Pile on!

    • Actually agreeing with you Peter!

    • Waahh! Waahh!. Some time ago, you famously promised to take your marbles and go home because the blog had gotten too rancorous. It appears that you, like the mainstream media you represent, still haven’t understood the mood of the country. In fairness, neither did I, at least not so completely as to contemplate a Trump victory, though that became apparent by about 7:15 Tuesday night. The elites, such as yourself, will recover more quickly if you ditch your attachment to the statist narrative and attempt to understand what drives the heart of this country. Tip: it isn’t government.

  5. More evidence that it’s not just Appalachia coal mining country with the health issues:

  6. >>That means that they ALREADY have done a pretty good job of prioritization and hard choices.>>

    That’s a rather large assumption. I don’t think it means what you say at all.

    >>Do you think an elected govt can lobby for an increased tax for a specific purpose then once it passes – not spend it on their purpose and not have consequences at the ballot box – as well as the credit rating folks?>>

    I think they can and they do, on a fairly regular basis This is where you and I part company. You have a lot more faith in government than I do. As it turns out, your position is not well reflected in the recent election, thank God.

    >> how do you pay them back without cutting other things?

    my point exactly. You wouldn’t cut anything; I would. Including pickle ball.

  7. Perhaps you might like Standard and Poors criteria better:

    •Revenue and expenditure assumptions;
    •Budget amendments and updates;
    •Long-term financial planning;
    •Long-term capital planning;
    •Investment management policies;
    •Debt management policies; and
    •Reserve and liquidity policies.

    Our overall FMA assessments are communicated in Standard & Poor’s analyses using the following terminology:

    •”Strong” indicates that in our view practices are strong, well embedded, and likely sustainable.

    •”Good” indicates that in our view practices are deemed currently good, but not comprehensive.

    I do not believe that local elected can promise one purpose for getting approval of increased taxes and bonds – and then renege on it without serious consequences – both from the voters and from folks like Standard and Poors.

    If a locality is determined to be lying about it’s motivation and intent with regard to taxes and budget – the auditors are not going to believe or trust a lot of what they are doing … and rightly so.

    A locality can get away with some of which you say – for a while – but the requirement for them to generate a GAAP-compliant CAFR and have an external audit will get them in trouble eventually.

    besides Guy – 30-50-100 million dollars worth of new capital projects – you’re not going to pay for that with budget adjustments in the Operating budget – that’s why localities are required to have separate capital budgets – and not be able to move money between them – doing that would kill their AAA rating.

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