Will Tax Cuts Ease Economic Distress and Health Disparities?

The 13-state Appalachian Regional Commission just released its latest county economic status rankings. Mississippi has 24 ARC counties with 12 ranked “distressed,” nine “at-risk,” three “transitional,” and none “competitive” or “attainment.” Rankings did not change from last year.

What do these rankings mean? ARC calculates the economic status of counties based on unemployment rates, per capita market income, and poverty rates. It then ranks its counties against all counties in America.

According to ARC, “distressed” counties rank in the worst 10% of all counties nationwide, “at-risk” counties in the worst 25%, “transitional” counties between the worst 25% and the best 25%, “competitive” counties in the best 25%, and “attainment” counties in the top 10%.

The eight-state Delta Regional Authority rates its counties’ economic status too. Mississippi has 47 counties in DRA. Using a slightly different methodology based on unemployment rates and per capita income, DRA rates 45 of these counties as distressed. (Note: seven DRA counties overlap with ARC; DRA rates them all distressed while ARC rates four distressed and three at-risk.)

Altogether, 64 of Mississippi’s 82 counties are served by the two regional commissions with 61 rated as having significant economic distress.

Not a pretty picture.

It gets worse.

A just released health study shows worsening infant mortality and shorter lifespans for people living in the ARC region. Two decades ago, the study reported, Appalachian rates were similar to national averages. But in recent years, the study found Appalachian infant deaths to be 16% higher and life expectancies to be 2.4 years shorter.

Another study released a year ago that reviewed 34 health measures showed Delta counties were “16% worse than those in non-Delta counties and 22% worse than those in the rest of the United States.”

In both studies, economic distress was cited as a major factor affecting health outcomes along with factors such as obesity, nutrition, smoking, and teen pregnancies.

Both ARC and DRA exist to relieve economic distress in their regions and both have initiatives to improve health and health care. (Both agencies are also targeted for elimination in the Trump budget).

Other entities have health initiatives too. For example, a partnership between Pew Charitable Trusts and the Robert Wood Johnson Foundation seeks to help counties address economic and other factors causing health disparities. Their “Health Impact Project: Advancing Smarter Policies for Healthier Communities” targets distressed counties in 14 states, including 34 counties in Mississippi.

The State of Mississippi, on the other hand, has chosen to slash budgets for agencies providing health care. In particular, cuts eliminating Department of Health services and cuts to Medicaid will negatively impact health in distressed counties.

These budget cuts result in large part because of corporate and business tax cuts that reduced state revenues. State leaders argue the tax cuts will result in business expansion, grow jobs, and improve economic status across Mississippi. As economic status improves, health should too.

But, while there is mounting evidence that health disparities are on the rise, there is no evidence that state tax cuts are improving the economic status of our many distressed and at-risk counties.

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