I have been very fortunate to see a solar eclipse before and my wife and I decided to journey to central Missouri this past weekend to see the recent one. The eclipse viewing, after some early morning trepidation due to rather extensive cloud cover, went off fine, as a large patch of blue sky overhead opened up to allow clear viewing of totality. Particularly striking was an intense pink partial ring as the moon began to move away from full coverage of the sun. We were in a pleasant little tourist town, Blackwater, in central Missouri. But the road trip to our destination was particularly revelatory about the state of much of America. The great bulk of American geography is rural, punctuated here and there by small and medium-sized towns and cities.
Our meander through Minnesota, Wisconsin, Iowa and Missouri took us through some beautiful landscapes, particularly along the Mississippi valley and rolling Missouri farm country, with its ribbons of woods bordering the crop fields. Farmers appear to be doing well, crops look healthy, buildings and homes are well-maintained or new. Nothing like a government income subsidy for your livelihood to help with prosperity. But the multitude of small towns and cities we passed through are clearly struggling. Abandoned or rundown commercial and residential buildings, poor road and street maintenance, trash laying about, and few solid businesses are the indicia of economic struggle. The people are frequently obese and display signs of other poor health habits. Their public education systems are basically incompetent at providing children with the skills to be successful in life.
Hopelessness and despair are rampant, and the resultant behaviors predictable. The economic underpinnings for this are the hollowing out of American manufacturing and other businesses that provided a middle class income for people with minimal education and the political ones are policies that created a system that truly favors the wealthy and intellectual elites. That is not a political observation, it is a fact of our current life, just look at the relative economic gains of the wealthy and the rest of the population. This stirs anger as it always does and has since the middle ages, among the vast majority of the citizenry who perceive that the economic and political elites have constructed a world that treats them as the dregs of society. If you wonder why Trump won, take this road trip, and stop in places like Hannibal and Sedalia, Missouri. Whether it was a rational choice or not, he seemed the perfect receptacle for that anger and resentment and despair.
These communities have high health costs and high chronic disease incidence, stemming from poor health behaviors. A comprehensive effort needs to be undertaken to remedy the decades of possibly well-intentioned but certainly disastrous in effect public policies, including creation of various social programs that actually reinforce the poor behaviors. Only when this is done, can we help people lead more meaningful lives and along the way help them adopt better health decisions and lower health spending.