Frequent concern has been expressed by health experts in the USA that life-expectancy in this country has been reducing steadily in comparison to levels attained in several other rich countries. This has led some researchers to explore the number of excess deaths in the USA (or number of ‘missing Americans’) which they define as the deaths which are in excess of the number that would have taken place if the life-expectancy rates in the USA had remained at par with those of comparable rich countries.
One such important recent study by Jacob Bor, Andrew C. Stokes and others has been published in the journal PNAS Nexus on May 29, 2023. This study has estimated the number of such excess deaths in the USA in 2019 at 622,534. During the next two years the number of such excess deaths went up to over a million, but as these were Covid years and a number of other issues become involved, we will go here only by the lower number of excess deaths recorded for a normal year at over 600,000. So what this study is saying that on the basis of comparisons with other rich countries, the USA should have been able to achieve the sort of life expectancy that results in avoiding over 600,000 deaths in a year.
Earlier another study by David Brady on only poverty related mortality published in the USA in JAMA Internal Medicine in April 2023 (for over 15 years age group) had estimated that there are 183,000 poverty related deaths in a year in the USA. UN data tells us that at a time when maternal death rate was declining in most countries, in the USA maternal death rate increased to a shocking extent from 12 to 21 during 2000-2020.
More such data can be provided to show that the number of excess, easily avoidable deaths in the USA is shockingly high at well over half a million every year. A very big contribution to human welfare can be made by taking steps to ensure that these avoidable deaths are actually avoided.
The steps that are needed for improvements are well-known in a country so blessed with eminent scholars. In a nutshell, health services have to be improved in a big way for all weaker sections without any discrimination, inequalities must be reduced in a big way so that the poorer people have much better access to nutrition, environment and safety must be much better protected, shelter and health and overall social conditions need to be improved to make way for better physical and mental health while avoiding all harmful addictions.
The bigger question is—when these solutions are well-known, why have not these been adopted and why the situation in some importance respects continues to deteriorate? This is the really crucial question which needs to go beyond the analysis generally available in academic papers as this concerns important political issues of injustice. We need to ask why billions are easily available in the USA for weapons but even millions are not available for some important aspects of social justice, why billions worth of tax gifts can be given to the rich but millions worth of essential expenditure for the poorest is more difficult to find.
The fact is that a system of injustice has become so deeply established in the USA that solutions outside this system are difficult to implement. What should be emphasized is that this system of injustice is causing even more harm to people of other countries than what it is causing to people within USA.
Due to this system if 600,000 excess deaths a year are caused in the USA, then a similar or higher number deaths are likely being caused in other countries as well. The number of deaths caused by the USA’s forever wars is in many millions as can be seen by adding up the immediate and longer-term mortality figures of wars in Korea, Vietnam, Cambodia, Laos, Iraq, Libya, Syria, Afghanistan and elsewhere ( in addition of course there was the use of atomic bombs against Japan after Japan had already been defeated for all practical purposes). Then there are a large number of deaths caused by arbitrary imposition of wide-ranging sanctions, highly unjust interventions and coups in other countries which resulted in a large number of deaths (in countries like Congo, Chile, Iran, Nicaragua, Haiti, Greece etc.). Then there are also the large number of deaths associated with exports of weapons as well as several highly hazardous products and technologies. Hence in brief we can say that unjust systems in the USA cause avoidable 600,000 excess deaths in the USA and a somewhat higher number in other countries annually. Excess deaths in other countries are defined here as deaths caused by various injustices of the US (or allies acting under US leadership), whether in the form of wars or coups or subversions or exploitation.
These excess deaths inside and outside USA are two parts of the same unjust system, an important aspect missed by most academic studies. Once you establish an unjust system that inflicts unjust wars on other countries, then the same unjust system adopts internal unjust and discriminative policies within the country too, although this may get partially softened by electoral considerations at times.
Another reflection of how internal and external injustices are closely related is the fact that the leaders with the biggest promise of justice have been assassinated within the USA as also in other countries with fingers pointed towards the same US agency. This is how the assassinations of President John Kennedy and President Allende are related, this is how the assassinations of Presidential candidate Robert Kennedy Sr. and President Lumumba are related, this is how the killings of Martin Luther King Jr. and Che Guevara are related. Leaders most capable of bringing justice and peace are removed before they can fulfill their potential.
So as several eminent scholars have suggested the solution for the USA to avoid excess deaths is to improve health care and socio-economic conditions for the lower half of the population, but in addition if we go a step further and ask why this has not happened in recent years, then we also need to say more clearly and loudly that the established unjust system must be challenged and replaced by a system that is based on justice internally and externally.
Such struggles against well-established systems of injustice are needed in so many countries but most of all these are needed in the USA as this is the most powerful and influential country in the world whose policies have a worldwide impact. From a world perspective the struggle is against the unjust establishment of the USA, just the top 5% or so, and never against the people of the USA and in fact the struggling American people need all the worldwide solidarity to help in their struggles. The creation of a justice-based USA is a very important part of the worldwide struggle against injustice. The aim should never be to replace a world dominated by the USA by a world dominated by China but instead our aim should be to create a USA, a China and the entire world based on justice, peace and environment protection.
Bharat Dogra is Honorary Convener, Campaign to Save Earth Now. His recent books include Planet in Peril, A Day in 2071, Protecting Earth for Children and Earth without Borders.
