Public policy and health in the Trump era – The Lancet

Disdain for science and cuts to global health programmes and public health agencies have impeded the response to the COVID-19 pandemic, causing tens of thousands of unnecessary deaths, and imperil advances against HIV and other diseases. And Trump’s bellicose trade, defence, and foreign policies have led to economic disruption and threaten an upswing in armed conflict.
Although Trump’s actions were singularly damaging, many of them represent an aggressive acceleration of neoliberal policies that date back 40 years. These policies reversed New Deal and civil rights-era advances in economic and racial equality. Subsequently, inequality widened, with many people in the USA being denied the benefits of economic growth. US life expectancy, which was similar to other high-income nations’ in 1980, trailed the G7 average by 3·4 years in 2018 (equivalent to 461 000 excess US deaths in that year alone). The so-called war on drugs initiated by President Richard Nixon widened racial inequities and led to the mass incarceration of Black, Latinx, and Indigenous people. Overdose deaths soared, spurred by drug firms’ profit-driven promotion of opioids and the spread of despair in long-afflicted communities of colour and among working-class white people. Market-oriented health policies shifted medical resources toward high-income people, burdened the middle class with unaffordable out-of-pocket costs and deployed public money to stimulate the corporate takeover of vital health resources.

Source: Public policy and health in the Trump era – The Lancet