There is often much screaming among conservatives that big government programs — new ones like universal healthcare, universal college education, or guaranteed work, and long-established ones like Social Security, Medicaid, and Medicare — somehow lead to dictatorship. There is, naturally, no actual evidence for this. The imagined correlation is justified with nothing beyond “that’s socialism, which always becomes totalitarianism,” ignorance already addressed. The experience of advanced democracies around the world, and indeed the U.S. itself, suggests big government programs, run by big departments with big budgets and big staffs helping tens of millions of citizens, can happily coexist alongside elected governing bodies and presidents, constitutions, and human rights, as one would expect.

Threats to democracy come from elsewhere — but what’s interesting to consider is how conservatives have things completely backward. Big government programs — the demonstration that one’s democracy is a government “for the people,” existing to meet citizen needs and desires — are key to beating back the real threats to a republic.

In a recent interview with The Nation, Bernie Sanders touched on this:

“Why it is imperative that we address these issues today is not only because of the issues themselves—because families should not have to spend a huge proportion of their income on child care or sending their kid to college—but because we have got to address the reality that a very significant and growing number of Americans no longer have faith that their government is concerned about their needs,” says the senator. “This takes us to the whole threat of Trumpism and the attacks on democracy. If you are a worker who is working for lower wages today than you did 20 years ago, if you can’t afford to send your kid to college, etc., and if you see the very, very richest people in this country becoming phenomenally rich, you are asking yourself, ‘Who controls the government, and does the government care about my suffering and the problems of my family?’”

Sanders argues that restoring faith in government as a force for good is the most effective way to counter threats to democracy.

And he’s right. Empirical evidence suggests economic crises erode the rule of law and faith in representative democracy. Depressions are not the only force that pushes in this direction, but they are significant and at times a killing blow to democratic systems. Unemployment, low wages, a rising cost of living — hardship and poverty, in other words — drive citizens toward extreme parties and voices, including authoritarians. Such leaders are then elected to office, and begin to dismantle democracy with support of much of the population. Europe in the 1930s is the oft-cited example, but the same has been seen after the global recession beginning in 2008, with disturbing outgrowths of recent declining trust in democracy: the success of politicians with demagogic and anti-democratic bents like Trump, hysteria over fictional stolen elections that threatens to keep unelected people in office, and dangerous far-right parties making gains in Europe. The Eurozone and austerity crisis, the COVID-induced economic turmoil, and more have produced similar concerns.

What about the reverse? If economic disaster harms devotion to real democracy and politicians who believe in it, does the welfare state increase support for and faith in democracy? Studies also suggest this is so. Government tackling poverty through social programs increases satisfaction with democratic systems! The perception that inequality is rising and welfare isn’t doing enough to address it does the exact opposite. A helping hand increases happiness, and is expected from democracies, inherently linking favorability views on republics and redistribution. If we wish to inoculate the citizenry against authoritarian candidates and anti-democratic practices within established government, shoring up loyalty to democracy through big government programs is crucial.

It is as Sanders said: the most important thing for the government to do to strengthen our democracy and even heal polarization (“Maybe the Democrats putting $300 per child per month in my bank account aren’t so evil”), is simply to help people. To work for and serve all. Healthcare, education, income support, jobs…such services help those on the Right, Left, and everyone in between. This should be done whether there is economic bust or boom. People hold fast to democracy, a government of and by the people, when it is clearly a government for the people. If we lose the latter, so too the former.

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In the past year, it has been heavily impressed upon Kansas Citians that one’s health is to a significant degree determined by factors beyond one’s control. The COVID-19 era is a key moment to further break down the reactionary notion that personal health choices are all that stands between an individual and optimal physical and mental well-being. It’s broadened our understanding of how health is also a product of social conditions.

The first and most elementary fact to note is that viruses, while often focusing on vulnerable populations such as the elderly, are not often entirely discriminatory. They end the lives of the young and healthy as well. Regardless of one’s habits of eating, exercise, or not smoking, random exposure to illnesses new or old as one shops for groceries or rides in an Uber helps introduce the point: The environment often makes a mockery of our personal choices, as important as those are.

The family you are born into, where you grow up, and other factors beyond your control — and often your own awareness — have a large impact on your development and health as a child, which in turn impacts your health as an adult. (And the environment you happen to be in continues to affect you.) Poverty, extremely stressful on the mind and body in many ways, is the ultimate destructive circumstance for children and adults alike. Take the disturbing life expectancy differences between the poor and the better-off, for instance. In Kansas City’s poorest ZIP codes, which are disproportionately black, you can expect to live 18 fewer years on average compared to our richest, whitest ZIP codes, as Flatland reported on June 22. Poor families are less likely to have health care offered by an employer or be able to afford it themselves. They live in social conditions that include more violence or worse air and water pollution. They can at times only afford housing owned by negligent landlords slow to take care of mold, and cope with a million other factors.

During the pandemic, what serious observers of the social determinants of health predicted came true: Black Kansas Citians were hammered by COVID-19. Here we feel, today, the cold touch of slavery and Jim Crow, which birthed disproportionate poverty, which nurtured worse health, which resulted in Black Kansas Citians being more likely to catch coronavirus and die from it, as The Star reported even in the early stages of the pandemic. Worse still, on Feb. 24, the paper noted that richer, whiter ZIP codes — the areas of less urgent need — were getting disproportionately more vaccines than poorer areas with more Black residents. The vaccines were first shipped by the state to health centers that were convenient for some but distant from others.

Imagine history and race playing a role in your health, how soon you could get a shot. Imagine transportation options and where you live being factors. Likewise, imagine the kind of job you have doing the same: Lower-income workers are more likely to have front-line jobs at restaurants and grocery stores, where you can catch the virus. The privileged, better-off often work from home.

Whether it is drinking water you don’t know is unsafe or working at a job that requires much human contact during a pandemic, the determinants of health stretch far beyond exercising, eating right, and choosing not to smoke. To reflect on this fact is to understand a moral duty. If social conditions affect the health of individuals and families, it is urgent to change social conditions — to build a decent society, one without poverty and the many horrors that flow from it.

In this moment, one important way to help move toward this goal is to urge the U.S. House to pass the reconciliation budget that just passed the Senate, to extend the direct child tax credit payments to families, boldly expand education and health care, and more. Onward, a better world awaits.

This article first appeared in The Kansas City Star: https://www.kansascity.com/opinion/readers-opinion/guest-commentary/article253638658.html or https://edition.pagesuite.com/popovers/dynamic_article_popover.aspx?artguid=1ce78851-fef4-4f5d-b7a4-448618c1526c.

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As August 2021 began, 50% of the U.S. population was fully vaccinated against COVID-19, over 165 million people. There have been 615,000 confirmed deaths — the actual number, given the national excess mortality rate since the start of 2020, is likely double official figures. Over a 12-month period, since last August, 2.5 million people were hospitalized, many leaving with lasting medical problems. All the while, protests and foaming at the mouth over mask and vaccine mandates continue; half the population has refused or delayed the vaccine, this group disproportionately (+20%) Republican.

Attempting to convince the conspiracy theorists, bullheaded conservatives, and those concerned over how (historically) fast the vaccine breakthrough occurred is of course still the moral and pressing thing to do. This piece isn’t an exercise in fatalism, despite its headline. However, great frustration exists: if the hesitant haven’t been convinced by now, what will move the needle? With over a year and a half to absorb the dangers of COVID, deadly and otherwise, and eight months to observe a vaccine rollout that has given 1.2 billion people globally highly effective protection, with only an infinitesimally small percentage seeing any side effects (similar to everyday meds), what could possibly be said to convince someone to finally listen to the world’s medical and scientific consensus, to listen to reason? People have been given a chance to compare the disease to the shots (the unvaccinated are 25 times more likely to be hospitalized from COVID and 24 times more likely to die, with nearly all [97, 98, 99%] of COVID deaths now among the unprotected population), but that requires a trust in the expert consensus and data and trials and peer-reviewed research and all those things that make American stomachs churn. Giving people accurate information and sources can even make them less likely to see the light! There is, for some bizarre reason, more comfort and trust in the rogue doctor peddling unfounded nonsense on YouTube.

It may be of some comfort then to recognize that the insanity will surely decrease as time goes on. It’s already occurring. The most powerful answer to “what will move the needle?” is “personal impact” — as time passes, more people will know someone hospitalized or wiped from existence by the disease, and also know someone who has been vaccinated and is completely fine. There will be more family members who get the vaccine behind your back and more friends and acquaintances you’ll see online or in the media expressing deep regret from their ICU hospital beds. You may even be hospitalized yourself. Such things will make a difference. States currently hit hardest by the Delta variant and seeing overall cases skyrocket — the less vaccinated states — are also witnessing increases in vaccination rates. Even conservative media outlets and voices are breaking under the weight of reason, finally beginning to promote the vaccine and changing viewers’ minds, while naturally remaining in Absurdsville by pretending their anti-inoculation hysteria never occurred and blaming Democrats for vaccine hesitancy. Eventually, falsities and mad beliefs yield to science and reason, as we’ve seen throughout history. True, many will never change their minds, and will go to their deaths (likely untimely) believing COVID to be a hoax, or exaggerated, or less risky than a vaccine. But others will yield, shaken to the core by loved ones lost to the virus (one-fourth to one-third of citizens at least know someone who died already) or vaccinated without becoming a zombie, or even by growing ill themselves.

To say more time is needed to end the foolishness is, admittedly, in part to say more illness and death are needed. As stated, the more people a hesitant person knows who have grown ill or died, the more likely the hesitant person is to get his or her shots. A terrible thing to say, yet true. That is why we cannot rest, letting time work on its own. We must continue trying to convince people, through example, empathy (it’s often not logic that changes minds, but love), hand-holding, and other methods offered by psychologists. Lives can be saved. And to convince someone to get vaccinated is not only to protect them and others against COVID, it suddenly creates a person in someone else’s inner circle who has received the shots, perhaps helping the behavior spread. Both us and Father Time can make sure hesitant folk know more people who have been vaccinated, the more pleasant piece of time’s function.

Hopefully, our experience with coronavirus will prepare us for more deadly pandemics in the future, in terms of our behavior, healthcare systems, epidemiology, and more. As bad as COVID-19 is, as bad as Delta is, humanity was exceptionally lucky. The disease could have been far deadlier, far more contagious; the vaccine could have taken much longer, and been less effective. We’ve seen four million deaths worldwide, but even with this virus evolving and worsening, we’ll likely see nothing like the 50 million dead from the 1918 pandemic. Some see the rebellion against masks, lockdowns, and vaccines as a frightening sign: such insanity will spell absolute catastrophe when a deadlier virus comes around. This writer has always suspected (perhaps only hoped) that view to be a bit backward. A deadlier virus would likely mean less rebellion (as would a virus you could see on other people, something more visually horrifying like leprosy). It’s the relative tameness of COVID that allows for the high degree of madness. Admittedly, there was anti-mask resistance during the 1918 crisis, but there could be a correlation nonetheless between the seriousness of the epidemic and the willingness to engage in suicidal foolishness. That aligns with this idea that the more people you lose in your inner circle the more likely you are to give in and visit your local health clinic. Let’s hope science and reason reduce the opportunities to test this correlation hypothesis.

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