(CN) — A new assessment by medical journal The Lancet lays out in shocking detail the repercussions President Donald Trump’s health policies had on the wellbeing of the American people, with the report attributing thousands of avoidable deaths and increased racial and economic disparities to his administration.
Shortly after Trump was inaugurated in 2017, The Lancet — one of the oldest medical journals in the world — launched the Commission on Public Policy and Health.
The objective of the commission was clear, but by no means simple: to chronicle the consequences born from Trump’s actions as they related to public health and to chart how exactly the lives of the American people were being influenced by his policy decisions.
With the election of Joe Biden putting a period on Trump’s time in office, that commission has revealed the results from their four-year long assessment of Trump’s health policies and their findings say his policies increased deaths in the U.S.
In 2018 alone, the commission reports that 461,000 fewer Americans would have died had the United States maintained life expectancies and death rates similar to countries like Canada, Japan and the U.K.
The commission reports that under Trump’s watch, the county entrenched itself in policies that further steered the United States away from the equitable, public health-conscious ideas that represented the advancements of the New Deal and Civil Rights eras of the past.
The report says that these ideas — and Trump’s endorsement of them, such as through his signature trillion-dollar tax cuts that cut public health programs — have had such a negative effect that it has put American’s life expectancies well behind that of other advanced nations.
Dr. Adam Gaffney, a pulmonary and critical care specialist at Cambridge Health Alliance and Harvard Medical School and one of the members of the commission, said that while the data points to clear failures of the Trump administration, it is also an indictment of decades of poor health policy in America.
“I think the magnitude of the harm done to the U.S. public by the really reckless incompetence of the Trump administration is startling,” Gaffney said in a phone interview. “But to some extent the stage was set for him by many decades of poor policy and years of reduced and inadequate public health funding, rising inequality and worsening health over a number of years.
“So this is both an indictment of the Trump administration, but also of a much longer period of bad policy and inequity.”
The report details how Trump enacted massive funding cuts that saw the loss of roughly 50,000 front line staff in the health industry and oversaw a profit-centric health care system that crippled crucial safety nets, added an additional 2.3 million people to list of uninsured Americans and allowed nearly 11% of Americans to suffer from food insecurity.
These failures, according to the commission, made it certain that the United States was tragically ill-suited to face the challenges of Covid-19 — challenges Trump only seemed to inflame.
At a time when the United States needed a leader who understood the threat of a deadly pandemic, the commission says Trump instead used his pulpit to pull the country away from the World Health Organization, defund the Pan American Health Organization and downplay the severity of a virus that was ripping through American communities.
Gaffney said that to help combat these issues, the United States is in desperate need of a medical community that is willing to endorse change and speak out against these dangerous trends.
“Physicians need to take care of the patient that’s sitting in front of them, but they need to also speak for all the patients out there that may not ever even get to the doctor’s office they can’t afford to see,” Gaffney said. “Medical professionals need to speak for the health of the nation and need to speak in favor of reforms that are necessary to rescue a sinking ship.”
But perhaps nowhere was Trump’s dangerous health policies more devastating than among communities of color.
The report found that Trump spent his time in office taking advantage of the fears of low and middle-income white people to worsen racial tensions, advanced blatantly racist immigration and policing policies and made it generally more difficult for racial minorities to gain access to quality healthcare in the midst of a pandemic.
That report says that these decisions taken together, coupled with Trump’s extensive rollbacks of environmental protections that became a staple of his presidency, resulted in tens of thousands of deaths after Covid-19 struck that could have been avoided.
The commission says that if the United States is to begin correcting these problems, several major policy changes are going to be desperately in order.
To start, the commission advocates for a series of sweeping reforms that will reverse Trump’s actions while in office. A handful of these have already put into place by the Biden administration, such as by rejoining the Paris Climate Agreement and revoking Trump’s Muslim travel ban, but the commission also urges the repeal of Trump’s 2017 tax cuts and a greater enforcement of voting and civil rights across the country.
But the commission says the country cannot simply stop there. While Trump’s actions in office were uniquely damaging to the public health of the United States, many of the problems he exacerbated have been plaguing American society for decades, making fundamental change moving forward essential.
“We need to stop just playing defense and actually try and push real policies forward that aren’t just reverting to the past,” Gaffney said. “We can’t just go back to 2016 and hope things are going to be okay. We need to press forward. We have to be bold and we have to think bigger.”
The report says there are a number of ways to begin accomplishing this. These include enacting the Green New Deal that would end tax breaks for fossil fuels and reduce our reliance on non-renewable energy sources, revamping our criminal justice system that unfairly targets minorities and making Medicare for All a reality in America.
Gaffney said it is only through bold and crucial changes like this can the country begin to put itself on a better, healthier path and if we don’t, we are likely to watch the health of the country deteriorate even further.
“The health of the country is worsening and it doesn’t need to be this way,” Gaffney said. “If we take action we can live healthier lives, we can live longer lives, we can live happier lives. But that’s going to require confronting powerful interests and until we are willing to do that, things are only likely to get worse.”
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