The richest states will vote Obama and the poorest states will vote Romney

Yes, "it's the economy, stupid" is true, but other issues are influencing voters counter-intuitively, too.

According to a report last month, the five richest states in the USA are Maryland, Alaska, New Jersey, Connecticut and Massachusetts whilst the five poorest states are Mississippi, West Virginia, Arkansas, Kentucky and Alabama. Politically, four of the five richest states (the exception is Alaska) are regarded as safe for Barack Obama and all five of the poorest states are regarded as safe for Mitt Romney.

Viewed from these shores, this is puzzling because the richest states are supporting the candidate of the left-wing party while the poorest states are voting for the candidate of the right-wing party. In England, if a constituency is prosperous you can be sure it does not have a Labour MP; very probably it will have a Tory MP and occasionally a Lib Dem. If a constituency is deprived, the Tories are glad if they save their deposit and the MP is invariably Labour.

A partial explanation for the prosperous citizens of a state like Maryland voting for a Democrat is that the centre of politics in the US is significantly to the right of the centre of politics in the UK and Europe. However, it is still the case that if you are earning very well you can expect to pay more tax under the Democrats.

Journalists often use the phrase “it’s the economy, stupid” when analysing elections and it is true that some people vote in elections on the basis of which party they think will make them and their family better off financially. It is ironic, as the phrase originated in the US, from Bill Clinton’s 1992 presidential election campaign, that this test is applied more by voters in the UK than those in America. In the US millions of votes are cast for non-economic reasons.

For the last few decades fierce debates have raged in America which have come to be known as “Culture Wars”. These cover a range of issues which are highly controversial in the US, such as the importance of religion, the law on abortion, gun-control and issues around homosexuality like gay marriage. Depressingly, even the issue of climate change, rather than being judged on the basis of scientific evidence, has become caught up in these Culture Wars. On these issues, the Democrats tend to have progressive, liberal views and the Republicans conservative, traditional views. For millions of Americans these issues are decisive.

Many of the poorest states in the US are in the Deep South. These states now vote solidly Republican in presidential elections. The vote is split on racial grounds. In 2008, Obama received some 98 per cent of the black vote in Mississippi and Alabama but was easily beaten by John McCain who received some 90 per cent of the white vote. The result was much the same when the Democrat candidate has been white.

Once it was the Democrats who were the beneficiary of white Southern voters as a result of the civil war and its aftermath. The states in the Deep South were slave states and they were defeated in the Civil War by a government led by Abraham Lincoln. Lincoln was a Republican, in fact the first Republican president.

After the Civil War and after Lincoln’s assassination it was the Republican Party that tried and failed to secure proper rights for the blacks in the Deep South. It was the Democrats who ensured that, although slavery was finished, the blacks in their states had minimal rights. Into the 1960s southern blacks faced discrimination, segregation and were denied the right to vote. Southern whites at the time never voted anything other than Democrat.

In 1964 it was a Democrat president, Lyndon Baines Johnson, who forced through the 1964 Civil Rights’ Act to make sure that blacks in the South could vote and had proper legal rights. He knew that this would earn his party the hatred of the white voters in the South. As he signed the law he reportedly said: “There goes the South for a generation.”

LBJ was right in that voters who had only ever voted Democrat now proceeded to only ever vote Republican. He was wrong about this voting pattern lasting “for a generation” – it has already been far longer than that.
The economy may well be the most important issue in the battle between Obama and Romney but it is by no means the only important issue.

Romney supporters. Photograph: Getty Images
Getty
Show Hide image

A swimming pool and a bleeding toe put my medical competency in doubt

Doctors are used to contending with Google. Sometimes the search engine wins. 

The brutal heatwave affecting southern Europe this summer has become known among locals as “Lucifer”. Having just returned from Italy, I fully understand the nickname. An early excursion caused the beginnings of sunstroke, so we abandoned plans to explore the cultural heritage of the Amalfi region and strayed no further than five metres from the hotel pool for the rest of the week.

The children were delighted, particularly my 12-year-old stepdaughter, Gracie, who proceeded to spend hours at a time playing in the water. Towelling herself after one long session, she noticed something odd.

“What’s happened there?” she asked, holding her foot aloft in front of my face.

I inspected the proffered appendage: on the underside of her big toe was an oblong area of glistening red flesh that looked like a chunk of raw steak.

“Did you injure it?”

She shook her head. “It doesn’t hurt at all.”

I shrugged and said she must have grazed it. She wasn’t convinced, pointing out that she would remember if she had done that. She has great faith in plasters, though, and once it was dressed she forgot all about it. I dismissed it, too, assuming it was one of those things.

By the end of the next day, the pulp on the underside of all of her toes looked the same. As the doctor in the family, I felt under some pressure to come up with an explanation. I made up something about burns from the hot paving slabs around the pool. Gracie didn’t say as much, but her look suggested a dawning scepticism over my claims to hold a medical degree.

The next day, Gracie and her new-found holiday playmate, Eve, abruptly terminated a marathon piggy-in-the-middle session in the pool with Eve’s dad. “Our feet are bleeding,” they announced, somewhat incredulously. Sure enough, bright-red blood was flowing, apparently painlessly, from the bottoms of their big toes.

Doctors are used to contending with Google. Often, what patients discover on the internet causes them undue alarm, and our role is to provide context and reassurance. But not infrequently, people come across information that outstrips our knowledge. On my return from our room with fresh supplies of plasters, my wife looked up from her sun lounger with an air of quiet amusement.

“It’s called ‘pool toe’,” she said, handing me her iPhone. The page she had tracked down described the girls’ situation exactly: friction burns, most commonly seen in children, caused by repetitive hopping about on the abrasive floors of swimming pools. Doctors practising in hot countries must see it all the time. I doubt it presents often to British GPs.

I remained puzzled about the lack of pain. The injuries looked bad, but neither Gracie nor Eve was particularly bothered. Here the internet drew a blank, but I suspect it has to do with the “pruning” of our skin that we’re all familiar with after a soak in the bath. This only occurs over the pulps of our fingers and toes. It was once thought to be caused by water diffusing into skin cells, making them swell, but the truth is far more fascinating.

The wrinkling is an active process, triggered by immersion, in which the blood supply to the pulp regions is switched off, causing the skin there to shrink and pucker. This creates the biological equivalent of tyre treads on our fingers and toes and markedly improves our grip – of great evolutionary advantage when grasping slippery fish in a river, or if trying to maintain balance on slick wet rocks.

The flip side of this is much greater friction, leading to abrasion of the skin through repeated micro-trauma. And the lack of blood flow causes nerves to shut down, depriving us of the pain that would otherwise alert us to the ongoing tissue damage. An adaptation that helped our ancestors hunt in rivers proves considerably less use on a modern summer holiday.

I may not have seen much of the local heritage, but the trip to Italy taught me something new all the same. 

This article first appeared in the 17 August 2017 issue of the New Statesman, Trump goes nuclear