In a long feature on differing health outcomes in the continuous adjacent arc of three demographically and economically similar counties in three different states along the southeastern shore of Lake Erie – Ashtabula County, Ohio, Erie County, Pennsylvania, and Chautauqua County, New York – the Washington Post crunches the numbers and finds a pretty unambiguous reality that people in Ashtabula by and large die younger than those in Erie and Chautauqua.

Data from the 2020 census shows Chautauqua, Erie, and Ashtabula almost in complete lockstep: 86.3, 82.9, and 88.1 percent non-Hispanic white, median annual household incomes of $50,408, $55,949, and $49,680, and poverty rates at 17.2, 15.8, and 15.2 percent, all respectively. Yet the death rate in Ashtabula in 2020 was 650 per 100,000 between the ages of 35 and 65 compared to under 500 in Erie and about 525 in Chautauqua. The Post attributes the disparity to lax seatbelt laws (people are twice as likely to die in car accidents in Ashtabula than in Chautauqua), low cigarette taxes, and lack of Medicaid funding, three policy issues the Republican-dominated Ohio state legislature have refused to do anything about for fear of becoming a “nanny state.”

“Between 2015 and 2019, nearly five times as many Ashtabula residents in their prime died of chronic medical conditions as died of overdoses, suicide and all other external causes combined, according to The Post analysis of the Centers for Disease Control and Prevention’s death records,” the Post writes in the article, which is interspersed with a profile of a local funeral director’s long hours. Mike Czup told the Post he recently had to prep the body of a 34 year-old heart attack victim whom the 52 year-old Czup had coached on a YMCA basketball team when he was a kid.