Written by JEFF GOLDSMITH
The disappointing debate performance of Joe Biden has left Democrats in despair, realizing that preventing the return of Donald Trump may be a challenging task. The root causes of the adverse political climate can be understood by examining the map featured in the Economist’s article on declining US population.

While America’s economy thrives, there is a growing disparity between different regions. The reality on the ground varies significantly depending on where one lives. Those in the red areas of the map feel that wealth and power have been unjustly taken from them by corrupt leaders and elites, leading to the rise of MAGA. This divides the nation, with the affluent feeling America is already great, while others face challenges like high gas prices, unaffordable housing, and despair.
The prevalence of “deaths of despair” in these struggling communities reveals deeper issues. Factors like health/life expectancy and local economic conditions play a crucial role in shaping the political landscape. Despite significant relief spending and investments in red areas, the disconnect between policy advocates and the recipients of these programs persists, contributing to the current political climate.
If current trends continue, the Biden Presidency may face further challenges, with Republicans gaining more control. Effective communication and understanding of the needs of the working class are essential to prevent further polarization and political setbacks.
Jeff Goldsmith is a veteran health care futurist, President of Health Futures Inc and a regular contributor to THCB. This article is adapted from his personal substack.