By Carlos Lozada, Book critic
May 1, 2020 at 5:00 a.m. PDT
DEATHS OF DESPAIR AND THE FUTURE OF CAPITALISM
By Anne Case and Angus Deaton.
Princeton University Press. 312 pp. $27.95
Even before the coronavirus struck, America was suffering an eviscerating epidemic. Its cause was not a virus; its spread could not be blamed on foreign travelers or college kids on spring break. No masks or gloves could slow its contagion, no vaccine could prevent new cases. Its toll is clear in the rising deaths of white Americans in their mid-40s to mid-50s over the past two decades, particularly in states such as Arkansas, Kentucky, Mississippi and West Virginia.
Princeton University economists Anne Case and Angus Deaton call these “deaths of despair” — the deaths from suicide, drug overdoses and alcoholic liver disease ravaging swaths of the country. The victims, overwhelmingly, are less-educated Americans whose loss of life was preceded by a loss of jobs, community and dignity, and whose deaths, the authors argue, are inextricable from the policies and politics transforming the U.S. economy into an engine of inequality and suffering. “The American economy has shifted away from serving ordinary people and toward serving businesses, their managers, and their owners,” Case and Deaton write in their new work, “Deaths of Despair and the Future of Capitalism.”
Although the authors completed this book before the onset of the coronavirus pandemic — it was published four days after President Trump declared a national emergency — their diagnosis is still painfully relevant. Mass unemployment and mass infection, occurring simultaneously in a nation where health insurance often depends on employment, threaten to both prove and aggravate the conditions Case and Deaton describe. The debate over how quickly to ease social distancing restrictions and get the economy moving again forces a reckoning: How do we balance the risk of increased coronavirus infections if we reopen the economy too soon against the risk of more deaths of despair if we do so too late? “Jobs are not just the source of money; they are the basis for the rituals, customs, and routines of working-class life,” Case and Deaton write. “Destroy work and, in the end, working-class life cannot survive.”
Reading this book during a pandemic, I found myself bracing for more death — from the virus or from despair, and, more likely, from both.
Many memoirs, histories and investigations have been written on America’s white working class in recent years, probably too many, but fewer purely economic studies. Case and Deaton are world-renowned practitioners of the dismal science (Case is a top expert on the links between economic and health status, while Deaton snagged a Nobel in 2015 for his work on household poverty and welfare), and their lens on the subject makes for stark reading. They estimate the magnitude of the deaths of despair in the United States by comparing the improving trend lines of recent decades — i.e., if mortality rates had continued falling as before — with what actually came to pass.
“When we add up those numbers from 1999, the critical point where the turnaround began, to 2017,” the authors report, “we get a very large total: 600,000 deaths of midlife Americans who would be alive if progress had gone on as expected.” Case and Deaton liken that number to “what we might see during the ravages of an infectious disease, like the Great Influenza Pandemic of 1918.” They also compare it to the roughly 675,000 deaths of HIV/AIDS in the United States since the early 1980s.
Case and Deaton are largely dismissive of arguments that stress the supposed individual or cultural failings of the white working class, and they focus instead on systemic shortcomings that lead to deaths of despair. Manufacturing towns and cities have seen their factories boarded up, they write, and “in the wreckage, the temptations of alcohol and drugs lured many to their deaths.” Education is another consideration, the authors argue, with “almost all” of the increase in deaths due to suicide, alcoholism and drug overdoses found among people who lack bachelor’s degrees. Deteriorating health matters as well. “Many people are experiencing pain, serious mental distress, and difficulty going about their day-to-day lives,” Case and Deaton write. These conditions make it harder for them to work, which reduces income and undercuts work as a source of “satisfaction and meaning” in their lives.
Who lives, who dies, who decides: How the virus makes us weigh the value of one life
More than 30 million Americans have sought unemployment aid since mid-March, a level of dislocation not seen since the Great Depression. In this context, the impulse to return to work is understandable. Yet the loss of earnings, Case and Deaton contend, is just part of the challenge. “Much more important for despair is the decline of family, community, and religion,” they write, a decline they regard as related to falling wages and disappearing jobs, but distinct from them. Other authors have tackled this problem recently — see, for instance, Timothy P. Carney’s insightful 2019 book, “Alienated America” — and collectively, their conclusion is clear: Long before we began social distancing, Americans had already grown far too distant from one another.
Case and Deaton focus on the white working class because it is undergoing a particularly harrowing shift, not because they believe this demographic matters more than others (they don’t) or because it is worse off in absolute terms than others (it isn’t). Black mortality rates remain persistently higher than white ones, the authors point out, even considering the increased deaths of despair among white Americans. But black mortality rates are falling faster than white rates — and the deaths of despair among white citizens are the difference. “The main reason why death rates of blacks fell more rapidly than death rates of whites at the beginning of the twenty-first century is that blacks were not suffering the epidemic of overdoses, suicide, and alcoholism,” Case and Deaton explain. [...]
It's worth reading the whole thing. While I don't consider myself an anti-capitalist at all, there have been changes in the economy, locally an globally, that have been eliminating working class jobs and incomes. It's a reality.
When Obamacare tried to force small businesses to provide health care for full time employees, the employment industry responded by making all employees part time. I worked as a tax preparer, dealing with all their W-2 forms, and was astounded at how many families were raising children, with two parents working at an assortment of part-time jobs, to pay their bills and keep thier families alive.
This article touches on many causes, and asks many questions we need to face, as it's only going to continue to get worse for the majority of people, if viable solutions are not found.
Many of these people are Trump supporters. And they will vote for Trump, no matter what anyone says, because they feel that the Democrats don't care wether they live or die, so they will vote for anyone who opposes the Democrats. You can argue about wether that perception is right or wrong. But it won't change the fact that they percieve it that way. If the Democrats are serious about winning more votes, they should be addressing this, instead of only attacking Trump non-stop. They have been doing that for the past four years, and it hasn't worked. Isn't it about time they try something that does?
I have Democrat friends who believe that all Trump supporters are racists, bigots and morons. And that if they keep repeating that mantra, it's going to win them the elections. But I think they have forgotten, what every election is about: it's the economy, stupid. Duh. It affects the most people. And the majority will vote for whoever they think, whoever they perceive, will do the better job of that.
