Something has gone dramatically amiss with white working-class America.
Among middle-aged white Americans with a high school degree or less, the death rate from drug and alcohol overdoses quadrupled between 1999 and 2013. The suicide rate rose by a heartbreaking 81 percent. Death associated with alcohol abuse rose by 50 percent. Overall, the death rate among working-class, white Americans aged 45-54 jumped by a magnitude seldom seen in modern times, by any cause. Anne Case and Angus Deaton, authors of a new study published in =the Proceedings of the National Academies of Science, estimate the death toll so far at almost half a million additional people.
Half a million additional dead over a 14-year period — that is an epidemic. According to Case and Deaton, it is “comparable to lives lost in the U.S. AIDS epidemic through mid-2015.”
If we follow the trail back to its source, we know that alcoholism, drug abuse and suicide have a common root in despair, and if you look at economic trends, that despair is understandable. Earnings for those with a high school diploma or less have fallen significantly thanks to technology and overseas competition, as have jobs that provide health insurance and pension. Economic security is almost non-existent. In short, this is an epidemic born of hopelessness.
In our political debate, we are wrangling over the basic question of how to respond to an economy that both major parties now acknowledge has changed in fundamental ways. Some argue that in the face of such change, it is a fiscal and moral imperative to cut Medicare, Medicaid, Social Security, food stamps, housing, job training, day care and tuition assistance. They believe that such social programs have undercut our national work ethic, producing a “culture of dependency”. And I suppose you could argue that this alleged growth in dependency is somehow responsible for the growth in despair.
But there’s a fatal flaw in that theory. As Case and Deaton point out, this epidemic is a purely American phenomenon. Similar populations in other Western industrialized countries have suffered similar or even greater economic setbacks, “yet none have had the same mortality experience.” And in all of those other Western countries, the social safety net is considerably more substantial than it is here in the United States. That would indicate that programs that enhance a sense of economic security and opportunity are useful in avoiding the desperation that is the root problem here.
More specifically, in the face of this epidemic, do we continue to raise the Social Security retirement age, putting that reward even further out of reach as some now advocate? What effect is that likely to have? And do we address this health crisis by repealing programs that offer health insurance to working-class Americans of all ages, people who would otherwise have no financial means of attaining it? Is that really the direction that logic dictates?
And overall, do we continue to pretend that this once-hidden crisis is a product of individual shortcomings, or something reassuringly confined to a particular demographic group, rather than something born of a despair shared by many?
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