Change in mortality rate may reflect harsh economy

Starting around the turn of the millennium, the United States experienced the most alarming change in mortality rates since the AIDS epidemic. This shift was caused not by some dreadful new disease but by drugs and alcohol and suicide — and it was concentrated among less-educated, late-middle-aged whites.

We knew suicide was increasing among the middle-aged, that white women without a high school degree were struggling with health issues, that opiate addiction was a plague in working-class communities. But we didn’t know it was all bad enough to send white death rates modestly upward in the richest nation in the world.

Now we know, thanks to a new paper from Nobel laureate Angus Deaton and his wife, Anne Case. And their findings, inevitably, are the latest ideological Rorschach test in the debate over how to save the U.S. working class.

To many conservatives, the mortality rate shock is the latest indictment of modern liberalism’s mix of moral permissiveness and welfare-state paternalism.

Then why, the progressives object, is the death rate rising starkly only in the U.S.? In the more secular and socialist territory of the European Union, Deaton and Case are at pains to note, white mortality rates continue to decline.

This buttresses the liberal argument that the U.S. working class has fallen victim to a punishing economic climate. If we had the same institutions as France and Germany, our working class might be struggling, but at least it would be protected from economic impoverishment and despair.

Yet here, too, Deaton and Case’s data is somewhat confounding, because if economic stress were everything, you would expect the crisis to manifest itself more sharply among black and Hispanic Americans. But the mortality rate for minorities continued to fall between 1999 and 2013.

So, why only white Americans? One solution is suggested by a paper from 2012, whose co-authors include Andrew Cherlin and Brad Wilcox, leading left- and right-leaning scholars, respectively, of marriage and family.

Their paper argues that white social institutions have long reflected a “bourgeois moral logic” that binds employment, churchgoing, the nuclear family and upward mobility. But in an era of stagnating wages, family breakdown and social dislocation, this logic no longer seems to make as much sense. The result is a mounting feeling of what the American Conservative’s Rod Dreher calls white “dispossession” — a feeling that what you were supposed to have has been denied to you. (The Donald Trump phenomenon, Dreher notes, feeds off precisely this anxiety.)

If this has policy implications, it suggests that liberals are right to emphasize the economic component to the crisis. But it cautions against the idea that transfer payments can substitute for the sense of meaning and purpose that blue-collar white Americans derived from the nexus of work, faith and family until very recently.

Maybe a welfare state that’s friendlier to work and family can help revive that nexus. Or maybe working-class white America needs to learn from the resilience of communities used to struggling in the shadow of elite neglect. Or maybe it will take a little bit of both, more money and new paths to resilience alike, to make some of the unhappiest white lives feel like they matter once again.