Deaths by despair, opioids
This editorial first appeared in the St. Louis Post-Dispatch. T wo years ago, Princeton University economists Anne Case and Angus Deaton disclosed a shocking finding: Between 1999 and 2014, middle-aged (45-54) white Americans with a high school education or less died at a rate never before seen in a modern industrialized society.
Alone among every other demographic group, this group’s life expectancy was shrinking. The annual mortality rate jumped from 281 per 100,000 to 415 per 100,000 during the 15 years studied.
Big reasons: Striking increases in the number of suicides, drug overdoses and liver disease caused by alcohol poisoning. Case and Deaton called them “deaths by despair.”
In a new report from the Brookings Institution, the two scholars suggest that a lifetime of “cumulative disadvantage” catches up with this demographic.
They are the slice of the population who hit the job market as low-skill jobs were being mechanized, computerized and globalized. They grew up as cohesion-building social institutions like marriage, family and churches became weaker. Often they didn’t have spouses, pastors, work buddies or kids to back them up.
They did have opioid painkillers, which Case and Deaton say “added fuel to the flames, making the epidemic much worse than it otherwise would have been.” They cite a study from the Boston Federal Reserve that found that among men not in the labor force, nearly half are taking pain medication, most often by prescription.
They see ominous implications: “This account, which fits much of the data, has the profoundly negative implication that policies, even ones that successfully improve earnings and jobs, or redistribute income, will take many years to reverse the mortality and morbidity increase, and that those in midlife now are likely to do much worse in old age than those currently older than 65.”
Obviously the same forces also affect middle-aged blacks and Hispanics, but their mortality rates are decreasing, and they don’t suffer high rates of deaths by despair. The authors speculate that expectations may be higher among whites, leading to greater disappointments.
Many of these folks put their faith in Republican promises of help, and the GOP owes them something. Addressing opioid addiction is a place to start. So is keeping the social safety net intact. GOP politicians can boast about bringing back jobs and passing right-to-work laws, but voters must hold them accountable if they make things worse for the people the corporate economy has left behind.