A couple of weeks ago President Obama mocked Republicans who are «down on America,» and reinforced his message by doing a pretty good Grumpy Cat impression. He had a point: With job growth at rates not seen since the 1990s, with the percentage ofAmericans covered by health insurance hitting record highs, the doom-and-gloom predictions of his political enemies look ever more at odds with reality.
Yet there is a darkness spreading over part of our society. And we don’t really understand why.
There has been a lot of comment, and rightly so, over a new paper by the economists Angus Deaton (who just won a Nobel) and Anne Case, showing that mortality among middle-aged white Americans has been rising since 1999. This deterioration took place while death rates were falling steadily both in other countries and among other groups in our own nation.
Even more striking are the proximate causes of rising mortality. Basically, white Americans are, in increasing numbers, killing themselves, directly or indirectly. Suicide is way up, and so are deaths from drug poisoning and the chronic liver disease that excessive drinking can cause. We’ve seen this kind of thing in other times and places – for example, in the plunging life expectancy that afflicted Russia after the fall of Communism. But it’s a shock to see it, even in an attenuated form, in America.
Yet the Deaton-Case findings fit into a well-established pattern. There have been a number of studies showing that life expectancy for less-educated whites is falling across much of the nation. Rising suicides and overuse of opioids are known problems. And while popular culture may focus more on meth than on prescription painkillers or good old alcohol, it’s not really news that there’s a drug problem in the heartland.
But what’s causing this epidemic of self-destructive behavior?
If you believe the usual suspects on the right, it’s all the fault of liberals. Generous social programs, they insist, have created a culture of dependency and despair, while secular humanists have undermined traditional values. But (surprise!) this view is very much at odds with the evidence.
For one thing, rising mortality is a uniquely American phenomenon – yet America has both a much weaker welfare state and a much stronger role for traditional religion and values than any other advanced country. Sweden gives its poor far more aid than we do, and a majority of Swedish children are now born out of wedlock, yet Sweden’s middle-aged mortality rate is only half of white America’s.
You see a somewhat similar pattern across regions within the United States. Life expectancy is high and rising in the Northeast and California, where social benefits are highest and traditional values weakest. Meanwhile, low and stagnant or declining life expectancy is concentrated in the Bible Belt.
What about a materialist explanation? Is rising mortality a consequence of rising inequality and the hollowing out of the middle class?
Well, it’s not that simple. We are, after all, talking about the consequences of behavior, and culture clearly matters a great deal. Most notably, Hispanic Americans are considerably poorer than whites, but have much lower mortality. It’s probably worth noting, in this context, that international comparisons consistently find that Latin Americans have higher subjective well-being than you would expect, given their incomes.
So what is going on? In a recent interview Mr. Deaton suggested that middle-aged whites have «lost the narrative of their lives.» That is, their economic setbacks have hit hard because they expected better. Or to put it a bit differently, we’re looking at people who were raised to believe in the American Dream, and are coping badly with its failure to come true.
That sounds like a plausible hypothesis to me, but the truth is that we don’t really know why despair appears to be spreading across Middle America. But it clearly is, with troubling consequences for our society as a whole.
In particular, I know I’m not the only observer who sees a link between the despair reflected in those mortality numbers and the volatility of right-wing politics. Some people who feel left behind by the American story turn self-destructive; others turn on the elites they feel have betrayed them. No, deporting immigrants and wearing baseball caps bearing slogans won’t solve their problems, but neither will cutting taxes on capital gains. So you can understand why some voters have rallied around politicians who at least seem to feel their pain.
At this point you probably expect me to offer a solution. But while universal health care, higher minimum wages, aid to education, and so on would do a lot to help Americans in trouble, I’m not sure whether they’re enough to cure existential despair.
PAUL KRUGMAN
The New York Times November 9, 2015
