Death by despair, and politicians who exploit it
There may be no topic in public health today more overlooked, and so full of political implications, than recent findings that in the last 18 years, almost half a million poorly educated, middle-aged white Americans have killed themselves.
They’ve done so deliberately by outright suicide, or in slow motion through not-necessarily intentional opioid addiction, alcohol poisoning or chronic liver disease. They’ve been dying at a rate never before seen in an industrialized society. The affected group is whites age 45 to 54, with a high school education or less.
Every other demographic group has seen a longer life span and steady decrease in disease rates. But since the late 1990s, poorly educated whites ages 45 to 54 have defied the trend.
Before 1998, mortality rates among this group had been falling steadily. Princeton University’s Anne Case and Angus Deaton, in a study published last fall in the Proceedings of the National Academy of Sciences, reported that if the pre-1998 trend had continued through 2013, 488,050 fewer deaths might have occurred. In recent U.S. history, only the AIDS epidemic took more lives.
The Case-Deaton study speaks to numbers, not the reasons behind them. But we suspect one culprit is a radically changed economy whose benefits flow chiefly to the wealthiest Americans. Another is America’s shrinking demand for skilled blue-collar labor.
Those without at least some college have been left with fewer opportunities. Blacks and Hispanics appear to be adapting to the changing labor marketplace, but the dislocation has proven more wrenching for whites.
Democrats, at least, are on to this. The Case-Deaton study came up at a debate in Milwaukee this month between presidential candidates Hillary Clinton and Bernie Sanders.
“People with a high school education or less are not even living as long as their parents lived,” Clinton said. “This is a remarkable and horrifying fact.”
Sanders said that regardless of their race, people no longer can rely on factory jobs for a living: “What have you got now? You are working at McDonald’s? That is why there is massive despair all over this country.”
Among Republicans, Donald Trump appears to be benefiting from the anger of white voters who don’t have college diplomas. “Donald Trump’s strong showings are entirely attributable to huge leads among voters without a college degree, while voters with a degree are split among several candidates,” say the polling analysts at FiveThirtyEight.
Political numbers are easier than political fixes.
Federal and state lawmakers should be focusing on increasing college and technical school access for students regardless of race. That means investing in education at all levels. It means creating opportunity and reforming the tax system so that America’s bounty is more broadly shared. Despair can’t be the default option.
Reprinted from the St. Louis Post-Dispatch
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