Deaths of Despair
This week: a conversation with economist Anne Case and Nobel-winner Angus Deaton about declining life expectancy. Hear it today at 2 pm, or anytime at our website.
Life expectancy declined in the US in the 2010s, especially for certain demographics and regions. From Reuters last fall: “The largest relative increases in midlife mortality rates occurred in New Hampshire, 23.3%, West Virginia, 23.0%, Ohio, 21.6%, Maine, 20.7%, Vermont, 19.9%, Indiana, 14.8% and Kentucky, 14.7%.” The increase has been mostly due to drug overdoses, suicide, and alcoholism, according to JAMA. These are called “deaths of despair,” which is also part of the title of a new book by Princeton economists Anne Case and Angus Deaton, who consider the causes and contexts for this bleak turn in American history.
Americans especially susceptible to deaths of despair, Case and Deaton have found, are those without four-year college degrees, for whom opportunities are becoming increasingly scarce. We have a rigid class system founded upon the supposed class-mobility and meritocracy of college education, but access to and success through college education depends on more than merit (there’s the cost, and there’s the fact that getting in so often depends on a focused, privileged educational track well in advance of applying to college). The ideal of “meritocracy” has misled us, then. It’s entrenched inequality, establishing an elite class of those with college degrees, which is only about one-third of Americans. Angus Deaton tells us,
We built this sort of plutocratic meritocracy based around having a four year college degree. And, you know, no one wants to go back to the days when the Duke of X or Y had inherited the title and with it all this privilege. But at least they had the feeling that the people who were not privileged could not blame themselves, nor did the people who were privileged. . .
Now you have these people with BAs who are these educated elite, who are doing great . . . They think they deserve it, and they think people who don’t have it, don’t deserve it. Of course, people who didn’t make it, half of them think the world is rigged against them, which is true. But others think, “Well, you know, maybe I am at fault to some extent.” And I think it’s very hard for them. So we’ve got this very sharp division that really didn’t used to be there.
The misery resulting from this inequality has been deepened by a cracked healthcare system, by, for example, the exacerbation of the opioid crisis by Purdue Pharma’s marketing of OxyContin. But as Case and Deaton tell us, this isn’t a crisis that can be attributed so clearly or strictly to any one factor or bad guy. Case says on this week’s show, “There are real villains out there, like Purdue Pharmaceuticals, sending 800 marketers around the country, targeting areas where they thought the pain levels of working class people would be higher . . . there are villains in this story, but there’s also something else that happened.”
That something else is the flourishing of a system that directs wealth toward the wealthy, based on the false premise of their merit. This logic has even altered how we can deal with the suffering it causes. Healthcare is outrageously expensive in the U.S., enriching further a select and highly educated few, and yet, Anne Case tells us, “our life expectancy is the lowest among any of the rich countries. . . Our health is worse than in most other rich countries. So it’s not that kind of a tradeoff that we should be willing to pay for, to make some very wealthy people much richer.”
Read: Durkheim on Suicide
On this week’s show, Case and Deaton cite the work of Émile Durkheim, pivotal figure in the history of sociology, who studied how suicide exists in a social context. He wrote, for instance, of how suicide was more likely in urban than rural contexts, and he concluded that suicide could result often from insufficient “social integration,” or connection to a coherent social or cultural system. This isolation (worsened by modern conditions like urban and industrial alienation, the state of being alone in the modern city) could be fatal when it led to anomy, listlessness, a sense of being unmoored. Writes Durkheim:
Anomy, in fact, begets a state of exasperation and irritated weariness which may turn against the person himself or another according to circumstances; in the first case, we have suicide, in the second, homicide.
Listen: Yuja Wang and John Adams
John Adams’s Must the Devil Have All the Good Tunes?, performed on piano by Yuja Wang and conducted by Gustavo Dudamel, takes Henry Mancini’s “Peter Gunn” and somehow makes something just as cool. Definitely listen to this.
Steve Smith writes that after “the burly, funky opening” there’s “a limpid central reverie” that “prefaces a finale whose rhythms possess a demoniac swagger. In this recording, Yuja Wang, the soloist, performs with athleticism and grace; the orchestra, conducted by Gustavo Dudamel, matches her with power and atmosphere aplenty.”
Support Us on Patreon and Hear from Gilbert Hernandez
Over at Patreon, where you can show Open Source your support, you can hear Adam Colman’s conversation with an author of what Neil Gaiman has called “one of the finest pieces of fiction of the last 35 years.” This is Gilbert Hernandez, of the Hernandez brothers, creators of the pioneering alternative comic series Love & Rockets. Listen to the conversation about creativity that draws from lurid thrill, fun, and self-indulgence. It’s a consideration of the irresponsibility that makes fictions as vast and surprising as Hernandez’s L&R stories set in the fictional Latin American town of Palomar.
This Week’s Ephemeral Library
Jelani Cobb on Juneteenth and the meaning of freedom. Why doesn’t America do anything about disasters? A fight for workplace safety at Amazon. Jeff Sharlet: Inside the Cult of Trump. A new phase of the QAnon conspiracy theories. Jon Stewart weighs in.
That’s it for this week folks. Don’t despair, we’ll back next Sunday.