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United States of Despair by Anne Case & Angus Deaton [1]

['Anne Case', 'Angus Deaton', 'Torbjörn Becker', 'Yuriy Gorodnichenko', 'Kenneth Rogoff', 'Mariana Mazzucato', 'Pinelopi Koujianou Goldberg', 'Barry Eichengreen', 'Ashoka Mody', 'Shashi Tharoor']

Date: 2020-06-15 09:51:00+00:00

Anne Case and Angus Deaton say the US is engulfed by two epidemics – the “deaths of despair” from suicide, drug overdoses and alcoholic liver disease, and the Covid-19 related deaths. The two epidemics expose “deep inequalities across races and levels of educational attainment.” Before Covid-19 struck, the other epidemic has been running rampant since the mid-1990s, killing working-age white men and women at unprecedented rates. The current pandemic is seeing higher Covid-19 deaths among African-Americans. Nevertheless, both cases show “the stunning secular decline in US life expectancy.”

The authors – a team of spouses with Case being a top expert on the links between economic and health status, and Deaton a Nobel laureate known for his work on household poverty and welfare – give a disturbing account of life expectancy in the world’s wealthiest nation in their new book, Deaths of Despair and the Future of Capitalism. In 2015, life expectancy fell for the first time in decades. Then it fell again in 2016 – and for a third time in a row in 2017. Outside of wars or pandemics, life expectancy has been consistently rising across the world.

Although the “deaths of despair” in the US that predated Covid-19 have exposed the “pre-existing inequalities,” no vaccine would be able to inject optimism, help reduce anxiety, ease fears and pains. Deaths of despair, while less visible and less broadly disruptive than Covid-19, is equally devastating as the coronavirus, preying disproportionately on low-income and less-educated white working-class Americans. In 2017 alone, there were 158,000 deaths of despair. Their loss of life was preceded by a loss of jobs, community and dignity, and whose deaths are inextricably linked to the policies and politics that had transformed the US economy and increased inequalities.

The authors focus on the white working class because it is undergoing a particularly harrowing shift. However they do not believe that this demographic matters more than others, nor it is worse off in absolute terms than others. Death rates among African Americans remain persistently higher than those of their white counterparts, even considering the increased deaths of despair among white Americans. But black death rates are falling faster than white rates, which involve mainly deaths of despair among white citizens.

The main reason why death rates of blacks fell more rapidly than death rates of whites at the beginning of the twenty-first century is that blacks were not suffering the epidemic of overdoses, suicide, and alcoholism, according to the authors. They “do not believe that the post-Covid-19 economy will provoke a spike in deaths of despair. The fundamental cause of that epidemic, our analysis suggests, was not economic fluctuations, but rather the long-term loss of a way of life among white working-class Americans.”

The grim irony of this discrepancy is that the appearance of African American progress itself may be a contributing factor in the rising deaths of despair among white Americans. Case and Deaton mention a survey published in 2017 finding that more than half of white working-class Americans believe that discrimination against whites is as big a problem as discrimination against minority groups. Yet more than two-thirds of college-educated white Americans disagree. However Trump has hijacked the grievances of the whites to garner their support, vowing to fight the opiod crisis.

The authors conclude that the simultaneous erosion of work and community life, together with “at least the perception of a loss of racial privilege,” forms a potent combination, more powerful than simply income losses. They believe “the most likely post-Covid America will be the same as pre-Covid America, only with even more inequality and dysfunction. True, public anger over police violence or outrageously expensive health care could create a structural break.” Even so, real changes take time.

Popular grievances among white working class Americans fuel the rise of populism and might help Trump win again this year. But another four years of Trump will not improve their fortunes, because Republicans have no appetite to provide for the current and future generations, citing they can not afford a budget overreach. Many millennials fear being worse off than their parents, given the grim economic prospects. This despair has driven their elderly counterparts to suicide, drug and alcohol abuses. It is imperative that they do not follow in their footsteps. To start with they need to vote in November.

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[1] Url: https://www.project-syndicate.org/commentary/deaths-of-despair-covid19-american-inequality-by-anne-case-and-angus-deaton-2020-06

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