American whites, like American blacks, are dying young


     As Michael Pollan suggests, middle-aged white Americans often eat food-like substances rather than food.  We are contracting new diseases (early onset diabetes; teenage obesity) and dying.  We are exposed to a thousand kinds of mistreatment through corporate abuse. Consider, for example, the Times story on the replacement of the rule of law at all – available of course mainly to those who have the money to hire able lawyers –  and the new system of arbitration by corporate flunkeys here.  

        Despite Obamacare, health costs, if one becomes ill, are still exorbitant.  And in the recent depression, ours was a heavy loss of jobs and decline of incomes.  Is it  surprising then, as the economists Angus Deaton and Ann Case report, that  death-rates are suddenly rising between ages 39-54 among middle class Americans?

    “Suddenly” – the normal expectation among academics is that life expectancy, across the board except in the case of those discriminated against or in poor countries, are improving as “development” goes on.  But as Thomas Piketty says in Capital in the 21st Century, what is happening now bears close relationship to the Gilded Age (the 1920s) or in some way, even to the early 19th century of Charles Dickens than to the optimistic but false thesis of Simon Kuznets in the 1960s.  Wages rose, with union organization and during World War for a period.  But since the 1980s, income inequality has grown rapidly.
     The researchers and statisticians cited in the article make it clear how much this conclusion – that ordinary whites are dying at an earlier age (and that many more are threatened by the conditions which produce despair and early death) – startles and saddens them.
      Alcohol and drugs are also a cause.  But why despair so much about one’s life?  Possibly because alternatives are closing because ordinary white people are being rampantly taken advantage of by the powerful. Blacks, as the article notes are even more taken advantage of, have by and large poorer health and higher death rates.  But in an economy where the .0001% flourish, most whites as well as most blacks more seriously, are suffering.

      The connection of the fate of whites to blacks and to immigrants (the even more irrational party of cutting taxes for the .0001% is crazed against immigrants for this reason) is ordinarily a secret in the corporate press and mainstream academia. But Michael Reich’s Racial Inequality: a Political-Economic Analysis (Princeton, 1984) shows strikingly that wherever racial inequality is at its most intense, wages and social services for whites are at their lowest, and the income differential between the top 1% of the population and everyone else is at its greatest.  
    Ironically, even Paul Krugman who has studied inequality for years, is an outstanding opponent of austerity, sees that a Marxian explanation a la Michal Kalecki, is right about the failure of Keynsian policies here and in Europe. Spending money on public works or tax cuts for the poor who spend locally gets an economy going again – has a “multiplier effect,”  That is why, through Obama’s stimulus program, the American economy got going again at all (Europe is still in a depression).    But the rich will not allow this known Keynsian solution to depression because it will cause rising wages or incomes for ordinary people.  That is, in today’s capitalism, class struggle from above blocks the application of economic insight in public policy and tends to make permanent stagnation/underproduction/unemployment and ruining of lives/depression.


     Hence, the rich (and the corporate press’s) hysteria against the stimulus.  Worse yet, as Krugman underlined yesterday (below), following a striking paper of Larry Summers and Antonio Fatas on the “Permanent Effects of Fiscal Consolidations” here, the destruction of economic output and lives resulting from depression – hysteresis – is worse than economists had previously thought; it results in long term unemployment, that is loss or erosion of job-relevant skills for many, and produces through lack of housing construction, persistently higher rents, for example.  And hysteresis ironically makes “austerity” measures counterproductive even from the standpoint of lessening budget deficits (the Simpson-Bowles report and other exercises of “Very Serious People” here and in Europe – Paul Ryan’s for instance – are really really stupid)…Seehere.   Yet even Krugman does not yet quite articulate this central point about racism as a driving force.

      Krugman, Deaton and Case are all at Princeton and Krugman admires Deaton’s work – see here – on the dominance of government by the .0001% (blog, October 12, 2015).  Deaton does see the implication that everyone else may be hurt:
     “[T]here is a danger that the rapid growth of top incomes can become self-reinforcing through the political access that money can bring. Rules are set not in the public interest but in the interest of the rich, who use those rules to become yet richer and more influential…
   To worry about these consequences of extreme inequality has nothing to do with being envious of the rich and everything to do with the fear that rapidly growing top incomes are a threat to the wellbeing of everyone else.”  
    But this point, coupled with the articles below, suggests that great harms to blacks also result in considerable harms to whites as well.  Racism is a great danger to all; it also benefits the ultra-rich as a form of divide and rule (why it is also not a psychologically healthy thing to be rich, why being a sociopath is often a condition of being hired for CEOs is perhaps revealed by this finding).  Krugman emphasizes inequality (see his article on race and class below); he simply doesn’t see pushing racism by the elite, for instance in the form of racist ideas (for instance, eugenics, i.e. Herrnstein and Murray, The Bell Curve as a creepy underpinning for the bad advice of “Very Serious People”)/divide and rule as the key.  But perhaps this understanding will find its way into Krugman’s columns soon.
      Reading this front page Times article, one has but to ask the question: how does the death rate fit with inequality and the answer will leap out at one.  This article with is a profound and sorry comment on modern America, “the most powerful nation in the world,” and with Barack Obama, admirably, as President.  What it reveals makes the researchers sad; it also underlines the need for a muliracial, anti-racist movement from below – a democratic movement – to fight back.
Death Rates Rising for Middle-Aged White Americans, Study Finds
[the photo did not reproduce]
Angus Deaton with his wife, Anne Case, right, last month after he won the 2015 Nobel Memorial Prize in Economic Science. Together, they wrote a study analyzing mortality rates.
Ben Solomon for The New York Times
Something startling is happening to middle-aged white Americans. Unlike every other age group, unlike every other racial and ethnic group, unlike their counterparts in other rich countries, death rates in this group have been rising, not falling.

That finding was reported Monday by two Princeton economists, Angus Deaton, who last month won the 2015 Nobel Memorial Prize in Economic Science, and Anne Case. Analyzing health and mortality data from the Centers for Disease Control and Prevention and from other sources, they concluded that rising annual death rates among this group are being driven not by the big killers like heart disease and diabetes but by an epidemic of suicides and afflictions stemming from substance abusealcoholic liver disease and overdoses of heroin and prescription opioids.
The analysis by Dr. Deaton and Dr. Case may offer the most rigorous evidence to date of both the causes and implications of a development that has been puzzling demographers in recent years: the declining health and fortunes of poorly educated American whites. In middle age, they are dying at such a high rate that they are increasing the death rate for the entire group of middle-aged white Americans, Dr. Deaton and Dr. Case found.

The mortality rate for whites 45 to 54 years old with no more than a high school education increased by 134 deaths per 100,000 people from 1999 to 2014.

“It is difficult to find modern settings with survival losses of this magnitude,” wrote two Dartmouth economists, Ellen Meara and Jonathan S. Skinner, in a commentary to the Deaton-Case analysis to be published in Proceedings of the National Academy of Sciences.

“Wow,” said Samuel Preston, a professor of sociology at the University of Pennsylvania and an expert on mortality trends and the health of populations, who was not involved in the research. “This is a vivid indication that something is awry in these American households.”

Dr. Deaton had but one parallel. “Only H.I.V./AIDS in contemporary times has done anything like this,” he said.

In contrast, the death rate for middle-aged blacks and Hispanics continued to decline during the same period, as did death rates for younger and older people of all races and ethnic groups.

Middle-aged blacks still have a higher mortality rate than whites — 581 per 100,000, compared with 415 for whites — but the gap is closing, and the rate for middle-aged Hispanics is far lower than for middle-aged whites at 262 per 100,000.
David M. Cutler, a Harvard health care economist, said that although it was known that people were dying from causes like opioid addiction, the thought was that those deaths were just blips in the health care statistics and that over all everyone’s health was improving. The new paper, he said, “shows those blips are more like incoming missiles.”

Dying in Middle Age 
Death rates are rising for middle-aged white Americans, while declining in other wealthy countries and among other races and ethnicities. The rise appears to be driven by suicide, drugs and alcohol abuse. 

per 100,000 people aged 45–54

per 100,000 people aged 45–54

[this graph did not reproduce, but the categories here name the lines for groups other than White Americans]
Per 100,000 white Americans, 45–54
Chronic liver
diseases and
Alcohol and
drug poisoning
Sources: Anne Case and Angus Deaton; PNAS
Dr. Deaton and Dr. Case (who are husband and wife) say they stumbled on their finding by accident, looking at a variety of national data sets on mortality rates and federal surveys that asked people about their levels of pain, disability and general ill health.

Dr. Deaton was looking at statistics on suicide and happiness, skeptical about whether states with a high happiness level have a low suicide rate. (They do not, he discovered; in fact, the opposite is true.) Dr. Case was interested in poor health, including chronic pain because she has suffered for 12 years from disabling and untreatable lower back pain.

Dr. Deaton noticed in national data sets that middle-aged whites were committing suicide at an unprecedented rate and that the all-cause mortality in this group was rising. But suicides alone, he and Dr. Case realized, were not enough to push up overall death rates, so they began looking at other causes of death. That led them to the discovery that deaths from drug and alcohol poisoning also increased in this group.
They concluded that taken together, suicides, drugs and alcohol explained the overall increase in deaths. The effect was largely confined to people with a high school education or less. In that group, death rates rose by 22 percent while they actually fell for those with a college education.

It is not clear why only middle-aged whites had such a rise in their mortality rates. Dr. Meara and Dr. Skinner, in their commentary, considered a variety of explanations — including a pronounced racial difference in the prescription of opioid drugs and their misuse, and a more pessimistic outlook among whites about their financial futures — but say they cannot fully account for the effect.
Dr. Case, investigating indicators of poor health, discovered that middle-aged people, unlike the young and unlike the elderly, were reporting more pain in recent years than in the past. A third in this group reported they had chronic joint pain over the years 2011 to 2013, and one in seven said they had sciatica. Those with the least education reported the most pain and the worst general health.
The least educated also had the most financial distress, Dr. Meara and Dr. Skinner noted in their commentary. In the period examined by Dr. Deaton and Dr. Case, the inflation-adjusted income for households headed by a high school graduate fell by 19 percent.
Dr. Case found that the number of whites with mental illnesses and the number reporting they had difficulty socializing increased in tandem. Along with that, increasing numbers of middle-aged whites said they were unable to work. She also saw matching increases in the numbers reporting pain and the numbers reporting difficulty socializing, difficulty shopping, difficulty walking for two blocks.
With the pain and mental distress data, Dr. Deaton said, “we had the two halves of the story.” Increases in mortality rates in middle-aged whites rose in parallel with their increasing reports of pain, poor health and distress, he explained. They provided a rationale for the increase in deaths from substance abuse and suicides.
Dr. Preston of the University of Pennsylvania noted that the National Academy of Sciences had published two monographs reporting that the United States had fallen behind other rich countries in improvements in life expectancy. One was on mortality below age 50 and the other on mortality above age 50. He coedited one of those reports. But, he said, because of the age divisions, the researchers analyzing the data missed what Dr. Deaton and Dr. Case found hiding in plain sight.

“We didn’t pick it up,” Dr. Preston said, referring to the increasing mortality rates among middle-aged whites.

Ronald D. Lee, professor of economics, professor of demography and director of the Center on Economics and Demography of Aging at the University of California, Berkeley, was among those taken aback by what Dr. Deaton and Dr. Case discovered.

“Seldom have I felt as affected by a paper,” he said. “It seems so sad.”


Race, Class and Neglect
MAY 4, 2015
Paul Krugman
Every time you’re tempted to say that America is moving forward on race — that prejudice is no longer as important as it used to be — along comes an atrocity to puncture your complacency. Almost everyone realizes, I hope, that the Freddie Gray affair wasn’t an isolated incident, that it’s unique only to the extent that for once there seems to be a real possibility that justice may be done.
And the riots in Baltimore, destructive as they are, have served at least one useful purpose: drawing attention to the grotesque inequalities that poison the lives of too many Americans.
Yet I do worry that the centrality of race and racism to this particular story may convey the false impression that debilitating poverty and alienation from society are uniquely black experiences. In fact, much though by no means all of the horror one sees in Baltimore and many other places is really about class, about the devastating effects of extreme and rising inequality.
Take, for example, issues of health and mortality. Many people have pointed out that there are a number of black neighborhoods in Baltimore where life expectancy compares unfavorably with impoverished Third World nations. But what’s really striking on a national basis is the way class disparities in death rates have been soaring even among whites.
Most notably, mortality among white women has increased sharply since the 1990s, with the rise surely concentrated among the poor and poorly educated; life expectancy among less educated whites has been falling at rates reminiscent of the collapse of life expectancy in post-Communist Russia.

And yes, these excess deaths are the result of inequality and lack of opportunity, even in those cases where their direct cause lies in self-destructive behavior. Overuse of prescription drugs, smoking, and obesity account for a lot of early deaths, but there’s a reason such behaviors are so widespread, and that reason has to do with an economy that leaves tens of millions behind.
It has been disheartening to see some commentators still writing as if poverty were simply a matter of values, as if the poor just mysteriously make bad choices and all would be well if they adopted middle-class values. Maybe, just maybe, that was a sustainable argument four decades ago, but at this point it should be obvious that middle-class values only flourish in an economy that offers middle-class jobs.
The great sociologist William Julius Wilson argued long ago that widely-decried social changes among blacks, like the decline of traditional families, were actually caused by the disappearance of well-paying jobs in inner cities. His argument contained an implicit prediction: if other racial groups were to face a similar loss of job opportunity, their behavior would change in similar ways.
And so it has proved. Lagging wages — actually declining in real terms for half of working men — and work instability have been followed by sharp declines in marriage, rising births out of wedlock, and more.
As Isabel Sawhill of the Brookings Institution writes: “Blacks have faced, and will continue to face, unique challenges. But when we look for the reasons why less skilled blacks are failing to marry and join the middle class, it is largely for the same reasons that marriage and a middle-class lifestyle is eluding a growing number of whites as well.”
So it is, as I said, disheartening still to see commentators suggesting that the poor are causing their own poverty, and could easily escape if only they acted like members of the upper middle class.
And it’s also disheartening to see commentators still purveying another debunked myth, that we’ve spent vast sums fighting poverty to no avail (because of values, you see.)
In reality, federal spending on means-tested programs other than Medicaid has fluctuated between 1 and 2 percent of G.D.P. for decades, going up in recessions and down in recoveries. That’s not a lot of money — it’s far less than other advanced countries spend — and not all of it goes to families below the poverty line.
Despite this, measures that correct well-known flaws in the statistics show that we have made some real progress against poverty. And we would make a lot more progress if we were even a fraction as generous toward the needy as we imagine ourselves to be.

The point is that there is no excuse for fatalism as we contemplate the evils of poverty in America. Shrugging your shoulders as you attribute it all to values is an act of malign neglect. The poor don’t need lectures on morality, they need more resources — which we can afford to provide — and better economic opportunities, which we can also afford to provide through everything from training and subsidies to higher minimum wages. Baltimore, and America, don’t have to be as unjust as they are.

Austerity’s Grim Legacy
NOV. 6, 2015
Paul Krugman
When economic crisis struck in 2008, policy makers by and large did the right thing. The Federal Reserve and other central banks realized that supporting the financial system took priority over conventional notions of monetary prudence. The Obama administration and its counterparts realized that in a slumping economy budget deficits were helpful, not harmful. And the money-printing and borrowing worked: A repeat of the Great Depression, which seemed all too possible at the time, was avoided.

Then it all went wrong. And the consequences of the wrong turn we took look worse now than the harshest critics of conventional wisdom ever imagined.
For those who don’t remember (it’s hard to believe how long this has gone on): In 2010, more or less suddenly, the policy elite on both sides of the Atlantic decided to stop worrying about unemployment and start worrying about budget deficits instead.
This shift wasn’t driven by evidence or careful analysis. In fact, it was very much at odds with basic economics. Yet ominous talk about the dangers of deficits became something everyone said because everyone else was saying it, and dissenters were no longer considered respectable — which is why I began describing those parroting the orthodoxy of the moment as Very Serious People.
Some of us tried in vain to point out that deficit fetishism was both wrongheaded and destructive, that there was no good evidence that government debt was a problem for major economies, while there was plenty of evidence that cutting spending in a depressed economy would deepen the depression.
And we were vindicated by events. More than four and a half years have passed since Alan Simpson and Erskine Bowles warned of a fiscal crisis within two years; U.S. borrowing costs remain at historic lows. Meanwhile, the austerity policies that were put into place in 2010 and after had exactly the depressing effects textbook economics predicted; the confidence fairy never did put in an appearance.
Yet there’s growing evidence that we critics actually underestimated just how destructive the turn to austerity would be. Specifically, it now looks as if austerity policies didn’t just impose short-term losses of jobs and output, but they also crippled long-run growth.
The idea that policies that depress the economy in the short run also inflict lasting damage is generally referred to as “hysteresis.” It’s an idea with an impressive pedigree: The case for hysteresis was made in a well-known 1986 paper by Olivier Blanchard, who later became the chief economist at the International Monetary Fund, and Lawrence Summers, who served as a top official in both the Clinton and the Obama administrations. But I think everyone was hesitant to apply the idea to the Great Recession, for fear of seeming excessively alarmist.
At this point, however, the evidence practically screams hysteresis. Even countries that seem to have largely recovered from the crisis, like the United States, are far poorer than precrisis projections suggested they would be at this point. And a new paper by Mr. Summers and Antonio Fatás, in addition to supporting other economists’ conclusionthat the crisis seems to have done enormous long-run damage, shows that the downgrading of nations’ long-run prospects is strongly correlated with the amount of austerity they imposed. [this paper is very important and worth studying…].
What this suggests is that the turn to austerity had truly catastrophic effects, going far beyond the jobs and income lost in the first few years. In fact, the long-run damage suggested by the Fatás-Summers estimates is easily big enough to make austerity a self-defeating policy even in purely fiscal terms: Governments that slashed spending in the face of depression hurt their economies, and hence their future tax receipts, so much that even their debt will end up higher than it would have been without the cuts.
And the bitter irony of the story is that this catastrophic policy was undertaken in the name of long-run responsibility, that those who protested against the wrong turn were dismissed as feckless.
There are a few obvious lessons from this debacle. “All the important people say so” is not, it turns out, a good way to decide on policy; groupthink is no substitute for clear analysis. Also, calling for sacrifice (by other people, of course) doesn’t mean you’re tough-minded.
But will these lessons sink in? Past economic troubles, like the stagflation of the 1970s, led to widespread reconsideration of economic orthodoxy. But one striking aspect of the past few years has been how few people are willing to admit having been wrong about anything. It seems all too possible that the Very Serious People who cheered on disastrous policies will learn nothing from the experience. 
And that is, in its own way, as scary as the economic outlook.