Have you heard what’s been happening to the death rate among middle-aged, white Americans? According to a study by economists Anne Case and Angus Deaton, it’s been rising. You might have missed the story, but earlier this month, the results of that study were all over the news. Why the interest? Well, for one thing, one of the authors of the study, Angus Deaton, received the Nobel Prize in economics in mid-October, so his work has been attracting more media attention than usual. But even if the author had been Joe Schmoe, the study would have received a lot of attention because it’s just plain newsworthy. Death rates have been on the decline for decades, so we’ve come to expect them to fall. But a rising death rate? That’s a “Man Bites Dog” story.
One striking finding of the Case-Deaton study is that while the death rate for middle-aged whites rose, death rates fell among members of every other ethnic, racial, and age group in America, as well as every demographic group—including middle-aged whites—in every other wealthy nation. Even more noteworthy, the death rate in the U.S. didn’t rise for all middle-aged whites. A certain subset was primarily responsible for the climbing death rate. Which subset? The one comprised of middle-aged whites with no more than a high school education. Within that subset, the death rate rose about 22 percent between 1999 and 2013, and the increase, according to Case and Deaton, “was largely accounted for by increasing death rates from drug and alcohol poisonings, suicide, and chronic liver diseases and cirrhosis.”
Given the demography of the subgroup and the causes of death, the report’s results have become, as Ross Douthat put it in The New York Times, “the latest ideological Rorschach test in the debate over how to save the American working class.” From the left have come proposals for raising middle- and working-class wages in the private sector; providing jobs in the public sector; raising taxes on the wealthy to provide the funds for those government jobs; and creating a stronger safety net. From the right the calls have primarily been for a return to traditional family values, lowering tax rates, reducing regulations, and ending welfare-state paternalism. Both left and right leave questions unanswered, however. The left-wing fails to explain why death rates are falling among middle-aged blacks and Hispanics while rising among whites; the right-wing fails to explain why Europe’s middle-aged whites are immune to the supposed ill effects of welfare-state paternalism. So although both sides offer plausible explanations, their answers are incomplete. What’s missing is a bridge that links the two sides and provides a complete, coherent answer.
What could that bridge be?
Humbly, I offer the following candidate: Lost identities.
I hope you’ll bear with me. This will take some explaining.
Let’s start by noting that the United States is largely a nation of immigrants. When the ancestors of today’s middle-aged whites left their native lands and came to the U.S., they severed many of the connections that had defined their identities. To feel more at home, the first generation of immigrants tended to settle in ethnic enclaves. There they were able to connect with others who shared their culture, religion, traditions, memories of their former homelands, and so on.
With each successive generation, the descendants of European immigrants assimilated more and more into American society. Many moved out of ethnic enclaves, out to the suburbs, even out of state. Some turned their backs on traditions and customs. They quit going to church, married outside their religion, and celebrated secularized versions of Christmas and Easter. In pursuit of the American Dream, they worked hard and spent what they earned. But because they were generally too busy for much of anything other than working and spending, the web of connections that had given earlier generations multidimensional identities frayed. Few cared or even noticed. Proud members of the consumer-class, they didn’t look back. They just kept working and spending, comfortable with their narrow identities as consumers and confident in the expectation that their incomes would grow until they were ready to retire.
But toward the end of the 20th century, a funny thing started happening to the descendants of European immigrants, at least to many in the subset that lacked a college education: They lost their jobs to robots at home and low-wage workers overseas. Because few found new jobs with pay and status comparable to their old jobs, the identities they had forged as workers and consumers fell apart.
Many in this group were proudly individualistic—Reagan Democrats. But, as Swarthmore Psychology Professor Barry Schwartz has explained: “[T]he modern emphasis on individual autonomy and control may be neutralizing a crucial vaccine against depression: deep commitment and belonging to social groups and institutions—families, civic associations, faith communities, and the like.”
To put it another way, when we have deep commitments and belong to a network of groups, multiple elements comprise our identities, so we can lose an element or two and still retain a strong sense of self. But when we streamline our lives for the sake of speeding our way to the American Dream, our self-images depend on our jobs and our consumption. If we become unemployed and lose our ability to show the world who we are through our jobs and possessions, we’re more likely to suffer from depression. And when we’re depressed, we’re more vulnerable to various forms of self-medication (alcohol and drugs) and suicide.
So conservatives seem to be correct in thinking that the diminution of familial, traditional, cultural, and religious commitments is a relevant factor in the rising death rate among less-educated, middle-aged whites. At the same time, the left is correct, no doubt, in arguing that the loss of the ability to maintain middle-class levels of consumption is a relevant factor as well.
The explanatory factor—the bridge connecting the left and the right—is, therefore, loss of identity.
lack of familial, traditional, cultural, and religious commitments, in the face of job loss >>> loss of identity
unemployment and the inability to maintain expected levels of consumption >>> loss of identity
loss of identity >>> depression >> alcoholism, drug abuse, and suicide >>> higher death rates
And it’s the loss of identity that leads to depression, which leads to alcoholism, drug abuse, and suicide, which lead, in turn, to higher death rates.
Conversely, the retention of identity might be a partial explanation for why death rates among middle-aged blacks and Hispanics have continued to fall. Decades after whites moved to the suburbs in droves, many blacks and Hispanics continue to live in ethnic or racial enclaves, and many maintain traditional, cultural, and religious commitments, and those commitments help to bolster their identities through rough times.
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Although conservatives and liberals offer different explanations for the rising death rate among less-educated middle-aged whites, both sides agree that unemployment and underemployment are contributing factors. In addition, both agree that increasing the rate of economic growth is the way to reduce unemployment. While they differ over how to go about increasing the growth rate, they’re united in their belief that growth is the answer. Growth has worked in the past, so they assume that it will work in the future. By now, there are some excellent reasons for thinking they’re wrong, however. The next blogpost will explore those reasons.
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P.S. It may take me a week or so to write the next blogpost because over the next week I’ll be busy with a book sale. (Please check it out at: http://www.amazon.com/ITS-Unconventional-Examination-Environmental-Predicament-ebook/dp/B0128CEBMA
In the meantime, here’s a two-word hint for you to contemplate concerning one of the main reasons why growth is not the answer: Environmental Overshoots.
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 Case, Anne, and Angus Deaton. “Rising Morbidity and Mortality in Midlife Among White Non-Hispanic Americans in the 21st Century.” PNAS Early Edition. November 2, 2015.
 Schwartz, Barry. 2004. The Paradox of Choice: Why More Is Less. New York: HarperCollins, p. 212.