The plight of the vulnerable in American life is of abiding concern to us here at Culture Briefing. As we wrote in Vol. 47, our conviction is that “One of the basic ways to evaluate the health of a given society is to assess the safety and wellbeing of its weakest members.” We continued: “In healthy social orders the vulnerable are defined not by their vulnerabilities, but by their membership in a wider community of care and responsibility.”

This came to mind this week when I read the following recap of a paper by two Princeton economists:

The authors find that the rate of “deaths of despair” (deaths by drugs, alcohol, and suicide) in midlife for white non-Hispanics rose in nearly every part of the country and at every level of urbanization—from deep rural areas to large central cities—hitting men and women similarly.

In an extended demographic study with over twenty pages of graphs and tables, Princeton economists Anne Case and Angus Deaton bring two disturbing trends to light. The first is that the uptick in these “deaths of despair” has deepened and spread within America’s white working class. The second is that America’s working class is faring far worse than their counterparts in other rich countries. As Jeff Guo put it in in the Washington Post:

The alarming fact isn't just that middle-aged whites are dying faster, but also that mortality rates have been dramatically declining in nearly every other rich country. The United States is getting left behind.

Case and Deaton conclude their report with a sobering assessment. “What our data show,” they say, “is that the patterns of mortality and morbidity for white non-Hispanics without a college degree move together over lifetimes and birth cohorts, and that they move in tandem with other social dysfunctions, including the decline of marriage, social isolation, and detachment from the labor force...Ultimately,” they continue, “we see our story as about the collapse of the white, high school educated, working class after its heyday in the early 1970s, and the pathologies that accompany that decline.”

While many of the specifics of Case and Deaton’s paper were reported throughout the mainstream press, two particular pieces of commentary on the study are worth highlighting.

First, UVA sociologist Allison Pugh’s short response in the Harvard Business Review connects the rise in deaths of despair to the instability of America’s labor market (see Vol. 85, 86, and 87). Pugh argues that the “unrequited contract” between American workers and employers (what we’ve called the “old bargain of sweat for security”) has fundamentally altered workers’ expectations about the possibility of sustained economic stability. Increasingly, workers find it necessary to “moderate the kinds of feelings they allow themselves to have in the event of a layoff.” According to Pugh, “when people have no way of addressing failed commitments at work, they double down on the importance of commitment in other parts of their lives. And when those commitments don’t meet their expectations”—as in the case of divorce or other family strife—“despair can grow.”

Second, Germain Lopez takes to Vox to address the opioid crisis—only one cause of deaths of despair, but one that’s currently generating a good bit of attention and legislative activity. While Lopez is in no way against legislation to assist opioid addicts, his analysis raises a basic question. Given that legislators tend to base legislation, in part at least, upon personal stories; and moreover, that the majority of legislators are white:

Is it any wonder, then, that the crack epidemic led to a “tough on crime” crackdown focused on harsher prison sentences and police tactics, while the current opioid crisis has led more to calls for legislation, including a measure Congress passed last year, that boosted spending on drug treatment to get people with substance use disorders help?

If it is sensible to talk about a “solution” to the substantial challenges facing America’s working class, Lopez thinks it will begin with a frank recognition of the failures of empathy that marked previous attempts to address drug addiction in America.  

It is good that people are taking a more compassionate view toward the opioid crisis. But if we want to avoid the crueler policies from popping up again during future crises, the research suggests that tearing down racial boundaries will need to be a part of the solution. Otherwise, history may just repeat itself when a problem inevitably hits a neighborhood that we consider different from our own.

The trends Case and Deaton describe are undeniably depressing. However, Lopez’s analysis points to a trend that could be both the source of our empathy gap and its solution. As we wrote in Vol. 71, American society is more fractured along lines of education, income, and race than in previous generations. Highly educated Americans living in “super-zips” (the nation’s wealthiest ZIP codes) have fewer and fewer points of contact with those Americans experiencing what Case and Deaton call a series of “cumulative disadvantages.” For this reason, the first step to addressing the challenges facing American society as a whole must be to insist upon decency between neighbors, particularly in areas of the country where the possibility of community across difference yet exists.