New data on the epidemic of despair
The ugly truth of American exceptionalism in the 21st century
If you’re looking to convince a skeptical high school senior of the value of a college education, you could do worse than show him the chart above. It plots the combined death rate for suicide, drug overdose and alcoholism — the so-called “deaths of despair” — for American adults by their educational attainment.
Among adults with at least a four-year degree, these deaths are up a little bit since 1992 — to roughly 25 per 100,000, or an increase of about 25 percent. But among those without a 4-year college education the rate has skyrocketed, rising roughly 150 percent from fewer than 40 in 1992 to nearly 90 in 2019.
Despair, in other words, is rising six times as fast among the working class as it is in the white-collar world.
These figures come from Anne Case and Angus Deaton’s latest research. They’re the team that coined the term “deaths of despair” several years back. The idea behind it is intuitive: generally speaking, people don’t kill themselves, drink themselves to death or develop a lethal drug habit unless they are experiencing a huge amount of suffering in their lives.
Case and Deaton’s explanation for the divergence in white- and blue-collar fortunes is largely an economic one. “Our story is one in which the economy has increasingly come to serve some, but not all, Americans, and where a central division is between those who do or do not have a four-year college degree,” they write. “We see the increasing mortality and declining adult life expectancy of less-educated Americans not only as a catastrophe in its own right but as a powerful indicator that American society is not working for the majority of its population.”
Since 1980, real wages have risen for people with four years or more of college education, and fallen for everyone else. At the same time the core necessities of modern life, including healthcare, childcare, and housing, have become more expensive.
This was deliberate. Over the past four decades, Republican and Democratic lawmakers alike have been monomaniacally obsessed with “keeping prices low.” You can’t raise taxes to fund social services, because we need to keep prices low. You can’t raise wages, because we need to keep prices low. You can’t have vacation or sick time, because we need to keep prices low.
We’ve been told, over and over, that low wages and a porous social safety net are simply the price we pay for the freedom to buy cheap stuff. But here’s the truth laid bare by Case and Deaton’s data in the chart above: for the Serious People selling us this agenda, wages kept going up and the safety net was never an issue. College degree holders got to reap all the benefits of our cheap-stuff economy while being largely insulated from the despair and misery that comes with it.
Only now, 40 years into this massive social experiment, have things become dire enough that the upper middle class is feeling the squeeze as well. And things are bad, indeed. Case and Deaton casually note that the suicide rate — perhaps the most reliable indicator of extreme population-level despair and misery — is higher than it’s been since the Great Depression. And in stark contrast to our international peers, which have generally experienced flat or falling suicide over the past two decades, our rate of self-inflicted death is rising.
Back in 2000 the U.S. suicide rate ranked 12th out of 17 of the world’s wealthiest democracies (again, I’m using the “peer nations” defined in a recent National Academies report on health outcomes). By 2019 we had risen to first place. That’s American Exceptionalism in the 21st century: no wealthy nation in the world drives its citizens to death the way the United States does.
From the outside, American society must look like a bizarre death cult. Over and over again, we’re told that widespread death, despair and misery is the price we pay for “freedom.” Whether it’s gun violence, poverty, a lethal pandemic, a health care crisis, or simply our short and dwindling life spans in general, lawmakers — nearly all of them Republican by this point — say that saving those lives would entail an unacceptable infringement upon our freedoms.
Look at the lines in the charts above and ask yourself: freedom to do what, exactly?