In 2015, economists Anne Case and Angus Deaton grabbed public attention by reporting that overall death rates for middle-aged White Americans had risen since the 1990s, sharply breaking with prior trends; they counted hundreds of thousands of new “deaths of despair.” Much news coverage, contention, and controversy followed.[1] By 2020, there was enough confusion that some people accepted the surge of deaths as fact and some dismissed it as just another academic kerfuffle.
This is a good time to revisit the claim. Last year, Case and Deaton produced a best-selling popular treatment, Deaths of Despair and the Future of Capitalism, and late this year they released two academic updates (here and here). Last March, the National Academies of Sciences, Engineering, and Medicine published a draft “Consensus Study Report” on High and Rising Mortality Rates Among Working-Age Adults. Meanwhile, the tide of studies that followed the initial controversy just keeps rising. What do we know?
We know that about three generations ago, newborn girls could be expected, on average, to live to about 71, newborn boys to about 65.This graph shows what happened then.
Lifespans rose and then they didn’t. Because more Americans in their prime years were dying, life expectancies leveled off for women and turned down for men,[2] despite continuing advances in health care and medical treatments. What happened?
Here are key questions: Who has suffered the rise of premature death rates? What kinds of deaths account for this trend? What distinguishes the individuals who were most vulnerable? And what social causes might explain their vulnerability in this era?
The tl;dr version of this post is that: Yes, there has been an unusual surge in American deaths in the last two decades; it has been concentrated among working-age, working-class Whites; “deaths of despair” is too expansive a description and explanation; the surge was basically due to the opioid epidemic and rising obesity; the opioid epidemic was mostly due to increased supply; economic and social dislocations mark the communities that have been most vulnerable to the opioid epidemic and thus premature deaths.The surge is real; Big Pharma and cardio health are most responsible; “left behind” communities have been the most vulnerable.
MADE IN AMERICA 