Sunday, January 12, 2020

How American socioeconomic policies create 'deaths of despair'

At the NY Times Nicholas Kristof and Sheryl WuDunn ask Who Killed the Knapp Family? It’s an important piece of research on how Across America, working-class people — including many of our friends — are dying of despair. And we’re still blaming the wrong people. (With thanks to Roving Reporter Sherry.)

So who are the right people to carry the blame? Not the Knapps. Poverty triggered by job loss is a more accurate answer. As is the failure - complete, abject, crappy failure - of our social and economic policies.

Here is just a small part of the case they make.

We Americans are locked in political combat and focused on President Trump, but there is a cancer gnawing at the nation that predates Trump and is larger than him. Suicides are at their highest rate since World War II; one child in seven is living with a parent suffering from substance abuse; a baby is born every 15 minutes after prenatal exposure to opioids; America is slipping as a great power.

We have deep structural problems that have been a half century in the making, under both political parties, and that are often transmitted from generation to generation. Only in America has life expectancy now fallen three years in a row, for the first time in a century, because of “deaths of despair.”

The meaningfulness of the working-class life seems to have evaporated,” Angus Deaton, the Nobel Prize-winning economist, told us. “The economy just seems to have stopped delivering for these people.” Deaton and the economist Anne Case, who is also his wife, coined the term “deaths of despair” to describe the surge of mortality from alcohol, drugs and suicide.

The kids on the No. 6 bus rode into a cataclysm as working-class communities disintegrated across America because of lost jobs, broken families, gloom — and failed policies. The suffering was invisible to affluent Americans, but the consequences are now evident to all: The survivors mostly voted for Trump, some in hopes that he would rescue them, but under him the number of children without health insurance has risen by more than 400,000.

The stock market is near record highs, but working-class Americans (often defined as those without college degrees) continue to struggle. If you’re only a high school graduate, or worse, a dropout, work no longer pays. If the federal minimum wage in 1968 had kept up with inflation and productivity, it would now be $22 an hour. Instead, it’s $7.25.

It would be easy but too simplistic to blame just automation and lost jobs: The problems are also rooted in disastrous policy choices over 50 years. The United States wrested power from labor and gave it to business, and it suppressed wages and cut taxes rather than invest in human capital, as our peer countries did. As other countries embraced universal health care, we did not; several counties in the United States have life expectancies shorter than those in Cambodia or Bangladesh.

Americans also bought into a misconceived “personal responsibility” narrative that blamed people for being poor. It’s true, of course, that personal responsibility matters: People we spoke to often acknowledged engaging in self-destructive behaviors. But when you can predict wretched outcomes based on the ZIP code where a child is born, the problem is not bad choices the infant is making. If we’re going to obsess about personal responsibility, let’s also have a conversation about social responsibility.

Why did deaths of despair claim Farlan, Zealan, Nathan, Rogena and so many others? We see three important factors.

First, well-paying jobs disappeared, partly because of technology and globalization but also because of political pressure on unions and a general redistribution of power toward the wealthy and corporations.

Second, there was an explosion of drugs — oxycodone, meth, heroin, crack cocaine and fentanyl — aggravated by the reckless marketing of prescription painkillers by pharmaceutical companies.

Third, the war on drugs sent fathers and mothers to jail, shattering families.

But there are solutions revealed by Kristof and WuDunn.

Yet it’s not hopeless. America is polarized with ferocious arguments about social issues, but we should be able to agree on what doesn’t work: neglect and underinvestment in children. Here’s what does work.

Job training and retraining give people dignity as well as an economic lifeline. Such jobs programs are common in other countries.

For instance, autoworkers were laid off during the 2008–9 economic crisis both in Detroit and across the Canadian border in nearby Windsor, Ontario. As the scholar Victor Tan Chen has showed, the two countries responded differently. The United States focused on money, providing extended unemployment benefits. Canada emphasized job retraining, rapidly steering workers into new jobs in fields like health care, and Canadian workers also did not have to worry about losing health insurance.

Canada’s approach succeeded. The focus on job placement meant that Canadian workers were ushered more quickly back into workaday society and thus today seem less entangled in drugs and family breakdown.

So do check out the Times essay for more on what we as a society might do to make sure that we don’t kill more Knapp families.

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