Economists grapple with rising American mortality
Understanding “deaths of despair” will require fresh thinking
Five years ago Anne Case and Angus Deaton of Princeton University introduced the world to the phenomenon of “deaths of despair”. A growing share of middle-aged white Americans, especially those without college degrees, are dying from suicide and drug and alcohol use. At first it seemed possible to hope that the troubling rise in death rates would reverse as the economy recovered from the financial crisis. Instead, mortality has risen further—a standing indictment of American society. Several books on the subject, and discussions at the meeting of the American Economic Association (aea) earlier this month in San Diego, do not quite provide an explanation. But they make significant contributions, while posing a substantial challenge to economics.
America’s mortality crisis actually predates the financial crisis: mortality rates for white Americans without a degree have been rising since at least the early 1990s. But it seems to be worsening. Life expectancy in America fell for three consecutive years between 2014 and 2017 (the most recent year for which data are available). That has not happened since the 1910s, when Americans were brought low by war and Spanish flu. Rising death rates are caused in large part by the opioid epidemic, which began with prescription painkillers and expanded to street drugs such as heroin and fentanyl. But suicide and alcohol-related mortality have also risen precipitously. Opioids, reckon Ms Case and Mr Deaton, were fuel on a fire already burning.
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