Deaths of Despair and the Future of Capitalism: A Review
Deaths of despair are a growing public health crisis in the United States. They are also a symptom of a deeper economic and social malaise that afflicts many Americans who feel left behind by a changing world. In their book Deaths of Despair and the Future of Capitalism, economists Anne Case and Angus Deaton offer a compelling analysis of how capitalism has failed to deliver for the working class and what can be done to fix it.
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What are deaths of despair?
Deaths of despair are defined as mortality resulting from suicide, drug overdose, and alcohol-related liver disease. These deaths have been on the rise in the United States since the 1990s, especially among middle-aged, less-educated white people. According to Case and Deaton's data, more than 150,000 Americans died from these causes in 2017 alone. That's more than twice as many as in 1999.
These deaths have contributed to a decline in life expectancy in the United States for three consecutive years between 2015 and 2017. This is a reversal not seen since 1918 or in any other wealthy nation in modern times. Case and Deaton argue that these deaths reflect a loss of hope and meaning among people who face bleak prospects in today's economy.
Why are deaths of despair rising?
Case and De aton identify several social and economic factors that contribute to deaths of despair, such as:
Job loss and wage stagnation: Many blue-collar workers have lost their jobs or seen their incomes decline due to globalization, automation, outsourcing, and competition from low-wage countries. These workers have also faced a decline in their bargaining power and union representation, making it harder for them to secure decent wages and benefits.
Income inequality and rent-seeking: The gap between the rich and the poor has widened in the United States, creating a sense of unfairness and resentment among the working class. Case and Deaton argue that much of this inequality is driven by rent-seeking, which is the extraction of profits by powerful groups or individuals without creating any value. For example, they point to the health-care sector, which consumes nearly 18% of the GDP but delivers poor outcomes and high costs for many Americans.
Family breakdown and social isolation: Many working-class Americans have experienced a deterioration in their family and social ties, leading to loneliness and despair. Case and Deaton show that marriage rates, fertility rates, and church attendance have all declined among this group, while divorce rates, single parenthood, and opioid use have increased.
Pain, addiction, and lack of access to quality health care: Many Americans suffer from chronic pain, mental illness, and substance abuse disorders, which are often linked to deaths of despair. However, they face barriers to accessing effective and affordable treatment, such as high deductibles, copayments, and limited coverage. Case and Deaton argue that the U.S. health-care system is designed to maximize profits for providers, insurers, and pharmaceutical companies, rather than to improve the health and well-being of patients.
How does capitalism play a role?
Case and Deaton contend that capitalism, which once lifted millions of people out of poverty and improved their living standards, is now destroying the lives of blue-collar Americans by creating a rapacious health-care sector that redistributes working-class wages into the pockets of the wealthy, weakening the position of labor, and increasing the power of corporations. They argue that capitalism has become distorted by cronyism, corruption, and lobbying, which undermine democracy and the rule of law.
They also challenge the notion that capitalism is synonymous with free markets. They point out that many markets in the U.S. are not free or competitive, but rather dominated by monopolies or oligopolies that stifle innovation and exploit consumers. They cite examples such as cable TV, broadband internet, airlines, banking, and pharmaceuticals. They call for more regulation and antitrust enforcement to curb these abuses and restore competition.
What can be done to prevent deaths of despair?
Case and Deaton propose some possible solutions to reduce deaths of despair and make capitalism more inclusive and equitable. Some of their suggestions are:
Reforming health care: They advocate for a universal health-care system that covers everyone regardless of income or employment status. They also call for more transparency and accountability in health-care pricing and quality. They suggest that Medicare should be allowed to negotiate drug prices with pharmaceutical companies, and that generic drugs should be made more available and affordable.
Strengthening labor unions: They argue that labor unions can help workers secure better wages, benefits, working conditions, and representation. They also claim that unions can reduce inequality by compressing the wage distribution and increasing the bargaining power of workers relative to employers.
Increasing education opportunities: They assert that education can enhance human capital and productivity, as well as provide a sense of purpose and dignity. They recommend expanding access to quality education for all Americans, especially those from disadvantaged backgrounds. They also suggest investing more in vocational training and lifelong learning programs that can help workers adapt to changing labor markets.
Promoting social cohesion: They stress the importance of social capital and community engagement for fostering trust, cooperation, and well-being. They encourage Americans to participate more in civic activities such as voting, volunteering, joining clubs or associations, or attending religious services. They also urge policymakers to address the root causes of social fragmentation such as racism, discrimination, polarization, and alienation.
Conclusion
Deaths of Despair and the Future of Capitalism is a timely and provocative book that sheds light on one of the most pressing issues facing America today. It offers a comprehensive diagnosis of the problem as well as some hopeful prescriptions for change. It is also a powerful critique of capitalism's failures and a call for its reform.
The book's strengths lie in its rigorous use of data and analysis, its clear and compelling writing style, and its bold and original insights. It also raises important questions about the nature and future of capitalism in America and beyond. The book's limitations include its narrow focus on white Americans, its lack of attention to the role of culture and politics, and its optimistic assumption that capitalism can be reformed rather than replaced.
Regardless of whether one agrees or disagrees with the authors' arguments, the book is a valuable contribution to the public debate and a must-read for anyone interested in understanding and solving the crisis of deaths of despair.
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Deaths of despair and the future
FAQs
Here are some frequently asked questions about the topic and their answers:
What is the difference between deaths of despair and suicides?
Deaths of despair are a broader category that includes suicides as well as drug overdoses and alcohol-related liver disease. Suicides are intentional acts of self-harm, while drug overdoses and alcohol-related liver disease may be accidental or intentional. However, all three types of deaths reflect a sense of hopelessness and distress among the victims.
How do deaths of despair compare across different countries?
The United States has the highest rate of deaths of despair among developed countries, followed by Canada, Australia, and New Zealand. European countries have lower rates of deaths of despair, although they vary widely across regions. For example, Eastern Europe has higher rates than Western Europe. Some developing countries, such as China and India, have also seen an increase in deaths of despair in recent years.
How do deaths of despair affect different racial and ethnic groups?
The book focuses mainly on white Americans, who have experienced the largest increase in deaths of despair since the 1990s. However, other racial and ethnic groups are also affected by this phenomenon. For example, Native Americans have the highest rate of deaths of despair among all groups, followed by blacks, Hispanics, and Asians. The causes and consequences of deaths of despair may differ across groups depending on their historical, cultural, and socioeconomic contexts.
How do deaths of despair relate to the COVID-19 pandemic?
The COVID-19 pandemic has exacerbated the problem of deaths of despair by creating more economic hardship, social isolation, mental stress, and health risks for many Americans. The pandemic has also exposed the weaknesses and inequalities of the U.S. health-care system and its response to the crisis. Some studies have estimated that the pandemic could lead to thousands or millions of additional deaths of despair in the coming years.
How can I help prevent deaths of despair in my community?
There are many ways to help prevent deaths of despair in your community, such as:
Supporting local organizations that provide mental health, substance abuse, and suicide prevention services.
Reaching out to people who may be struggling with loneliness, depression, addiction, or other issues.
Advocating for policies that improve the economic and social conditions of the working class.
Educating yourself and others about the causes and consequences of deaths of despair.
Seeking professional help if you or someone you know is experiencing suicidal thoughts or behaviors.
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