The deaths-of-despair narrative is out of date

MOST ECONOMIC theories come and go with little fanfare. Every once in a while, however, one catches fire. In 2015 Anne Case and Angus Deaton, two Princeton University economists, published a landmark study showing that from the late 1990s the mortality rate of white middle-aged Americans had started to rise after decades of decline—owing to a surge in alcohol-related deaths, fatal drug overdoses and suicides. This “deaths-from-despair” mortality rate has not slowed since: in 2022 more than 200,000 people died from alcohol, drugs or suicide, equivalent to a Boeing 747 falling out of the sky every day with no survivors. Yet even as America’s deaths-of-despair epidemic has intensified, its causes have grown harder to identify.When Ms Case and Mr Deaton put forward their thesis, their focus was on middle-aged white Americans without university degrees. For decades this group had been able to make a living with no more than a high-school diploma. But they were now suffering from stagnant wages and shrinking job opportunities. That, in turn, had contributed to an erosion of traditional social institutions, such as marriage and religion. Although black and Hispanic Americans had been affected by many of the same economic forces, it was whites that were left with particular feelings of despair and meaninglessness. The result was drug abuse and suicide, aided by exploitative pharmaceutical companies and inept regulators.