488 Comments

Ohh yes, this is that hot fire that I subscribe for.

Expand full comment

You know any take with the subtitle “it’s time to be a little ruder about this” will be spicy/delicious.

Expand full comment

He missed the opportunity to call the paper “bullshit” in the dang title!

Weak sauce from an ancestral northeasterner. I’d have dropped at least two f-bombs, bullshit, and weak-ass in there somehow.

Expand full comment

It's none of those things--it is pure, 100%, grade-A, uncut MALARKEY.

Expand full comment

In other words, the authors of the paper were smoking Dutch Cleanser (to use an Arlen Specter-ism).

Expand full comment

Overly polite Upper Midwesterners, ugh. I'll do it properly:

"The Fucking Weak-Ass Deaths of Despair Narrative is Fucking Bullshit, You Candy-Ass Bitch.

It's fucking well time to be a cunt about this shite."

Expand full comment

Oh, man, when does Season 4 of 'The Boys' drop anyway?

Expand full comment

See, I just think this sounds childish.

Expand full comment

Really? If my child said that she’d be sitting on her bed until at least first snowfall.

:D

Expand full comment

Is he lacking the additional Philadelphian touch to get there?

Expand full comment

Philly with a dash of Brit below. :p

Expand full comment

This is pure snarky Matt. I love it.

Expand full comment

And with a perfect target... When I heard Deaton on the Julia Galef podcast I formed the strong impression that he was a moron.

Expand full comment

I'm only mad because I was ruder about it first.

Expand full comment

It's easy to reconcile deaths of despair being a uniquely American thing if your priors are that America is a uniquely bad place to live compared to Europe.

Expand full comment

Translating observational data into robust conclusions in a scientific manner without resort to experimentation is damned hard. As I said below, most of them slip into charlatanism sooner or later, because you need to have ironbound control over your priors and a deep commitment to rigor to avoid doing so.

Most social scientists do not have enough of either, both in my limited personal experience and reflected in the shit they publish.

Expand full comment

yes but the idea that Europe with its relative material scarcity can be meaningfully better than the US on a number of very important metrics (years lived!!), it is pretty challenging to a policy agenda that believes every issue can be solved by redistribution of material resources.

Expand full comment

Why? Europe can be poorer overall but redistribute such that it’s poorer are richer than us poor.

Expand full comment

Also worth noting that this is even more true for wealth than for income— France, the UK, and the Netherlands all have higher median wealth per adult than the US even though mean wealth in the US is much higher.

Expand full comment

I feel like how wealth is measured affects that a lot

like, the poorest people on earth are recent american med school grads, who have hundreds of thousands less in net wealth than goat herders in burkina faso

Expand full comment

I recall a charity, Oxfam I think, made exactly the mistake you alluded to in a report they put out. They treated someone with a billion in assets and a billion in liabilities the same as a beggar without any assets or debt.

I think wealth in the broadest sense is related to the income you can generate both from knowledge and financial assets - which makes the medical graduate worth tens of millions of government bonds.

Expand full comment

That is also a good way to square the disparity in wealth between someone just out of college vs. the newly retired...one has no assets (or negative with student loans) but a lifetime of earning potential, while the other has (hopefully) substantial assets and little to no earning potential (income from spending down saved assets).

Expand full comment

Interesting to note that by wealth, the UK (151k) is doing better than the France (133k), the US (107k) and way better than Germany (66k)

https://en.wikipedia.org/wiki/List_of_countries_by_wealth_per_adult

That the median French are twice as "wealthy" as Germans makes me think the metric isn't all that useful...

Expand full comment

Homeownership is low in Germany (about 50%) (due mainly to government policies which are very generous to renting), causing it to have a lower mean and median wealth

Expand full comment

There's a significant difference between them in home ownership (50% to 64%). Does that add up to over 100% difference in median wealth? Hard for me to believe that. If so, think it demonstrates even more the limited use of this metric.

Expand full comment
Oct 10, 2023·edited Oct 10, 2023

Excellent point ! I didn’t know that and I suspect many commenter where who like to being up us material advantage again and again don’t know this either !

Expand full comment

Indeed— although I should add the caveat that European adults are older than their US counterparts on average and have had more time to accumulate and inherit.

Expand full comment

Yes its true but (1) the median and probably somewhat below the median in the US have much more access to material resources than comparable Europeans and (2) rich Americans who definitely have more stuff than rich Europeans, live shorter lives.

Expand full comment

Not at all sure about 1 when you realize resources include eg healthcrae and proper retirement savings. As for 2 - I’m not so sure about that either! I believe that sensational life expectancy study actually suggested college-educated Americas will be pretty high up on the chart? If so I’d guess that the smaller subset of rich American would be higher still?

Expand full comment
Oct 10, 2023·edited Oct 10, 2023

1 has been extensively discussed here, well beyond the point of beating the dead horse into paste. The mechanics of GDP as an accounting measure make it impossible to "discount" healthcare enough to close the gap between the US and Western Europe's richest nations aside from Switzerland, Norway, and the microstates. Even if you assume that the entire excess healthcare spend in the States relative to Germany or the Netherlands has zero value and mechanistically discount it from household incomes, then adjust for transfers, taxes, and insurance premiums, the median American household is still significantly better off in real purchasing power than their German or Dutch counterpart. You've read and participated in those exchanges without ever actually rebutting or disagreeing with those arguments.

So do you actually disagree with the conclusion that the median American household is considerably richer than the median German or Dutch one, let alone the British or French?

Expand full comment

Higher income yes, higher net worth no (although as I acknowledged above, that’s affected by European adults being older than their American counterparts).

Expand full comment

I don’t know. Polytroposnjust said that median wealth there is higher. That not the same as purchasing power. But in any case I’m not sure if purchasing power in the abstract is the best correlating for life expectancy. Medicine and healthcare treatment in the us is almost certianly far more expensive in the us than any purchasing power advantage.

Expand full comment

life expectancy is a synthetic measurement but Matt cites a study here that suggests rich Americans have higher death rates than average Europeans. https://www.slowboring.com/p/tackling-americas-weirdly-short-life

Expand full comment

Skimmed it, which graph do you mean?

Expand full comment

???? Not if the US in fact transfers less and part of its transfer is high cost health care,

Expand full comment

There is a tinge of “lost cause” narrative that has always seemed implied with this “deaths of despair” stuff. It’s the great white calamity, visited on innocent people because of how the outside world hated their simple and elegant ways. You see, they have no option but to drink themselves to death because eggs are more expensive, the customer service number gives them the Spanish language option FIRST, and the coal mine doesn’t hire as many people. What are they supposed to do? Literally anything else?

Expand full comment

I mean, the deaths of despair narrative always seemed kinda counter-cultural to me because these days, “fuck those white guys who just whine and moan” seems to be the far more dominant narrative. That said, narratives should be roughly accurate to be worth listening to.

Expand full comment
founding

I think the interesting thing about this is that they manage to get through to the audience that is most in on hating low education white people by selling this all as a story about how we shouldn’t be victim blaming.

Expand full comment

An odd thing with the coal mine and mill towns is that there really is a high rate of DoDs in many of those places. So it can look like the loss of jobs CAUSED the overdoses, etc..

But to a large extent that's an illusion, because when the mill closed the more together people with options and drive tended to leave, so the people who stayed behind were the people without drive or options, ie the drug addicts, those with criminal records, health problems, those who can't afford a bus ticket out of town, etc.. And the trickle of people moving back in might be disproportionately down on their luck.

I've looked at the demographic data on Kentucky and West Virginia and there are counties that have lost nearly 80% of their population since 1960. It's less that the collapse of the economy caused problems and more that the demographic change more problem-people behind in some places.

Expand full comment

Of course, the longer you stay, the harder it is to flee, and the cycle tightens. If you've got a lot of your net worth tied up in your house, as many Americans do--well shit, what does housing demand look like in a county that's lost half its population or worse?

Expand full comment

If you're a young homeowner you might sell at a loss and keep moving with your life. If you've lived in the house 25 years you very likely were going to stay anyway, so the price doesn't bother you as much.

Expand full comment

@wigan i hope this is not too much of a tangent from your comment but I think the same holds true on the upswing side of things in boom towns.

It's not like the fracking boom brought a great social situation to North Dakota or whatever. If you read anything about gold rushes or oil booms or whatever, if you create a bunch of high paying jobs for young men, the results are not necessarily great. They make money but they spend their money and time doing stupid stuff, mostly.

Factories are different because there is more reward for staying with a single company because you can develop firm-specific knowledge and you can have a stable community potentially build up around an industrial cluster. But just in general I think job creation is also a pretty overrated component of health.

Expand full comment

If it's a tangent it's a great one! I agree that job creation is overrated for health for just the reasons you're pointing out: the relation between having a job vs getting laid off and health is much more complicated than "have a job equals healthy" "no job equals not healthy"

Expand full comment
Oct 10, 2023·edited Oct 10, 2023

I on the other see more than a tinge of a unique animosity and hatred towards working class whites by educated Americans. It’s curious to me that some many Americans seem to be selective in their empathy based on skin color.

Expand full comment

I think the goal is to be empathetic to everyone, and that is super hard. Have been thinking about this a lot with the I/P issues right now -- and many ppl are very selective in their empathy/outrage

Expand full comment

I read "I/P issues" as "intellectual property issues" at first and was trying to figure out what was generating selective "empathy/outrage" about it, then the light went off over my head . . . .

Expand full comment

Sometimes, it can feel like intellectual property issues are more intractable than even Israel/Palestine issues!

Expand full comment

But is that even possible? We've been hearing about empathy fatigue for at least a decade. And while a noble goal--empathy for everyone--is it feasible?

I feel like this is where blanket policies can do so much good, by removing the need for empathy for any group at all, and making it a policy that will help everyone.

Expand full comment

If not everyone than more people

Expand full comment

I think empathy is overrated, to be honest. Instead of trying to empathize with everyone, and generally failing, maybe we could just fall back to "bad things happening to people is bad, and we should try to avoid/mitigate that." You don't have to read an NYT profile about someone to know that it sucks if they die young or suffer.

I think the empathy thing has been in part an attempt to do an end run around the in group / out group thing. Instead of saying, F those people, they're on the other side, you're supposed to understand their point of view and empathize with them. But of course people are still loyal to their political tribes, so the empathy thing often doesn't work either.

So my proposal is to say screw it and just fall back to the general respect for human rights that we should have had all along. Although obviously many people fail at that as well. We live in an F-ed up world, and there's no short-term fix for that.

Expand full comment

I dunno, I see a lot of true lefties being weirdly compassionate to a category of people they really do not know well... There's a lot of social conservatism out there in that group, and it's not all about money. These are the "cling to their religion and guns" folks that can be an obstacle to progress. Sometimes rich kids from the liberal suburbs seem to think these folks are noble savages, but they are fully-formed humans with their own beliefs and agendas.

Expand full comment

Yes, and strangely this lefty, for one, believes that even peole who don’t share my politics deserve to live a full life !

Expand full comment

Yes, and I ask them to afford me that same opportunity. When they try to legislate their religious beliefs, that line is crossed...

Expand full comment

Median incomes for non-college grads were stagnant for the four decades before Trump’s election. And still you mock. Even if the “deaths of despair” take was more hot than rigorous, the sad fact is the bottom 70% have stagnated needlessly

Expand full comment

I'd like to write a lengthy paper that splits people into two groups

Group A makes good choices

Group B makes bad choices

Then lets all be surprised at how Group B has bad outcomes & make me a famous academic.

Expand full comment

Goofus dies of a fentanyl overdose in a homeless encampment at age 26.

Gallant has an MBA and works in pharmaceutical marketing.

Expand full comment

Unrelated, but as a Coloradoan and frequent snowboarder I wish ski resorts would put Goofus & Gallant comics on ski lift pillars.

"Goofus has a family meeting right in the lift unload zone. Gallant gets his children out of the way."

"Goofus sits down in the middle of the run entry to strap his bindings. Gallant goes to the side so he doesn't block everyone else."

"Goofus plays music on a Bluetooth speaker. Gallant strangles Goofus, and everyone claps while ski patrol helps hide the body."

Expand full comment

Why are snowboarders always sitting down on the mountain? I don't understand why I always see packs of them sitting down on the cold snow, and then laboriously trying to get up from that position.

Skiing solved this problem for you! Why you do the less good option?

Expand full comment

We sit down to strap up our rear binding after using the lift.

I cannot speak for every snowboarder, but I skied before snowboarding. Compared to skiing I find snowboarding to be a little more interesting of a challenge*, I like only having one thing to carry, it's easier on the lower body, and the boots are vastly more comfortable.

*For people who shoot, I compare skiing to rifle and snowboarding to pistol. Snowboarding and pistol shooting both take more body control and ability to override instincts than skiing or rifle shooting.

Expand full comment

Yeah it's difficult to overrate the boot factor. Committed skiers spend an age and lots of money finding boots that are still less comfortable than the boots a first time snowboarder will rent. Huge barrier to entry.

Expand full comment

Early contender for comment of the week. The layers of meaning make me want to go take a walk.

Expand full comment

And we wonder why the Goofuses of the world mistrust us Gallants as we butter the shit out of our own bread under the guise of expertise and science.

Expand full comment

This comment will haunt me the rest of my days, kudos

Expand full comment

That's awesome.

Expand full comment

A+ comment!

Expand full comment

Except in the rest of the civilized world poor people don’t die as much from their so-called “choice” to be poor. This is gop level commenting here.

Expand full comment

You can look at within-group outcomes by income levels and still find that making good choice - or really, bad choices - makes a great difference for how your life turns out. Arguably more of a difference when you are poor - when you are wealthy you have more luxury to get away with some bad decisions.

I grew up amongst the rural poor. Many of those kids were not interested in learning, but I took school very seriously as a way to escape the boondocks. My path worked as expected and I climbed up the income ladder. Most of those other kids did not. I maybe wish things were better for them, but I consistently encouraged them to be more like me & they consistently declined (to put it mildly).

This is NOT every story! But it is a real phenomenon, and there is sometimes a Lefty silliness that people have no control over their lives. This is an unhelpful attitude - oddly shared by religious extremists who expect Jesus to take the wheel vs solving their own problems.

Expand full comment

Of course choices matters and personal responsibly matters and how good your parents were matters tons. That’s not an excuse to avoid better public policy and the huge difference in trend with Europe suggests strongly that such policy difference can make huge differences in people’s life. My big problem with the “bootstraps” rhetoric is that it seems like a way to rationalize and moralize the very morally dubious choice of avoiding policies that will dramatically save and improve tons of lives.

Expand full comment

I agree re public policy, and I would like a stronger social safety net, better public education, and more social mobility.

I don't think I'm describing the "bootstraps" narrative in my opener, just by pointing out the relevance of individual accountability. And we do have a real American challenge around getting people to TAKE the opportunities they are given. Look at how a bunch of people refused to take a free awesome Covid vaccine. Madness, driven by individual bad decisions.

Expand full comment
Oct 10, 2023·edited Oct 10, 2023

Well. Here I disagree. I don’t think Americans are “naturally” more or less likely to make good choice than Europeans. Ergo if they are on average making worse choices that itself is likely an issue to be addressed by better public policies. Vaccines are a good case in point. While the vaccines themselves were free Americans were hesitant because they’re used to paying much for healthcare, moreover being sick for one day due to side effects was *not* covered by the us government whereas Europeans have better sick leave policies and healthcare coverage for whatever side effects. Studies and polls suggests this accounts for some of the gap in “choice” of vaccines. The difference in public rhetoric presumably accounts for another slice of the gap. That’s not policy in the narrow sense but it’s still a matter of worse politics. Reducing this to individual choice is not helpful. You need to see the aggregate trend and try to account for the cumulative difference.

Expand full comment

You mention the issue of Americans having less ability to take time off for side effects, but skip over the part about Americans being accustomed to paying for healthcare--it seemed the more relevant issue (that I saw referenced a lot) was that many people were suspicious of the vaccine on the basis of it being “rushed” (Fauci was saying it would take at least 18 months, it was approved in less than a year). The fact that it was free made some people even more suspicious of whether it was safe (if it was really that great, why give it away?)

Expand full comment

I'm pretty sure there is a good deal of research out there showing that Americans are more individualistic and less trusting of government than Europeans. See the whole "nanny state" debate. So I think there definitely IS a cultural/psychological component to a lot of this stuff. There's not much we can do about that, so I agree it's often not helpful to spend time on, but at the same time not everything can be reduced to the impact of some government policy.

Expand full comment
Comment deleted
Expand full comment

I have a goddaughter who is quite poor. I gave her baby things to play with attached to one of those plastic chains that hooks to the stroller, so the baby could amuse herself and exercise her curiosity. She would not use it. I have no idea what the rationale is to discourage your kids from learning and exploring. I have classmates who had to beg their parents to let them go to college (this was many years ago.) These values, which can perhaps be summarized by the old time country song "Don't Get Above your Raisin' " seem to be quite deep in certain impoverished cultures.

Expand full comment

The bureaucratic world of education and government is inscrutable and threatening to a lot of people. I'm one of them. And not because my parents weren't smart and didn't do a good job, Mom went to Columbia and got her JD at Franklin Pierce, my father was a skilled craftsman. I had books and a good school and a therapist lol. I had a fine childhood, even if we were lower middle class because Mom and Dad didn't prioritize money/career. But the modern world doesn't make a lot of sense to people, and if you aren't adept at navigating it, it is very easy to fall by the wayside. This Is Not Bad Decision Making. This is a world that values paperwork and credentials that are gatekept. This is a world where the informal economy is throttled and deprecated by the State and the Elite. This is the world of Seeing Like a State. And lots of people hate it and fear it.

Now, I know a lot of this is the reason we have a fully electrified and networkes nation, and actual starvation is rare, and we have roads and schools. But it comes at a cost.

Expand full comment

The arg here is this is largely a function of other governments outlawing or heavily taxing bad choices.

Expand full comment

But you'd have to explain the choices.

Expand full comment

Man. I miss cigarettes. I still smoke occasionally with my brother in law, a few cigarettes a month, but have a permanent prescription to Chantix to keep me from back sliding.

But as an ex-smoker, I’m relieved that cigarettes have gotten so expensive and frowned upon. It motivates me to refrain from a vice I enjoy. (Thankfully ai don’t enjoy vaping however). I’m a living example of targeted policies working.

I’m rather curious about the long term effects of marijuana going forward. I wonder what health effects we will see as smoking weed becomes more ubiquitous among a larger group of people.

As for despair... drugs... it’s hard to gauge. I think fentanyl and meth might be extraordinarily deadly compared with cocaine or the past... but who knows. It’s it more despair or is it deadlier better drugs?

Expand full comment

I have some thoughts on this that I might write out when I get out of the gym…

Expand full comment

Make sure u send me the link!

Expand full comment

It's a combination of potency and route of administration. Powder cocaine is less dangerous than anything smoked or injected because the powder in the nose causes local vasoconstriction that itself limits the dose that is absorbed. You can't really overdose that way. There are no such limits on smoked or injected meth. Oral meth is still a problem, too., but probably mostly as a gateway to smoking or injection.

Fentanyl is so potent that it is medically dosed in micrograms. You can imagine how easily one can get too many micrograms of something, and street drug distributors and users aren't known for their precision. It's also absorbed through the skin, although the real thrill-seekers take the drug gel out of the patch and inject it.

I do quibble with Matt's argument that it's medication advertising that is the issue (though I abhor the direct to consumer (DTC) version). Medications like Oxycontin were not advertised DTC, which is what we are mostly aware of. They were advertised to providers through the usual professional channels (ads, articles in journals, conferences, paid speakers), which Europe also has (with the possibly exception of those drug company-paid lunch seminars). But I do think the fracturing and privatized nature of the US health care system makes it easier to have pill mills pop up., which drove the initial seeding of the population with oxycontin. I don't know how you'd set up a pill mill in Norway or France, or anywhere that has 1) a nationalized healthcare system and 2) fully integrated medical and pharmacy records.

Expand full comment

>Powder cocaine is less dangerous than anything smoked or injected because the powder in the nose causes local vasoconstriction that itself limits the dose that is absorbed. You can't really overdose that way

I'm sorry what. Of course people can OD on snorting blow, they do it literally all the time

Expand full comment

If that blow is laced with something else, sure.

Expand full comment

Dude you are utterly, utterly wrong. I find people saying the absolute craziest stuff on the Internet lol

Expand full comment

Potency dosen't necessarily imply lethality. LSD is dosed in micrograms too, but the dose that wil kill you is so high that nobody dies from it. In the hospital setting, fentanyl is used pretty frequently, but you know the exact dose, and you have Narcan on hand to reverse the effects.

Expand full comment

Fair. It's not potency per se, but "therapeutic" window - LSD has a high threshold for harm, fentanyl a low one. My point about the accuracy of dosing outside of therapeutic use is the same as yours, though. Street dealers and users aren't going to dose accurately. They don't even know what they have. And of course the degree to which someone has a tolerance to the narcotic interacts with the dose level they get. Russian roulette.

Expand full comment

One retort I've heard to that is "well just set up safe injection sites with staff that has Narcan on hand, and you'll reduce OD deaths to zero". I still think that's inadequate, because the staff will be reviving people left and right, and addicts are still living on the streets, living this marginalized life. My dream approach to this problem would be dispensing drugs like hydromorphone or morphine with controlled doses to addicts in a institutional setting, while slowly weaning them off in a long-term(yr or so) treatment plan, with the goal to eventually go onto a medication like Suboxone to help reduce cravings and the risk of relapse on an outpatient basis, while dealing with any other comorbid conditions they have(HIV, hepatitis, nutritional deficiencies from living on the streets) and/or job training, or psychological counseling. The current treatment programs are not long enough, or comprehensive enough to provide long-term sobriety. But, that would cost money, and community buy-in, although having residents no longer dealing with tent cities could be an incentive.

Expand full comment

I agree completely. Harm reduction has its place but it can't be the only approach. You have to try to get people into long-term treatment, even recognizing that the relapse rate is frustratingly high. And suboxone is critical to longer-term success, but not a panacea. We could fund this if we had the will to do it. But it probably requires an even more comprehensive approach than this, to include housing support, job support, etc., and of course there will still be failures.

Expand full comment

One simple solution is expanding drug court programs throughout the US, where you give people the option of charges being expunged if they undergo treatment, but you still need to make possession and use a misdemeanor or felony to be able to pull people into treatment, because while they may be mad at you and furious that you forced them into treatment, they may thank you months or years down the line that you did. Most addicts don't act rationally or think clearly, because their minds are clouded by drugs. It's amazing how much mentally sharper people are once they get sober. Some addicts do have coexisting or preexisting issues, like severe depression or hopelessness, but the drugs eliminate any possibility of those things getting better. That's also a place where skilled social workers can help.

Expand full comment
Oct 10, 2023·edited Oct 10, 2023

there is the Swiss model -- for long-term users who have failed to quit by other means, just indefinitely give free* access to pharmaceutical heroin at safe injection sites (and in some cases, give people doses to take home). therefore no question of "relapse".

(it says here average user stays in this program for about 3 years, but 20% had never left at the time of the survey.

http://www.citizensopposingprohibition.org/resources/swiss-heroin-assisted-treatment-1994-2009-summary/)

*: it's not actually free, rather it is covered by compulsory private health insurance

Expand full comment

Also, most of those programs were set up decades ago, before methadone treatment and Suboxone were used or available as maintenance medications. I think nowadays the goal would be be either those medications for a short time or indefinitely if some patients truly couldn't handle being off methadone or Suboxone, but the ultimate goal would be sobriety. We have more options now.

Expand full comment

Yeah, the UK has a similar program, i'd just wonder who would be liable if the patient OD, the litigation around medical malpractice in the US would be a problem.

Expand full comment

wouldn't you also have to force addicts into the program, which is a bigger problem the longer the program has to last. And if it's really long it may upend the addicts family or work life.

Expand full comment

Right, that is part of the problem, and it's a balancing act between personal liberty and community safety, although because these drugs are so incredibly addictive, addicts end up stealing, robbing people, becoming sex workers, forging checks, or stealing from family members to get money to get their next fix. Getting drugs becomes this all-encompassing thing, where their whole life revolves around getting high, remaining high, or buying more drugs. You only have about 3-4 hrs with opioids after the dose wears off, before you start experiencing withdrawal symptoms. I just think that addicts entrapped by the prison of drug addiction, deserve something better for their life, and if that means the state temporarily reducing their personal liberty, to give them a chance at that, then I'm willing to take that trade-off. I don't think anyone grows up hoping to become addicted to fentanyl, or envisioning their life turning out that way, but the stories are always very tragic when you hear people's backstories of why they ended up in this place.

Expand full comment
Oct 10, 2023·edited Oct 10, 2023

i'm especially interested in the data on vaping. lots of negative data but i'd imagine there may be worse effects we don't know about -- huge issue for my generation

Expand full comment

Vaping very much strikes me as a positive harm reduction avenue against tobacco smoking, so I'd be curious as to what negative data you've come across. It'd be nice if more vaping was nicotine free for those who have yet to be hooked on that, though.

Expand full comment

Agreed on both counts--especially the nicotine free.

It's of course possible that untold harms will arise in 10 or 20 years with vaping, but we know just how harmful cigarette smoking is, and many people would make the switch to vaping with some pressure. But the anti-vaping crowd seems motivated by a desire to keep anyone from doing anything *like* smoking, no matter how different it might be, on almost puritanical grounds. At least it seems to me.

Expand full comment

there are a surprising number of people who never smoked but do vape (or use other non-tobacco nicotine products like those pouches). many of these people now have a moderately expensive and unpleasant addiction, even if the health harms are probably quite small.

to the extent this happens to a lot of minors as a result of marketing, it does seem like a problem, although the moral panic and draconian response that happened a couple years ago were really stupid.

Expand full comment

Right. I think some people would prefer that humans never developed any vices, and I think that's a naive and potentially destructive tack to take.

To the extent that we can make vices less unhealthy, we should, taking into account explicitly that it's in our nature to seek out vices and escapes.

Expand full comment
Oct 10, 2023·edited Oct 10, 2023

I once asked Matt for his take on vaping in a mailbag, and he didn't answer it. I try to avoid asking him repeat questions (HOAs were the one exception, and I somehow got lucky when he answered it from a non-mailbag comment I made), but maybe it just didn't make the cut among better questions, and I can try again after some more time has passed. Given that he's a former tobacco smoker, I think his take would be quite insightful.

Expand full comment

As a young person (23yo, just graduated college) I don’t think I’ve ever seen a single member of my peer group smoking a cigarette in person. Meanwhile, I’ve seen dozens and dozens vaping; usually nicotine, but also weed. Most of these kids who started vaping in middle and high school were kids who would not have otherwise smoked cigarettes.

Expand full comment

Seems like a very good topic for him--policy, regulation, public health, and personal experience?!

Hope you keep at it.

Expand full comment
founding

Weed use is becoming more common but I don’t know that smoking is. Edibles have been the big boom category since legalization, while vaping has been taking over smoking in parallel with how it has in tobacco.

Expand full comment

I'm sure this varies state-by-state, but I remember when five dollars would buy a decent lunch and two packs of a cigarettes (a free lighter) were about a buck fifty; it was cheaper to smoke (which also killed my appetite) than to eat. That relationship literally inverted in less than a year with passing of huge tobacco taxes ratcheted up the price of a pack of cigarettes to five dollars. I literally could not afford my pack and a half a day habit and ended up quitting. (And gaining 20 pounds.)

I think the difference with weed is the lack of addiction. For me, having to restrict my cigarette intake was worse than abstinence, but weed was something you smoked when it was around and just didn't otherwise. Fentanyl is basically where tobacco was in the 90's; highly addictive and super cheap. Plus it kills you way faster.

A point that seems to be missed in the Slow Boring comments section is that a lot of fentanyl overdoses occur because people don't know they are using fentanyl. Dealers cut it into all kinds of drugs to enhance potency and create addiction. It also creates an addiction to an entire class of molecules (opioids). The meth heads I knew very deliberately took meth, got addicted to meth and then either went to jail, died or got off it. And they were snobs about it. They didn't like heroin or pills. They very specifically wanted the meth high.

Expand full comment
founding

I think the uppers and downers appeal to people in very different ways. There are some people who like both (even in combination) but there’s a good number who like one and hate the other. Both can be dangerous, but it seems that fentanyl on the downer side is much more dangerous than anything on the upper side.

Expand full comment

It's interesting to think about who chooses which drugs (alcohol and cigarettes included) and why. The deep numbness reported from people taking Oxy, for instance, doesn't appeal to everyone. Likewise, the opposite extreme of meth for others. Let alone which are used in more social settings (weed, cocaine, alcohol).

Expand full comment

Personally, my default setting is what you might characterize as "over caffeinated" so drugs that literally get you high (including caffeine) have little appeal to me. I had a roommate who was the exact opposite, kind of a slow, deliberate person. He was also an insomniac (sadly due to unrelated mental illness), so he worked a day job and a night job, often while on meth. (This particular place of employment was frequented by the type of people who would barter with drugs at 3:00 AM.)

But the heroin addicts I knew were just straight-up addicted. It really was all about chasing the high, almost like they were allergic to sobriety. It caused them to get into all kinds of trouble, including friends and relatives who got caught up in dealing and went to jail despite having every opportunity in life. I assume that is the case for other opioids like fentanyl.

Expand full comment

I've known three former heroin addicts intimately, and they all quit it on their own--but became severe alcoholics afterward.

I think there's a lot to be said and learned about brain chemistry, that some people literally are wired to chase that high.

Expand full comment
Oct 10, 2023·edited Oct 10, 2023

I know one that quit as part of a plea deal and who ended up quitting *everything* and is now an incredibly fit health nut. Another shifted to alcoholism. Another went to prison for a long time, so who knows what he is doing. But all three indeed have a proclivity for addictive behavior. Personally I stayed far away from addictive drugs except nicotine, which I was heavily addicted to and had a hell of a time quitting, which sometimes makes me wonder what would have happened if I had tried heroin.

Expand full comment

Not sure about fentanyl, but opioids such as Vicodin and Oxycontin can have the "opposite" effect on some people, giving them a feeling of euphoria and energy that's very addictive.

Expand full comment

Ah! I didn't know that somehow. I know a lot of people (myself included) feel sick/nauseous taking painkillers like that, but I hadn't heard about an energetic component.

Expand full comment

I think the pathway that leads to opioid addiction is multifaceted, and isn't the same for everyone. Some of the people I knew in high school started using because of dysfunctional home environments, broken homes, and found that opioids helped for a little while, until the bill came due in the form of addiction, and now they had to feed their habit. It seems that older Americans were prescribed excessive quantities of opioids like Percocet, or Oxycontin, but around 2009-2010, states began cracking down on things like a 90 day supply of Vicodin, and setting up electronic prescribing databases to see what doctors were prescribing, and how much. This is why you rarely see paper scripts anymore, you actually need a waiver from the DEA to write paper scripts, and everything is sent electronically. Many doctors who were overprescribing were scared of jail time, or losing their license, and cut patients off cold-turkey. But, you CAN'T cut patients whose bodies have become accustomed to opioids off cold-turkey. You have to slowly wean them off, if they're going to come off the medication.

I'm not a big Joe Rogan fan, but he recently interviewed Kurt Angle, the famous WWE wrestler and Olympic gold medalist, who won the gold at the 1996 Olympics in Greco-Roman wrestling. He said that despite all the injuries he suffered over the years, including breaking his neck numerous times, opioid withdrawal was the most painful thing he'd ever experienced. Every time you buy heroin, fentanyl, or any other opioid off the street, you have no idea of the purity of the drug, and it's essentially a coin flip whether you'll OD or not. Opioids are uniquely deadly, because they bind to opioid receptors in the brain, which control heart rate, and respiration, which is why you stop breathing.

Expand full comment

It seems to me that cocaine is a "party" drugs that people are just as likely to take when they are doing well in life or having fun at a party. And meth and meth-like drugs start (for some people) as a way to cope with big workloads that they me actually be excited about, not despairing of.

Expand full comment
founding

Meth is also very much a party drug - at least, among people who like male-male sexual parties.

Expand full comment

Today I learned...

Expand full comment
Oct 10, 2023·edited Oct 10, 2023

The movement for the legalization of drugs is a criminal folly. I could have stomach it when it was supposedly just about weed (still a bad idea but at least to be seriously contemplated) but now it’s full steam ahead to 19th cent standards. Absolutely awful. Why on earth is our politics so dysfunctional as to allows such legalization (cf Newsom’s commensensical vetoes this week. Why is the California legislator so bonkers? Seems to me like the mirror image of gop “guns for every child” politics)

Expand full comment
founding

The things I heard of him vetoing were a bill to legalize cannabis lounges, and a bill to legalize psychedelic therapy. Even if you think those are going to have massive broader outcomes on those drugs than just the supposedly targeted legalization, those drugs really aren’t dangerous in these ways.

Expand full comment

I thought it was a bill to legalize psychedelics period. My bad !!

Expand full comment
founding

You may be right and I may be wrong! Still, psychedelics cause very few, if any, deaths, despite moral panics about people jumping out of windows thinking they can fly in 1967.

Expand full comment

It would certainly cause social disruption I suspect. There is a reason why all this stuff was banned in the first place!

Expand full comment
founding

Reading more about the culture wars of the 1960s, and Timothy Leary in particular, it seems that psychedelics were the victim of a moral panic that resulted from the particular ways Leary was pushing them. If the face of psychedelics had been more Carlos Castaneda or Aldous Huxley, and there hadn't been as many people doing them at big public parties, they might never have been banned.

Expand full comment

I also wonder if another reason was hindering social productivity. With cannabis in particular that seems plausible.

Expand full comment
Comment deleted
Expand full comment
Oct 10, 2023·edited Oct 10, 2023

My teen son says weed is a "cringe old person thing." Given who was in the lines when our first dispensary opened locally last year, he may be correct. Perhaps that is because older folks have more aches and pains, and it may only grow as an "old person thing?"

Expand full comment

What are the based drugs of choice for his cohorts?

Expand full comment

Same old, same old - alcohol.

Expand full comment
Oct 10, 2023·edited Oct 10, 2023

Among my cusper Xer/Millennial cohorts, there was some serious ¿por qué no los dos? energy. I was never super into cannabis aside from social gatherings, though.

Expand full comment

Drunk people are a nuisance but tipsy people can be fun. Smoking (of all kinds) always stinks. That’s my deep philosophy on the issue.

Expand full comment

Cannabis has long been looked down upon as a "slacker" drug, fairly or unfairly.

Expand full comment
Comment deleted
Expand full comment

They smoked inside the coffee shop? How could anyone withstand the stink?

Expand full comment
Oct 10, 2023·edited Oct 10, 2023

I certainly already view it that way. It’s disgusting, smelly, and ought to go the way of cigarettes.

Expand full comment

I think you'll see a bifurcation between casual users, who use once a month, and heavy users with problematic use, who are using every day, and go through life in a cannabis haze every day. I'm not sure what percentage of people use that frequently, but if it's even 20% of cannabis users, you end up with a lot of apathetic, unmotivated, stoned people. Driving around, I smell a lot more weed coming from people's cars than I did 5-10 years ago, which I think is incredibly reckless, but people seem to think that because it's not alcohol, it's fine.

Expand full comment
Comment deleted
Expand full comment

Was this just for Amazon drivers (could make some modicum of sense) or for everyone at Amazon (no way)?

Expand full comment
Comment deleted
Expand full comment

Right, that's the inherent problem with cannabis testing is its unusual lingering in the system after consumption. I'm not inherently opposed to drug testing for professional drivers, but it needs to be a test that can actually detects impaired driving while on the job.

Expand full comment

At these prices??

Expand full comment
Comment deleted
Expand full comment

Good luck with that given how easy it is to grow, it's called weed for a reason.

Expand full comment
Comment deleted
Expand full comment

Eventually you'll reach an upper bound by generating a sustainable black market, and with cannabis that's proven quite daunting so far due to its ease of growth. Getting it legal everywhere would take out another aggravating factor.

Expand full comment

When I wrote my book review on Deaths of Despair I noted how the authors completely ignored supply side factors with guns, opiates, and alcohol.

Gun proliferationists facilitated suicides. Purdue and company legalized opiate abuse for a period. We have had a relaxing of alcohol laws and increases in ABV.

Reading their book it seemed like an outsider’s take of what is going on in desindustrialized areas. It seemed very conjectural.

Expand full comment
founding

As an alumnus of a Big Ten school, seeing "Purdue" when talking about opioids always causes me to momentarily pause. Until today, I never actually checked why the school and the company share a name. So, in the interest of those who might share my situation:

"The pharmaceutical company was founded in Manhattan in 1892 by John Purdue Gray and George Frederick Bingham as the Purdue Frederick Company. Purdue University was founded in 1869 as Indiana’s land-grant institution, named for benefactor John Purdue."

Expand full comment

Many people are saying that potent synthetic opioids were invented as a form of palliative care for fans of Purdue football.

Expand full comment

At least they had Drew Brees and Kyle Orton to watch back in the day. They've had it better than their in-state rival has.

Expand full comment

Meanwhile, Notre Dame needs to be reminded that IU and Purdue play football.

Expand full comment

And just to further confuse things, there is also Perdue Farms, most notable for its chicken. Also, TIL that there's no connection to the Perdues from Georgia, namely Senator David Perdue and former Trump Ag Secretary Sonny Perdue.

Expand full comment

ABV increased for *craft* brews, but the DoD crowd don’t exactly drink those. AFAIK Bud and Miller Lite are still in the ~4.2% range they’ve always been, which is considered a session beer these days by craft snobs like myself.

So, no, ABV creeping up doesn’t have anything to do with it.

Expand full comment

There are other cheap drinks besides beer though

Expand full comment

Indeed, but there's a difference between "the ABV of the average drink consumed is increasing" and "the ABV across this industry or subsegment is increasing".

For instance, as I demonstrated, the average ABV of beer can increase, but if that's mostly from craft brews that the DoD crowd don't drink, then it loses explanatory power.

However, maybe the DoD crowd shifted from beer to liquor. Okay, now we're getting somewhere! That's definitely an ABV increase, right? But again, in the liquor industry, most of the ABV-creep has come from high-end brands -- you've got Wild Turkey coming in at 94 proof, and then Wild Turkey's "Special Super Duper Select Single Barrel Angel's Ass-Crack" coming in at 110 proof and also $90 more expensive. The industry's average ABV is going up, but is the economically-pressured DoD crowd really drinking WT's SSDSSBAAC, let alone WT, or are they drinking whatever's $2 cheaper than Evan Williams down there on the bottom shelf?

Also, how much are they mixing it? Even if the average ABV across liquor is going up, maybe people are just mixing more mixer in. Or less! The point is, the amount and ABV of liquor *produced* simply can't be assumed to be directly proportional to the amount and ABV *consumed on any given night* [ed: and it's the depth and consistency of the binges that is most directly linked to liver disease. If I'm drinking 2 low-ABV beers a day and then add in 1 super-stiff drink once a month, my average ABV consumed spikes up, but I'm not going to get liver disease. But if I'm drinking a bottle of whiskey a week (or more), then the amount of mixer does start to matter on the margins, and we're really talking about margins here after all.]

Maybe it's a reasonable proxy, but the more of these "reasonable proxies" we rely on up and down the chain of the DoD argument, the less power the argument carries, and the more correct Matt is vs Dan here.

Expand full comment

“Social ‘scientists’ are mostly charlatans, story at 5.”

Not sure this is news…

Expand full comment
Oct 10, 2023·edited Oct 10, 2023

No, sir, it’s other social scientists who did the work to debunk the “deaths of despair” meme. Yglesias relied on their critiques to inform his views and is just summarizing these for us. The review and challenge around this issue is a good example of good social science.

Expand full comment

"Mostly" is consistent with a world where all of the reasonably competent sociologists have to spend all their time wrestling the meme-friendly bullshit turned out by their hack peers back into the grave...

Expand full comment

I think meme-friendly bullshit will exist whether or not social scientists exist (for example: Aristotle on "natural slaves"). But the "reasonably competent sociologists" who debunk the bullshit won't exist without a social science industry.

Expand full comment
founding

Note that this is one of the cases where *economists* (which people with your attitude often think of as the “good” social scientists) are causing the problems while other social scientists are attempting to clean it up.

Expand full comment

Eh, they were protected by seniority and tenure at an Ivy. I would take this as a case of ivory tower elitism.

Someone at a flyover R1 finds something important and valuable? Crickets. Someone at Harvard tweets. Accolades.

Expand full comment

I don't think of economists as any more rigorous than the rest of the social sciences, lol. If they were there would be some degree of fundamental agreement on core knowledge and there doesn't seem to be.

As I noted above, their task is legitimately hard: discover explanatory mechanisms for shit without experimentation. But so few of them seem up to it.

Expand full comment

It’s like the reverse Matthew Desmond effect

Expand full comment
Comment deleted
Expand full comment

Yes, but economists have tremendous training in quantitative techniques that most other social scientists lack. For the past ~30 years, economists have "pinch hit" in other disciplines when a quantitative paper can make an interesting claim, to the point that I'd say it's now just part of the discipline.

Expand full comment

You people only read about social science research that's extremely overhyped and news-prominent, and often only because it's being debunked by MattY or similar, and then you conclude it's all bullshit, thereby commiting the same selection bias error that social scientists SOMETIMES fall prey to

Expand full comment

I actually used to read quite a lot of social science, especially back when I was a grad student with tons of journal access and very slow-running FEA models. A lot of it is bullshit, shot through with problems with methodology and statistical analysis that are glossed over in favor of reaching a desired conclusion.

But you and the other commenter are correct that my pre-coffee hot take is uncharitable.

It should be something more along the lines of "A lot of 'social scientists' are charlatans, news at 5."

Expand full comment

Ya fair. I'm a statistics PhD and basically agree with the lukewarm take that social science broadly has some problems and econ tends to be more rigorous than like sociology/psych/public health. But I see people (especially this comments section) hyperfocus on stuff like today's topic and throw the baby out with bathwater, effectively concluding that punditry and their own hot takes are more reliable than academic research

Expand full comment

I don't think punditry and hot takes have a particularly high success rate either, they're just low-value in terms of time to craft *and* time to consume so no one cares when something you read six months ago turned out to be wrong. For folks like those on here, I'd like to think that remembering those failures goes into people's heuristics about the future, I know I try to recall what I've read and said that turned out to be terribly wrong before talking about the issue du jour.

I have read so very many papers that turned out to be bullshit but seemed plausible at first reading, and skimmed so many more that were transparently bullshit to start.

In the hard sciences everyone is trying to produce something novel and hardly any novel results can be replicated. In the soft sciences everyone is trying to produce something counter-intuitive and the vast majority of it turns out to be bullshit.

In both instances, not enough researchers are willing to devote time to replicating other work quickly so all but the most sensationalist bullshit claims go unrebutted for years.

It's a mess. Exacerbated by the fact, as I pointed out yesterday, that journalism doesn't pay enough to attract solid, knowledgeable, capable "explainers of complicated issues" who have or can learn the necessary degree of subject matter expertise to understand, simplify, critique, and trust/not trust the experts. Most mainstream outlet reporters, at this point, don't know which bits of their interviews are relevant for quotes, let alone how to elaborate or explain their sources' statements, let alone judge their credibility!

Expand full comment

The soft science-hard science distinction in terms of rigor seems less and less valid these days, at least according to research on potential p-hacking by field.

Expand full comment

I mean, to be honest I kinda sympathize more with the soft disciplines.

Their hacks are hacks because their job is *hard*.

The hard sciences’ hacks are hacks because they think their job is boring.

Expand full comment

I won’t say you’re entirely wrong but from my (limited) observation Discourse Enjoyer’s original point still kinda stands. And in fact there’s even a almost self-congratulatory atmosphere around it. Which has an incongruous vibe to it since this comment section’s participants typically frame themselves as being better than the one they mock. But again that’s based on my limited experience here.

Expand full comment

To your point about journalists not being paid enough, one thing I've been noticing recently is that almost no jobs pay enough to keep out hacks and charlatans. Caveat emptor!

Expand full comment

Has any society ever gotten much value out of its least talented tenth? The least talented tenth is not a huge problem under Malthusian conditions as they are culled every time grain prices rise and this mechanically increases their genetic quality and, once grain prices moderate, improves their overall virulence.

Societies with Western levels of wealth can heavily subsidize the bottom tenth. Instead of watching them die from malnutrition or polluted water, we watch them drink and smoke and medicate themselves to death. This is, in a very real sense, what humanitarian progress looks like. Matt is certainly correct that nanny state regulations could make the bottom tenth die even more slowly, the question is whether the top 80% should sacrifice even more for a group that already contributes much less than it takes.

(Whether and to what extent the second decile is a net contributor seems complicated and contingent).

Expand full comment

This is genuinely one of the most awful comments I've seen in this comments section, ever.

Expand full comment

That’s his thing, the resident edgy guy floating at the borders between evolutionary biology and social Darwinism.

Expand full comment

David Abbott strikes me as the commentariat member most likely to have a personality disorder.

Expand full comment

I embrace evolutionary psychology fully. However, social darwinism is an anachronism, more fit for societies with far fewer means to cultivate gardens than 2023 America. The question is to what degree should the strong and the normal sacrifice for the weakest. I do not think the answer obvious

Expand full comment

In his defense the Lake Erie piece noted a significant gap in seatbelt usage and its effect on life expectancy.

If people are dying in 2023 because they won’t wear a seatbelt then my sympathy for their plight begins to wain. How much effort should we be putting into saving people from themselves?

Expand full comment

people who make crappy choices still have kids! If nothing else, preventing harm to those who failed to choose better parents justifies plenty

Expand full comment

if you are a big enough loser, it’s better that you die than stay home, trade your kids food stamps for malt liquor, and beat your girlfriend

Expand full comment

>If people are dying in 2023 because they won’t wear a seatbelt then my sympathy for their plight begins to wain.<

I mean, sure? But is there something about Ohio DNA that's uniquely stupid compared to what's in the cellular nuclei of Pennsylvania and New Yorkers? My guess is no, which suggests public policy can indeed play a role in protecting people from their own ignorance. And probably should play a role in protecting people from their own ignorance.

But no can do in Ohio. Because John Galt.

Expand full comment

I was hateful but this is just fine!???

Expand full comment

Not following you. I didn't join the pile on at your comment, by the way, but surely I wasn't engaging in anything remotely resembling "hate" with mine. My point (I thought expressed clearly) was that petty libertarianism gets people killed if it manages to dictate public policy.

Expand full comment

I would say Youngstown and Findley might be evidence of this, but most regions got weird places.

Expand full comment

The Coast Guard risks their lives to save people stranded at sea. Cops and firefighters try to talk people off literal ledges. Doctors work to save people who injure themselves.

Note that all of these actions are seen as heroic.

Expand full comment

I’ll use the example of mandatory evacuation orders before a hurricane. After folks have been warned repeatedly that they have to leave, I’m totally fine with police, fire, coast guard telling people they are on their own.

Expand full comment

Are you aware that this is not actually what happens, and those people expend significant and risky effort to save those people anyway?

Expand full comment

And they shouldn’t waste their time. Walk me through why you think people should risk their lives to save those who have repeatedly refused to abide by an evacuation order.

Expand full comment

Aren't most of the people staying behind the ones that can't get a place to stay or way to flee? It's not like entire cities can just up and move with no issues

Expand full comment

Any halfway decent state or county government has plans and resources in place to deal with that situation.

Expand full comment

I’m thinking of the residents of barrier islands who have the means and opportunity to evacuate but chose not to.

Expand full comment
founding

What could it be about the place that means that one place has more people who still don’t wear seat belts and the other place got over that in the late 1970s? Is it because one place just has worse people? Or is it because there was a different set of policies around seatbelt use adopted in the late 1970s that has had time to work on one population, but not on the other?

Expand full comment
Oct 10, 2023·edited Oct 10, 2023

If seatbelt-wearing is all about laws, why doesn't New Hampshire have the highest car-crash death rate in the country?

Expand full comment

As a NH native, all people under age 18 are required to wear seat belts, so by the time you're an adult you just do it anyway.

Expand full comment

I doubt it's "all" about laws. The majority of people realize seatbelt wearing reduces their odds of death-by-car.

I think it's about *marginal* cases: those who are too lazy/find it uncomfortable or are uninformed as to the statistics. Some of them will wear a seatbelt to avoid getting fined.

Expand full comment

How much effort? A lot, that's how we who smugly think we're smarter actually got here. It may seem to you self evident that folks should wear seat belts, and yet for decades seat belts sat in cars unbuckled amongst both the smartest and the dumbest. It took big pushes and coercive measures to get to the point where you have probably never not worn a seat belt, but your parents and certainly grandparents went years without wearing one. The forces and inclinations that made your grandparents too stupid to wear a seatbelt don't go away. So we, as a society, need to always continue the efforts to overcome them, it may not be as extensive a fight over time, but there's no reason to think that if we stopped now your grandkids might not bother to buckle up.

Expand full comment

How are seat belt laws even being enforced these days anyway? Checkpoints devoted solely to that are inefficient. Tacking it on after pulling over for an unrelated moving violation could work, but it's not the main goal. I'm sure someone will mention traffic cameras, but my gut instinct is to shudder there, warranted or not.

Expand full comment

It's the middle option for adults. You won't be pulled over for driving without a seat belt, but if you're pulled over for speeding and aren't wearing one it's an extra fine. If a minor isn't wearing a seat belt in your car, that might be enough for you to get pulled over on its own

Expand full comment

The middle option can also be dismantled by quickly putting your seat belt on before the cop gets to your car. The question is how many non-seat belt wearers will have the wherewithal to do that.

Expand full comment

what did i say that is untrue?

Expand full comment

I mean, you ignore social mobility statistics completely, for one... the bottom tenth of the income distribution is mostly very, very transient.

A lot, if not an outright majority, of the bottom half of the income distribution and more than a few folks up to the 80th percentile will find themselves at the very bottom of the heap for a year or two of their lives, and the middle-class folks are likely among the hardest hit emotionally when they do.

Expand full comment
Oct 10, 2023·edited Oct 10, 2023

I think you're mostly right, but I feel like I'm kinda gonna split the difference. Social mobility is very specifically the reason not to excessively counteract the disincentives of poor decision making. Overinvesting in programs that insulate individuals from the consequences of their choices is subsidizing bad choices regardless of the psuedo-evolutionary woo in the initial take. Incentives are more important than who does or doesn't deserve a particular outcome whatever the basis on which you choose to define "deserving".

Expand full comment
Oct 10, 2023·edited Oct 10, 2023

Ehh, in the abstract I agree, but that is very far away from what we actually do to soften the realities of life for the poor. We are in no danger of providing the bottom decile with a "free" standard of living that disincentivizes folks from getting back out of it, as evidenced by the very social mobility statistics we're discussing!

EDIT: You also have to recall that you're not splitting the difference at all. David is likely *more* in favor than I am of coddling the shit out of the poor. I mostly think that if we had a functioning healthcare system and squeezed the rent-seeking out of that, education, and housing, the current limited social safety net would be more than sufficient to protect people from horrible outcomes due to uncontrollable factors. The rest of our efforts should be on improving primary and secondary education and the social services which help kids escape their parents' fuckups.

Expand full comment
Oct 10, 2023·edited Oct 10, 2023

Responding to the Edit:

I think you're right. A closer reading of Abbott has a little more of a noblesse oblige thing going on than I caught on first pass.

Expand full comment

How do you square the "we are in no danger" claim with the data presented at https://johnhcochrane.blogspot.com/2022/12/calomiris-on-gramm-ekelund-and-early-on.html ?

There is difference in that the graphs there use quintiles, not deciles, so perhaps your claim is that post-tax-and-transfer the bottom decile is a lot worse off than the second decile? That's possible, but would imply that the second decile is a lot better off than the next 4 deciles' average....

My read of the data is that the US successfully implements social transfers that keep actual "money you end up spending on things or having spent on things for you" about flat for the bottom 60% of American households.

Now some of that "money spent on things for you" might not be spent the way you would spend it yourself, so it's very possible that the bottom 10% ends up with less disposable income in practice than people in the second quintile. That would require a bit more analysis. But that's a subtle point that would need measurement, not an obvious "no danger" slam-dunk.

Expand full comment

Right. I think the two actual dominant strains of thinking about poverty in the US are:

1. Paternalistically imposing "better" choices on individuals than they would make for themselves.

2. Zero sum bullshit about redistributive taxation.

both of which I consider hot garbage, but others mileage will vary.

Expand full comment

I said least talented tenth, not lowest income tenth

Expand full comment

Then why are they the ones who starve to death amidst grain shortages, or poison themselves in poverty?

Expand full comment

there’s a lot of overlap! however, there may be some high functioning neo pastroralisr types or (dare I say) higher education students who are in the bottom tenth of the income but are quite talented.

there are plenty of old people who are in

the top half of the income distribution but whose talents have withered into oblivion. anyone in a hospice or nursing home is, almost tautologically, in the bottom tenth of the present talent distribution. ditto babies and toddlers. of course there’s also average talent over a lifetime. the world is complicated!

Expand full comment

My brother in law was not only a fantastic human being but also a very successful and smart businessman who owned a company that large commercial construction projects.

He was a drinker like his Dad and he slowly descended into alcoholism. When the economy took a downward turn his business ran into some trouble and his drinking increased. Within about a year, the business was dead and he was drunk all the time. He kept descending, became homeless when his wife kicked him out and the rest of the family couldn’t handle him and his behavior anymore. He drifted between homelessness, various treatment programs and family. He was, by this point, physically addicted. And the story ends with his death in his mid-50’s.

He was in the top 10-15 percent until he wasn’t anymore, and his final years he was in that bottom 10 percent.

I’m not sure how to categorize him in the various schemas, but it makes me think that many in that bottom 10% are addicts or have mental health, or other issues. When he was homeless, all the people he hung out with were addicts or not right in the head.

Expand full comment

You say this because you can’t say “you’re wrong” and you know it.

Expand full comment

No I said this because being wrong (which the comment of course is) is a regular occasion here on the Internet but being a horrible person is slightly less so.

Expand full comment

It’s very social Darwinian.

Expand full comment

I think he is perhaps my teenage son - writing things just to get a rise out of me.

Expand full comment