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.
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?
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?
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.
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).
Toward the end of the original weeds lineup you guys did an episode on the decline on life expectancy. In that episode Ezra basically made the point that if this were really about "despair" people in Portugal (a country that essentially experienced an 8 year long recession) would be dropping like flies.
Ezra at some point (either in this episode or another one) proposed basically taking every single public health related policy idea and stacking them all on top of each other to see which ones would save lives the most efficiently.
I think these ideas were sort of aligned with the public health establishment's line of thinking at the time... basically we should try to do whatever it takes to save lives. At some point though it has become anathema within the Democratic party to concede that nanny state policies are super effective, which is why the prevailing public health narrative is a story about economics written by economists.
I'm a bit more critical of the Washington Post article by Weber, et. al - Ashtabula County, OH is not that similar to Erie County, PA. The latter is naturally home to Erie Pa which apparently has 95k people. In the grand scheme of things being the biggest city between cleveland and buffalo isn't a big deal, but it makes a lot of difference in terms of what jobs exist as well as the size and quality of the hospital systems. Presumably a lot of people in Ashtabula work in Erie (or maybe Cleveland, idk), which leads to increased travel times - the census bureau estimates the mean travel time to work as being 25.8 minutes in Ashtabula and 19.9 in Erie. Traffic death statistics don't mean that much if you don't adjust for miles driven. Erie county is also somewhat richer as well though the poverty rate is similar.
Maybe that's a nitpick, and it doesn't make the conclusion wrong, there's just a lot of confirmation bias in what gets put out and then in what gets criticized. The Case & Deaton article was popular because it felt right to people, this article is good for those that support public health regulation and good for the Washington Post because it's framed in a pro-Democrat way. Is everything else not just working backwards?
Great article. One correction: There was not a “post-Floyd depolicing.” And certainly not one that remotely explains the widespread, nationwide, bipartisan-city increase in the murder rate.
I think the trends in suicide rates need to be addressed on their own, although Matt does an admirable job of covering the other key categories.
A few years ago I saw a couple of newspaper articles that were striking enough to make me write a Facebook post about them, otherwise I doubt I'd remember. The US suicide rate hit a 30-year high just as the UK suicide rate hit a 30-year low. (One of these statistics was for men only and the other was for both sexes, but I forget which.)
My random, non-evidence-based conclusion was that it probably had something to do with the existence of universal health coverage (or not) and welfare state protections more broadly. Working-class Americans and working-class Europeans may both be angry about inequality, demographic change and various other common trends and they may both vote for far-right politicians in response, but it seems to be only in America that they decide to kill themselves.
(It also occurs to me that low-skilled, nonwhite immigration might have a stronger effect on the self-esteem of low-skilled white people in America than in Europe, because there's more of it. But this is my permanent hobbyhorse, so take it with a grain of salt.)
Anyhow what I wrote back then may be wrong but unless there's a freestanding explanation for the divergence in suicide rates, I don't think the "despair" hypothesis has been refuted.
I'll stress that I'm indifferent to changes in suicide rates (I think it's people's own business whether they kill themselves or not), but one thing I can't help but notice is that people who do express concern about increasing suicide rates, at least from a "left" perspective, all but completely ignore that, historically, suicide was severely stigmatized in Western cultures, both religiously and civilly, going back even to the pre-Christian era. Given that all forms of stigma around suicide have been substantially reduced, either directly (e.g., repeal of property forfeiture laws for suicide victims) or indirectly (e.g., general decline in religiosity), over the past century or so, how clear is it that we're genuinely seeing an increase in suicidality versus finding the "natural rate" of suicides in the absence of stigmatization?
Shorter version TL;DR: whites are dying of despair in America because guns, drugs are too available and seatbelt laws are too relaxed, but they are *living* with despair in Europe where it's harder to kill yourself by accident or on purpose either quickly or slowly.
Ergo there's nothing wrong with US neoliberalism that more euro style paternalism wouldn't cure.
Me: But shouldn't we be asking why Western society produces so much despair in the first place and despair seems to be getting worse? Or is the neoliberal technocratic response mainly concerned with making the mortality stats better?
I sure would love a deeper dive into opioid policy, a subject I occasionally write about and ask Matt about. I grew up in one of the harder-hit areas, so the explosion of what was a local issue to me when I was a teen into a national gigantic clusterfuck has been wild to watch.
The last time I asked about this, a reasonable-sounding commentator made the case to me that the FDA didn't do anything wildly wrong- that opioids were already legal to prescribe, that the FDA can't do anything in real time about Purdue marketing, and that pharma companies are incentivized to push the envelope on their marketing before their patent runs out. I dunno, is this all true? Government policy was a non-factor in opioid deaths? The FDA is too strict about some things (as we saw during the Covid era) and helplessly hands-off on others?
And then you get the inevitable 'the deaths are all fentanyl, it's because there's a black market, just legalize drugs' crowd who will inevitably show up. Every time I point out that half or more of total opioid deaths were from *legally prescribed ones*, but that doesn't seem to make a dent with this crowd. After all, they have black markets for drugs in Europe too, but way less opioid deaths!
This articles contains a lot that is informative and good, but sentence like this “ People without a BA are a smaller, more negatively selected group than they used to be — a group increasingly composed of low-conscientiousness people.” Smacks of the worst kind of victim blaming and a lack of empathy that frankly raises the question regarding Matt’s on conscientiousness in his writing.
Ohh yes, this is that hot fire that I subscribe for.
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.
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?
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.
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?
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.
“Social ‘scientists’ are mostly charlatans, story at 5.”
Not sure this is news…
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).
Toward the end of the original weeds lineup you guys did an episode on the decline on life expectancy. In that episode Ezra basically made the point that if this were really about "despair" people in Portugal (a country that essentially experienced an 8 year long recession) would be dropping like flies.
Ezra at some point (either in this episode or another one) proposed basically taking every single public health related policy idea and stacking them all on top of each other to see which ones would save lives the most efficiently.
I think these ideas were sort of aligned with the public health establishment's line of thinking at the time... basically we should try to do whatever it takes to save lives. At some point though it has become anathema within the Democratic party to concede that nanny state policies are super effective, which is why the prevailing public health narrative is a story about economics written by economists.
I'm a bit more critical of the Washington Post article by Weber, et. al - Ashtabula County, OH is not that similar to Erie County, PA. The latter is naturally home to Erie Pa which apparently has 95k people. In the grand scheme of things being the biggest city between cleveland and buffalo isn't a big deal, but it makes a lot of difference in terms of what jobs exist as well as the size and quality of the hospital systems. Presumably a lot of people in Ashtabula work in Erie (or maybe Cleveland, idk), which leads to increased travel times - the census bureau estimates the mean travel time to work as being 25.8 minutes in Ashtabula and 19.9 in Erie. Traffic death statistics don't mean that much if you don't adjust for miles driven. Erie county is also somewhat richer as well though the poverty rate is similar.
Maybe that's a nitpick, and it doesn't make the conclusion wrong, there's just a lot of confirmation bias in what gets put out and then in what gets criticized. The Case & Deaton article was popular because it felt right to people, this article is good for those that support public health regulation and good for the Washington Post because it's framed in a pro-Democrat way. Is everything else not just working backwards?
Great article. One correction: There was not a “post-Floyd depolicing.” And certainly not one that remotely explains the widespread, nationwide, bipartisan-city increase in the murder rate.
I think the trends in suicide rates need to be addressed on their own, although Matt does an admirable job of covering the other key categories.
A few years ago I saw a couple of newspaper articles that were striking enough to make me write a Facebook post about them, otherwise I doubt I'd remember. The US suicide rate hit a 30-year high just as the UK suicide rate hit a 30-year low. (One of these statistics was for men only and the other was for both sexes, but I forget which.)
My random, non-evidence-based conclusion was that it probably had something to do with the existence of universal health coverage (or not) and welfare state protections more broadly. Working-class Americans and working-class Europeans may both be angry about inequality, demographic change and various other common trends and they may both vote for far-right politicians in response, but it seems to be only in America that they decide to kill themselves.
(It also occurs to me that low-skilled, nonwhite immigration might have a stronger effect on the self-esteem of low-skilled white people in America than in Europe, because there's more of it. But this is my permanent hobbyhorse, so take it with a grain of salt.)
Anyhow what I wrote back then may be wrong but unless there's a freestanding explanation for the divergence in suicide rates, I don't think the "despair" hypothesis has been refuted.
I'll stress that I'm indifferent to changes in suicide rates (I think it's people's own business whether they kill themselves or not), but one thing I can't help but notice is that people who do express concern about increasing suicide rates, at least from a "left" perspective, all but completely ignore that, historically, suicide was severely stigmatized in Western cultures, both religiously and civilly, going back even to the pre-Christian era. Given that all forms of stigma around suicide have been substantially reduced, either directly (e.g., repeal of property forfeiture laws for suicide victims) or indirectly (e.g., general decline in religiosity), over the past century or so, how clear is it that we're genuinely seeing an increase in suicidality versus finding the "natural rate" of suicides in the absence of stigmatization?
Shorter version TL;DR: whites are dying of despair in America because guns, drugs are too available and seatbelt laws are too relaxed, but they are *living* with despair in Europe where it's harder to kill yourself by accident or on purpose either quickly or slowly.
Ergo there's nothing wrong with US neoliberalism that more euro style paternalism wouldn't cure.
Me: But shouldn't we be asking why Western society produces so much despair in the first place and despair seems to be getting worse? Or is the neoliberal technocratic response mainly concerned with making the mortality stats better?
I sure would love a deeper dive into opioid policy, a subject I occasionally write about and ask Matt about. I grew up in one of the harder-hit areas, so the explosion of what was a local issue to me when I was a teen into a national gigantic clusterfuck has been wild to watch.
The last time I asked about this, a reasonable-sounding commentator made the case to me that the FDA didn't do anything wildly wrong- that opioids were already legal to prescribe, that the FDA can't do anything in real time about Purdue marketing, and that pharma companies are incentivized to push the envelope on their marketing before their patent runs out. I dunno, is this all true? Government policy was a non-factor in opioid deaths? The FDA is too strict about some things (as we saw during the Covid era) and helplessly hands-off on others?
And then you get the inevitable 'the deaths are all fentanyl, it's because there's a black market, just legalize drugs' crowd who will inevitably show up. Every time I point out that half or more of total opioid deaths were from *legally prescribed ones*, but that doesn't seem to make a dent with this crowd. After all, they have black markets for drugs in Europe too, but way less opioid deaths!
This articles contains a lot that is informative and good, but sentence like this “ People without a BA are a smaller, more negatively selected group than they used to be — a group increasingly composed of low-conscientiousness people.” Smacks of the worst kind of victim blaming and a lack of empathy that frankly raises the question regarding Matt’s on conscientiousness in his writing.