When a social affliction affects only the poor or people of color, it tends to be either ignored or treated cursorily. But as soon as the same affliction hits white people, it suddenly becomes worthy of study by social scientists and lead to calls for finding solutions. We saw this with the drug epidemic. As long as the problem of drug abuse was seen as mainly in the black community in the form of marijuana or crack cocaine, the reaction was harsh policing and punitive jail sentences, leading to the massive overcrowding of prisons and the ruination of lives and families, not to mention the numerous killings of black men by police where the initial interaction was caused by the police stopping and searching them for drugs. But when the opioid epidemic hit that largely affected white people, we have seen more humane approaches being taken, with an understanding that drug use is more a health problem than a criminal problem.

A similar issue is the recent rise in suicides among white people that have led to an actual decrease in the life expectancy of Americans. Roberto R. Apsholm reviews a recent book Deaths of Despair and the Future of Capitalism by a very well-known academic couple Anne Case and Angus Deaton that seeks to explain the recent increase in mortality in the white community.

Apsholm’s review is a very detailed critique that I would strongly urge people to read. The excerpts I give here are meant to highlight the main lines of his argument and by no means do it justice.

Deaths of Despair and the Future of Capitalism explores in great detail some variation of this last question, sans the implied pathology. Specifically, the book details and attempts to make sense of the remarkable increase in mortality among middle-aged white Americans without a bachelor’s degree over the last two decades or so, a period that has seen around 600,000 more middle-aged whites die than would have been expected based on both historical domestic trends and prevailing global patterns. That is nearly as many people as the total number of Americans who have died from HIV/AIDS in the roughly four decades since the onset of that epidemic in the early 1980s.

In fact, the increase in white middle-age mortality has been so pronounced in recent years that life expectancy among all Americans actually decreased between 2013 and 2017 (the last year of data included in the book). Outside of major wars and pandemic disease outbreaks, such a reversal in life expectancy has no precedent in recorded history.
…

In the most immediate sense, the increase in mortality among middle-aged whites is almost entirely attributable to three closely related causes: drug overdoses, suicides, and cirrhosis and other alcoholic liver diseases.
…

Drug overdoses, primarily from opioids, represent both the largest and fastest-growing category of such deaths. Though white middle-aged men are nearly twice as likely as their female counterparts to die from these various causes, the upward trajectories of both genders mirror one another. “These kinds of death are all self-inflicted,” Case and Deaton point out. “All the deaths show great unhappiness with life, either momentary or prolonged.” This reality brought the authors to discuss these phenomena collectively as “deaths of despair.”

Apsholm says that Case and Deaton avoid a popular line of reasoning in the liberal media of pathologizing the white working classes who are most affected and tended to vote for Trump as “inherently and irredeemably poor, dumb, angry, bigoted, and self-destructive”, and instead describe well the deteriorating living conditions of this group that have led to this state.

The story that they tell about these external forces is, by now, a largely familiar one: millions of good-paying, low-skilled, unionized jobs liquidated by a combination of automation, intensifying global competition, and offshoring; increasing numbers of working-age adults who have dropped out of the workforce entirely; a shift toward increasingly precarious, meaningless, and poorly paid jobs for those who are still working; a steady decline in real wages for large segments of workers; and an ever-greater share of national income and wealth being swallowed by capital. These shifts have had disastrous effects on people’s individual and familial finances. But they have also destroyed once-thriving communities and towns wholesale, as plants and mines closed, the esteem and meaning derived from dignified work disappeared, familial bonds strained and unraveled, and social institutions collapsed.

Apsholm says that similar forces have long been in play but were not much commented on because the people affected were different.

On this note, the authors productively link these trends with the similar implosion of working-class Black urban communities beginning in the 1960s. In fact, much of the industry that has recently disappeared from smaller, predominantly white towns and cities throughout the country initially emerged during the postwar era as manufacturers abandoned central cities for the suburbs and hinterlands in search of cheap land, low taxes, lax regulations, and a more pliable workforce.

His main criticism is that the authors, who are establishment academics, after carefully laying out the problem in the first two-thirds of the book, in the last third where they offer solutions, seem to carefully dance around what should be obvious from their own analysis, that what we are seeing is an indictment of capitalism itself. As a result their proposed solutions become the familiar list of liberal bromides.

The authors open and close Deaths of Despair by proclaiming their allegiance to capitalism, a commitment they reaffirm periodically throughout the book. Certainly, they are entitled to their beliefs. The problem is that those beliefs have seemingly left them without the capacity to adequately and honestly assess the forces that have caused the deaths of despair epidemic or to propose anything approximating an adequate raft of solutions. Rather, by propping up abstractions like “rent-seeking” and “unfairness” as scapegoats, Case and Deaton enable themselves to frame a “better monitored and regulated” capitalism as the solution. (As the foregoing discussion indicates, they are rather light on the specifics of what that would actually entail.)

Nonetheless, we should be clear that the gutting of the white working class, as with the Black working class before that, is directly attributable to the basic workings of capitalism—technological development, global trade, free markets, profit maximization—and not to the scapegoats that Case and Deaton invoke.

Apsholm says that the Democratic party shares much of the blame for the diversion of focus away from the basic problem created by capitalism.


[T]he fact is the Democratic Party left working people of color behind decades ago—at the same time that it left white workers behind.. After all, the decline of industrial employment, the gutting of organized labor, the shift to monetary policies designed to promote unemployment and suppress wages, the passage of worker-crushing trade policies, the hollowing out of the U.S. welfare state, and the rise of the carceral state—that is, the forces that have destroyed working-class life for Black people, whites, and everyone else in the United States over the last half century—have been decidedly bipartisan political projects.

The Democratic Party’s engagement with African Americans, Latinos, and other people of color in recent decades, then, has been a largely identitarian affair, rooted in appeals to racial and ethnic identities, as opposed to class position or material interests. Indeed, as historian Touré Reed notes, the former are often treated as proxies for the latter, with “racial justice”—in the form of symbolic representation and proportional inequality—being divorced from and substituted for broader agendas aimed at transforming the political economy for working people. When the alternative is an openly chauvinistic GOP, the potential appeal of this limited brand of politics to many voters is readily apparent. But that should not preclude a sober, critical assessment of its substantive and strategic shortcomings: If what the Democrats have offered Black people and other constituents of color are symbolic representation and a commitment to basic nondiscrimination, and, simultaneously, an intensification of inequality and precarity for working people of all identities, what have they had to offer working-class whites, who are in need of neither symbolic representation nor nondiscrimination?

He says that with a change in perspective in the last third of the book, it could be more accurately called Deaths of Despair and the Failure of Capitalism.