STARTING around the turn of the millennium, the United States experienced the most alarming change in mortality rates since the AIDS epidemic. This shift was caused, not by some dreadful new disease, but by drugs and alcohol and suicide — and it was concentrated among less-educated, late-middle-aged whites.
We had hints that something like this was happening. We knew suicide was increasing among the middle-aged, that white women without a high school degree were struggling with health issues, that opiate addiction was a plague in working-class communities. But we didn’t know it was all bad enough to send white death rates modestly upward in the richest nation in the world.
Now we know, thanks to a new paper from the Nobel laureate Angus Deaton and his wife, Anne Case. And their findings, inevitably, are the latest ideological Rorschach test in the debate over how to save the American working class.
To many conservatives, the mortality rate shock is the latest indictment of modern liberalism’s mix of moral permissiveness and welfare-state paternalism: The first undercuts the rootedness, discipline and purpose that marriage and religion once supplied, and the latter eases people into a life of dependence and disability payments that only encourages drug abuse and suicidal thoughts.
Continue reading the main story

Sign Up for the Opinion Today Newsletter

Every weekday, get thought-provoking commentary from Op-Ed columnists, The Times editorial board and contributing writers from around the world.
But if the problem is social liberalism and the welfare state, progressives object, then why is the working class death rate only rising starkly in the United States? In the more secular and socialist territory of the European Union, Deaton and Case are at pains to note, white mortality rates have continued to decline.
This buttresses the longstanding liberal argument that the American working class has fallen victim, not to dependency and libertinism, but to a punishing economic climate — stagnant wages, a fraying safety net, and Republican economic policies that redistribute wealth upward. Hence the European contrast: If we had the same institutions as France and Germany, our working class might still be struggling, but at least it would be protected from immiseration and despair.
Yet here, too, Deaton and Case’s data is somewhat confounding, because if economic stress were all, you would expect the mortality crisis to manifest itself more sharply among black and Hispanic Americans — who have consistently higher unemployment rates than their white neighbors, and lag whites in wealth by far.
But in fact the mortality rate for minorities in the U.S. continued to fall between 1999 and 2013, mirroring the trend in Europe, and the African-American death rate in particular fell hugely. Amid the stresses of the dot-com bust and the Great Recession, it was only white Americans who turned increasingly to drugs, liquor and quietus.
Why only them? One possible solution is suggested by a paper from 2012, whose co-authors include Andrew Cherlin and Brad Wilcox, leading left and right-leaning scholars, respectively, of marriage and family.
Noting that religious practice has fallen faster recently among less-educated whites than among less-educated blacks and Hispanics, their paper argues that white social institutions, blue-collar as well as white-collar, have long reflected a “bourgeois moral logic” that binds employment, churchgoing, the nuclear family and upward mobility.
But in an era of stagnating wages, family breakdown, and social dislocation, this logic no longer seems to make as much sense. The result is a mounting feeling of what the American Conservative’s Rod Dreher calls white “dispossession” — a sense of promises broken, a feeling that what you were supposed to have has been denied to you. (The Donald Trump phenomenon, Dreher notes, feeds off precisely this anxiety.)
For obvious historical reasons, though, Hispanic and (especially) black communities have cultivated a different set of expectations, a different model of community and family (more extended and matriarchal), a different view of success and the American story writ large.
These distinctives come with their own set of problems, particularly where family structure and fatherhood are concerned. But they may create a kind of resilience, a capacity for dealing with stagnation and disappointment (and elite indifference or hostility), which many working-class white Americans did not necessarily expect to ever need.
If this possibility has policy implications, it suggests that liberals are right to emphasize the economic component to the working class’s crisis. But it cautions against the idea that transfer payments can substitute for the sense of meaning and purpose that blue-collar white Americans derived from the nexus of work, faith and family until very recently.
Maybe sustained growth, full employment and a welfare state that’s friendlier to work and family can help revive that nexus. Or maybe working-class white America needs to adapt culturally, in various ways, to this era of relative stagnation, and learn from the resilience of communities that are used to struggling in the shadow of elite neglect.
Or maybe it will take a little bit of both, more money and new paths to resilience alike, to make some of the unhappiest white lives feel like they matter once again.