Deaths of Despair and the Future of Capitalism

by Anne Case, Angus Deaton

Overview

A New York Times Bestseller
A Wall Street Journal Bestseller
A New York Times Notable Book of 2020
A New York Times Book Review Editors’ Choice
Shortlisted for the Financial Times and McKinsey Business Book of the Year
A New Statesman Book to Read

From economist Anne Case and Nobel Prize winner Angus Deaton, a groundbreaking account of how the flaws in capitalism are fatal for America's working class

Deaths of despair from suicide, drug overdose, and alcoholism are rising dramatically in the United States, claiming hundreds of thousands of American lives. Anne Case and Angus Deaton explain the overwhelming surge in these deaths and shed light on the social and economic forces that are making life harder for the working class. As the college educated become healthier and wealthier, adults without a degree are literally dying from pain and despair. Case and Deaton tie the crisis to the weakening position of labor, the growing power of corporations, and a rapacious health-care sector that redistributes working-class wages into the pockets of the wealthy. This critically important book paints a troubling portrait of the American dream in decline, and provides solutions that can rein in capitalism's excesses and make it work for everyone.

Product Details

ISBN-13:	9780691217062
Publisher:	Princeton University Press
Publication date:	03/02/2021
Sold by:	Barnes & Noble
Format:	eBook
Pages:	336
Sales rank:	316,636
File size:	2 MB

About the Author

Anne Case is the Alexander Stewart 1886 Professor of Economics and Public Affairs Emeritus at Princeton University. Angus Deaton, winner of the 2015 Nobel Prize in economics, is the Dwight D. Eisenhower Professor of Economics and International Affairs Emeritus at Princeton University and Presidential Professor of Economics at the University of Southern California.

Table of Contents

Preface to the Paperback ix

Preface xv

Introduction Death in the Afternoon 1

Part I Past As Prologue 17

1 The Calm before the Storm 19

2 Things Come Apart 28

3 Deaths of Despair 37

Part II The Anatomy Of The Battlefield 47

4 The Lives and Deaths of the More (and Less) Educated 49

5 Black and White Deaths 62

6 The Health of the Living 71

7 The Misery and Mystery of Pain 83

8 Suicide, Drugs, and Alcohol 94

9 Opioids 109

Part III What's The Economy Got To Do With It? 131

10 False Trails: Poverty, Income, and the Great Recession 133

11 Growing Apart at Work 148

12 Widening Gaps at Home 167

Part IV Why Is Capitalism Failing So Many? 185

13 How American Healthcare Is Undermining Lives 191

14 Capitalism, Immigrants, Robots, and China 212

15 Firms, Consumers, and Workers 226

16 What to Do? 245

Acknowledgments 263

Notes 265

Index 293

What People are Saying About This

From the Publisher

"This book will be an instant classic, applying high quality social science to an urgent national matter of life and death. In exploring the recent epidemic of 'deaths of despair,' the distinguished authors uncover an absorbing historical story that raises basic questions about the future of capitalism. It is hard to imagine a timelier—or in the end, more hopeful—book in this season of our national despair."—Robert D. Putnam, author of Bowling Alone and Our Kids

"In the face of a government that failed to protect ordinary working-class Americans from the greed-fueled opioid epidemic and a media that was slow to notice the problem, Anne Case and Angus Deaton are true sentinels. Deaths of Despair and the Future of Capitalism is an urgent and clarion call to rethink pain, inequality, justice, and the business of being human in America. This book explains America to itself. I underlined damn near every sentence."—Beth Macy, author of Dopesick: Dealers, Doctors, and the Drug Company That Addicted America

"In this superb book, Case and Deaton connect the dots to explain the dramatic rise of deaths of despair among working-class white Americans. Totally unexpectedly, they trace the root cause to an exorbitantly expensive health-care system that sucks—and wastes—billions of dollars and so much human talent away from improving lives."—Ezekiel J. Emanuel, University of Pennsylvania

"With stunning data analysis, close observation, and smoldering urgency, Case and Deaton show why mounting deaths of despair are not only a public health disaster but also an indictment of the metastasizing stratification that is undermining working-class America."—David Autor, Massachusetts Institute of Technology

"This book explains so many of today's headlines with clear writing, sharp storytelling, and an almost symphonic use of research in economics, public health, and history. What it summons is a powerful analysis of who we are as Americans and what we have become as a country."—Sam Quinones, author of Dreamland: The True Tale of America's Opiate Epidemic

"America is experiencing a catastrophe. Those without a college degree are not just being left behind; they are dying from deaths of despair. Case and Deaton brilliantly describe and dissect the causes and explain how we can return to a path of rising prosperity and health. All citizens—voters as well as politicians aspiring to office—should read and discuss this book."—Mervyn King, former governor of the Bank of England

"Deaths of despair among US whites with low education cannot be attributed to lack of access to health care or ignorance of healthy lifestyles. When two leading economists turn their attention to the social determinants of this modern epidemic, the result is brilliant."—Sir Michael G. Marmot, author of The Health Gap

Editorial Reviews

…a big-picture complement to Nicholas D. Kristof and Sheryl WuDunn's tragic close-up in Tightrope: Americans Reaching for Hope. Case and Deaton's book is not so much a page-turner as a page-muller. It is a highly important book…The prose in Deaths of Despair and the Future of Capitalism is clear, the style is discursive and the spirit reflects the boundless curiosity that led the two economists to sociology…

The New York Times Book Review - Arlie Russell Hochschild

04/20/2020

Husband and wife economists Case and Deaton (The Great Escape) analyze the factors contributing to rising death rates among white, working-class Americans in this grim yet galvanizing account. Attributing much of the overall increase to suicides, drug overdoses, and alcoholic liver disease, Case and Deaton show that 158,000 people succumbed to such “deaths of despair” in 2017 (“the equivalent of three full 737s falling out of the sky every day, with no survivors”). They also note that the mortality rate among white men aged 45–54 without a bachelor’s degree has increased 25% since the early 1990s, while decreasing 40% for those with a college diploma. Looking behind the numbers, Case and Deaton examine how solid, blue-collar jobs that could support a stable family life have been replaced by low-paying service industry jobs, contributing to wage stagnation; the role of the pharmaceutical industry in the opioid epidemic; and deficiencies in American health care (“a disgrace”). In a brisk final chapter, they outline possible reforms, including universal health care, wage subsidies, the loosening of patent protections to buoy business innovation and competition, and German-style apprenticeship programs as a college alternative. Complementing their candid prose with enlightening charts and graphs, Case and Deaton make the scale and immediacy of the problem crystal clear. This is an essential portrait of America in crisis. (Mar.)

Publishers Weekly

"Excellent."

Joyce Carol Oates on Twitter

"Why economics really matters is illustrated in Deaths of Despair and the Future of Capitalism. . . . The authors argue that the capitalism that lifted countless people out of poverty is now destroying blue-collar America. They have solutions to make it work for all. They had better be right."

New Scientist

"Gripping. . . . [Case and Deaton] do not merely rehearse decades of mortality and wage statistics. Rather, they seek to catalogue how an entire way of life first frayed and then fell apart over the past half-century, and the cruelty of an American meritocracy that heaps lavish rewards on the winners while increasingly leaving others to rot."—-Joshua Chaffin, Financial Times

"A remarkable new book."—-John Harris, The Guardian

"Disturbing. . . . . Case and Deaton do a great job making the case that something has gone grievously wrong."—-Jim Zarroli, NPR

"I highly, highly recommend it."—-Cardiff Garcia, NPR Planet Money’s The Indicator

"[A] remarkable and poignant book."—-Dani Rodrik, Project Syndicate

"The system is broken and every bit of it needs fixing. This is a sobering – and essential – book."—-Diane Coyle, Enlightened Economist

From the Publisher

"This highly important book examines the pain and despair among white blue-collar workers and suggests that the hopelessness they are experiencing may eventually extend to the entire American work force."

New York Times Editors’ Choice

"This highly important book examines the pain and despair among white blue-collar workers and suggests that the hopelessness they are experiencing may eventually extend to the entire American work force."

New York Times Editors’ Choice

"Why economics really matters is illustrated in Deaths of Despair and the Future of Capitalism. . . . The authors argue that the capitalism that lifted countless people out of poverty is now destroying blue-collar America. They have solutions to make it work for all. They had better be right."

New Scientist

★ 2020-04-05
Noted Princeton economists Case and Deaton, a winner of the Nobel Prize, examine the effects of income and educational inequality on public health.

As Beth Macy’s Dopesickcarefully chronicled, there is a disease afoot in the land, born of economic anxiety, manifested in addiction and self-destruction. Building on a Brookings Institution paper of 2017, Case and Deaton give a name to this epidemic. In 1900, they write, the leading causes of death were infectious diseases such as tuberculosis and cholera. Writing before the unexpected onset of COVID-19, the authors mark the current leading causes as heart disease and cancer. However, especially among the poor and those without a four-year college degree, “the risk of dying in midlife from suicide, accidental drug overdose, or alcoholic liver disease” is markedly higher than in better-educated and more affluent cohorts. Thus the “deaths of despair” of the title, self-inflicted and generationally bound—for, as the authors note with grimly precise data, the chance of such a person’s dying at age 45 in 1960 were half again as high as in 1950, and in 1970 more than twice as high as in 1960. “The later you were born,” they conclude, “the higher your risk of dying a death of despair at any given age.” The epidemic of deaths of young people today to gunshot, cirrhosis, fentanyl and opioid overdosing, and such causes is sober testimonial to the authors’ mathematical reasoning. Non–college educated whites born in 1980, the authors write, are four times more likely to commit suicide as their college-educated white cohorts. Interestingly, the epidemic is not affecting other ethnicities in nearly the same numbers. What has affected nearly every group, however, is another manifestation of despair: obesity, which yields pain and often self-medication, especially among “those who are not at the top.”

An alarm every bit as urgent as The Jungle and a book that demands immediate attention.

Kirkus Reviews