In recent months companies at the center of the Opioid Crisis have been fighting in court about the roles they played in the epidemic that has affected millions of Americans. The over prescription of highly addictive drugs has had severe impacts on families, businesses, and the economy. (1) But the Opioid Crisis is only part of a much larger problem facing American Society.
In March of 2017 a landmark study was released connecting opioid abuse, financial insecurity, and death rates in the United States. The information is sobering and should be the focus of policy changes at all levels of government.
A recent study by Princeton Professors Anne Case and Angus Deaton titled, “Mortality and morbidity in the 21st century,” shows the connection between the rising mortality rates of the middle class in the US and “a measurable deterioration in economic and social wellbeing”. (2)
This deterioration has not suddenly developed. Rather, “Case and Deaton document an accumulation of pain, distress, and social dysfunction in the lives of working class whites that took hold as the blue-collar economic heyday of the early 1970s ended, and continued through the 2008 financial crisis and the subsequent slow recovery.”
In their 2021 book, “Deaths of Despair and the Future of Capitalism”, Case and Deaton point to several systemic issues that made this situation uniquely American. The lack of worker support and social safety net in the years following NAFTA created a cohort of workers who were unable to find comparable employment after jobs were shipped offshore. The decline of social institutions like church attendance and marriage led to an increased isolation. Case and Deaton also point out that the privatized healthcare system is poorly constructed to deal with mental health issues millions are suffering from. The medical system also has a built-in weaknesses that led to compensating doctors to overprescribing opioids. (4)
Case and Deaton found that it is mainly white males without a Bachelor’s degree who were the primary victims of the maelstrom these conditions created.
“Case and Deaton find that while midlife mortality rates continue to fall among all education classes in most of the rich world, middle-aged non-Hispanic whites in the U.S. with a high school diploma or less have experienced increasing midlife mortality since the late 1990s. This is due to both rises in the number of “deaths of despair”—death by drugs, alcohol and suicide—and to a slowdown in progress against mortality from heart disease and cancer, the two largest killers in middle age.”
To understand the scale of the change that is taking place… “The combined effect means that mortality rates of whites with no more than a high school degree, which were around 30 percent lower than mortality rates of blacks in 1999, grew to be 30 percent higher than blacks by 2015.”
As the economic situation continues to deteriorate for the middle class (just as it has for blacks in urban centers) in the United States, issues of alcohol, drug use and suicide worsen. Lack of education to keep up with a changing economy, lack of high paying jobs for physical labor, widening wealth and opportunity gap. And the situation does not improve for the next generation.
“Several studies have estimated how the resulting lost productivity due to opioid misuse translates to costs (for businesses), typically focusing on 5 main categories: unemployment/underemployment, absenteeism, presenteeism, incarceration, and premature mortality.” The studies found the financial impact of up to $430 billion. (3)
The authors suggest, “that the increases in “deaths of despair” are accompanied by a measurable deterioration in economic and social wellbeing, which has become more pronounced for each successive generation. Marriage rates and labor force participation rates fall between successive birth cohorts, while reports of physical pain, and poor mental health rise.” This becomes a long-term problem which cannot be overcome by simplistic policy prescriptions.
Declining marriage rates mean less stable households; falling labor force participation means less income and greater economic peril. Both of these, weaken the next generation of children. A declining sense of community and connection lead to a sense of isolation and depression… This leads to an increased use of drugs and alcohol.
What is required is an understanding and appreciation for the changes taking place in the economy and the need for schools empower students for this new age, regardless of their background or skills. The educational system of the 20th century will not suffice in an era of rapid technological change. Education needs to be promoted as a lifelong responsibility. Business needs to participate in this effort as well, not only for the sake of their own profitability, but also for the stability of the society they operate in… it is a stakeholder’s responsibility.
We also need to develop and fund the social services that children and families need in order for them to escape the forces that drag them into despair. PTSD and abuse in families is a widespread problem as evidenced by the controversy surrounding #metoo on Facebook. Millions have spoken up about abuse that they have suffered from but were long silent about because of societal pressures.
Someone once said, “It takes a village to raise a child.”
We all need to be invested in the success, safety and happiness of those around us. Do not leave things to chance. Teach and learn needed skills. Develop multiple ways to bring in income. Leverage what you know and what you can do. Protect your family from economic disaster using Life Insurance and Disability Insurance… they will thank you. Set money aside for the future… your future self will thank you. Develop a plan, and then learn to adjust as life changes things up on you.
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- Deaths of Despair and the Future of Capitalism, 2021, Anne Case and Angus Deaton