Book Review: ‘Deaths of Despair and the Future of Capitalism’ by Anne Case and Angus Deaton

We all are aware of how the economic conditions in this country have changed over the last 30-40 years. Where once assembly line manufacturing was the main driver of the GDP here in the US now it’s high-tech engineering, microchips and software, industries that require far fewer employees but those with greater education. These changes in the economy have brought with them demographic changes as millions of high school graduates lost well paying jobs with benefits while people with a college degree were in ever greater demand, and therefore saw at least a modest increase in their income and wealth.

I could have picked any of a hundred different graphs all saying the same thing. The higher the education a person attains the higher the average salary they will earn throughout their lives! (Credit: Fox Business)

One unexpected outcome of these economic changes is the effect on the overall health of the American people caused by a massive growth in ‘Deaths of Despair’ that is drug overdoses, suicide and alcoholism. ‘Deaths of Despair and the Future of Capitalism’ by Anne Case and Angus Deaton examines the increase in drug overdoses, suicide and alcoholism from both an economic and sociological perspective, both authors are retired professors of economics at Princeton University and Professor Deaton was awarded the Nobel Prize in Economics in 2016.

While the difference in salary between College graduates and High School graduates may be understandable the difference in Life Expectancy is harder to grasp. That’s the thesis of ‘Deaths of Despair’ by Anne Case and Angus Deaton. (Credit: World Socialist Web Site)

‘Deaths of Despair’ begins by demonstrating just how large a problem drug overdoses, suicides and alcoholism have become. In fact these social diseases were actually causing a decline in the average life expectancy of Americans before the Covid-19 pandemic. The book then goes on the show how these ‘Deaths of Despair’ reside almost exclusively in the white male population without a college degree, exactly the part of the population that has seen the most economic turmoil in the last 40 years. That turmoil being the driving force behind the despair a large part of our population now feels.

Cover art for ‘Deaths of Despair and the Future of Capitalism’ by Anne Case (l) and Angus Deaton (r). (Credit: YouTube)

The central portion of the book is a detailed examination of how the economy has changed over the last 40 years and why damage generated by those changes seem to have almost targeted white males with only a high school education or less. In addition to the lost of income in going from a well paid factory job with benefits to a low paid service job with few benefits ‘Deaths of Despair’ also considers such factors as the loss of pride and community that accompanied the switch from buildings cars at General Motors to flipping burgers at McDonald’s. At the same time social changes of the last few decades added to the despair of white, blue-collar males. The advancement of both woman and minorities only increased the feeling of lost prestige and privilege.

Symbol of a population left behind economically, a factory that once drove American prosperity left to rust and decay. What happened to the people who once worked here earning a good life for themselves? (Credit: Wikipedia)

Then, at just the time when these changes were generating despondency within a large section of the population the pharmaceutical industry began a campaign of selling synthetic, non-addictive opioids as a cure all for any kind of pain. Of course we now know that OxyContin and its relatives are actually highly addictive and can even act as gateway drugs to worse opioids like heroin and fentanyl. The callous greed of the drug companies who made billions by turning millions of Americans into addicts, or in all too many cases corpses is graphically detailed.

As a large portion of the American working class saw their once comfortable life disappearing many of them got caught up in the opioid epidemic. Notice how the number of overdoses among men is nearly twice that among women. (Credit: Wikipedia)
In ‘Deaths of Despair’ the authors cover the effects of suicide, alcoholism and the opioid epidemic on those with less than a college education. However they completely miss the equally tragic effect of education on smoking rates with high school graduates smoking, and dying because of smoking at more than twice the rate of those with a college degree. (Credit: Medical Express)

In the final section of ‘Deaths of Despair’ the authors give their recommendations on how to rebalance the economic system so as to better serve all Americans not just the top 1% or even the better educated. To be honest however the authors are academics and as such they are cautious in their suggestions.

While since 1975 many nations have seen the top 1% grab a larger share of the wealth here in the US that increase is significantly greater. Leaving that much less for the average person. (Credit: Wikipedia)

The most fundamental change put forward in ‘Deaths of Despair’ is a complete reform of the healthcare system in the US, which the authors contend does not even meet the criteria of a true capitalist marketplace. Not only are the drug companies and health insurance corporations criticized in detail but hospitals, ambulance services and even doctor’s associations are shown to be guilty of acting as an Oligopoly. (An Oligopoly is a small group of merchants or corporations that by colluding together rather than competing virtually become a monopoly, raising prices while using their power to destroy any competitors) According to the Authors this is why Americans spend more for their healthcare than any other nation while both life expectancy in the US and approval of our healthcare system rank amongst the lowest for any industrialized, wealthy country. In ‘Deaths of Despair’ the authors estimate that a through reform of the health care system could free up as much a a trillion dollars a year in GDP that could be used to maintain our infrastructure, improve education etc, etc, etc.

As a fraction of our countries wealth (GDP) the costs of Health Care have more than tripled since 1960! Are we living three times as long or has the Health Care Industry simply become inefficient and wasteful? (Credit: Kaiser Family Foundation)

While reform of the healthcare system is the author’s main recommendation they also suggest a stronger social safety net for those who lose their jobs due to changes in the economic system, the safety net must be of longer duration and include retraining for newer jobs. On the other hand they do not recommend simply raising taxes on the wealthy as a means of fixing income inequality nor do they endorse programs like the Universal Basic Income (UBI).

A dream of Socialists since the 19th century Universal Basic Income would make certain that no one falls into poverty despite lack of education, layoffs, sickness or any other circumstance. Conservatives counter that it simply promotes laziness. (Credit: The Nation)

Now, back in May of 2019 I reviewed the book ‘Dying of Whiteness’ by Jonathan M. Metzl, see my post of 5 May 2019, which covers much the same subject as’ Deaths of Despair’. Mr. Metzl however was a state health official while Professors Case and Deaton are among the world’s leading economists so there is a very different perspective in the two books, to my mind in a way that they compliment each other.

Jonathan M. Metzl and his book ‘Dying of Whiteness’ (Credit: Seminary Co-Op Bookstores)

So while I do highly recommend  ‘Deaths of Despair and the Future of Capitalism’ I do so with the proviso that it is a very technical book written by scholars who are among the best in their profession. Those readers who really want to understand the complexities of our current situation, both economic and political will gain a great deal from it.

In yet another blow to the Future of our Country, the Covid-19 pandemic has caused the largest 2 year drop in College Admissions in the last 50 years.

Everyone knows that the key to a better job, a more interesting career and, saving the best for last, a higher income is education. On average a person with a college degree earns 83% more than the average person with only a high school degree. Also, at any given time the high school graduate is on average twice as likely to be unemployed as someone with their bachelor’s degree.

The Statistics are clear. Higher education is the key to a better income, a better life. (Credit: Southern Nazarene University)

In fact the advantages of a college education are so undeniable that millions of young Americans are willing to spend four of their most productive years, and subject themselves to years of college loan payments in order to get their hands on that piece of sheepskin. Prior to the Covid-19 pandemic more than 18 million students were enrolled in undergraduate programs at colleges and universities across this nation. Only China and India, with their massive populations, have more college students than the US.

From the late 19th through the 20th Century the US always had the largest number of college students of any nation. Think that may have had something to do with our becoming the world’s richest and most powerful country? Now we’re in third place and dropping! (Credit: CEOWORLD Magazine)

That was before the pandemic. Like so much else in nations around the world Covid-19 has gotten a chokehold on education here in the US and is slowly draining away the strength of the collegiate system. I’m not just talking about virtual classrooms or having to get vaccinated and wear a mask.

Yes, learning in the days of Covid is both frustrating even even dangerous but we can’t just allow the education of our children to lapse. (Credit: Healthline)

The real harm that is being caused by Covid-19 is the large number of high school graduates who are choosing not to go to college because of Covid itself along with the disruptions due to the disease. In 2020 student enrollment in America’s colleges declined by almost 630,000 students (3.5%) while in 2021 the decline was more than 460,000 (3.1%) for a total decline in two years of more than a million students (and 6.6%).

Over the last 20 years enrollment college enrollment had remained steady or even showed a slight increase. Then covid hit in 2020 and enrollment showed a sharp drop across the board. (Credit: Federal Reserve Bank of Saint Louis)

Worst still the biggest decline was seen in Community Colleges, the most financially reasonable path to a degree, and therefore the path most chosen by lower income and minority students. Here enrollment was down by a whopping 13.2% since 2019. On the other hand the most expensive private colleges and universities saw a slight increase in enrollment which shows that, pandemic or not, America’s rich families know very well the importance of their children getting that bachelor’s degree.

For years Public 2-year colleges, also known as Community Colleges had become the ‘get your foot in the door’ college for low-income American kids. Of course Covid has hit them the worse! (Credit: Econofact)

Now many of those young people who have decided not to enroll in college right out of high school may eventually to do so once the pandemic is finally ended. Statistics have shown however that the success rate for a student getting their degree drops dramatically as a function of the time between high school and college. Meanwhile, those who put off going to college face an ever increasing risk of their simply never getting back in the educational system.

It’s never too Late! (Credit: Supermoney)

Then there is the possibility that this pandemic induced decline could become a trend. According to Doug Shapiro, executive director of the National Student Clearinghouse Research Center, “The longer this continues, the more it starts to build its own momentum as a cultural shift and not just a short-term effect of the pandemic disruptions.”

Trying to return to school anytime after age 24 is simply a hard road to take! (Credit: Education Data Org)

 Even back when our nation was just a collection of colonies the people who would become Americans understood the importance of higher education. And so they founded schools like Harvard, William and Mary, The University of Pennsylvania and the College of New Jersey, now Princeton University. In the midst of our bloodiest war Abraham Lincoln took time out to push for and implement the Morrill Land Grant Act of 1862, which led to the founding of dozens of State Colleges and Universities, which propelled this country to become the richest and most powerful nation on Earth.

The Morrill Land Grant Act of 1862 led to the founding of dozens of State Colleges and Universities across the US. This is why American became the richest and most powerful nation on Earth. Now we seem to have turned our backs on the very things that made us successful! (Credit: Wikipedia)

Will the Americans of today follow the wisdom of their forbears or will they come to look upon a college degree as something just for the rich. If that happens we will have truly lost the American dream.