Original by Thomas B. Edsall: The New York Times, Sept. 24, 2022
Throughout the past few decades there has been a rapid increase of "deaths of despair"—suicide, drug overdoes, alcohol abuse—within Republican leaning States in the U.S. "Deaths of despair" have not been the only thing increasing, there has been an increase in several other categories of disease. Lack of hope, in Graham’s view, "is a central issue. The American dream is in tatters and, ironically, it is worse for whites." The rest of the article goes on to articulate some possible reasoning and outcomes.
Connections to Caste
In the book Caste there is a section on these so-called "Deaths of Despair". When the upper caste feels threatened there is a widespread sense of despair that is created. They feel that they aren't getting what they worked hard for, that other people are stealing something from them. More recently, there has been a greater population of members historically in the lower caste. The upper caste (white people) are feeling that they are going to be over numbered.
Case and Deaton talk about this and make the case that Republicans "are surely not for a president who will dismantle safety nets but against a Democratic Party that represents an alliance between minorities — whom working-class whites see as displacing them and challenging their once solid if unperceived privilege — and an educated elite that has benefited from globalization and from a soaring stock market, which was fueled by the rising profitability of those same firms that were increasingly denying jobs to the working class."
This "alliance" between minorities can scare members of the upper Caste because they think everything that they "earned" will be lost. To add to this, blue collar jobs have been declining in profit for the past few decades.
Minorities have also had centuries of facing adversity, and developing skills that help them overcome that. Graham mentions how "African Americans remain more likely to believe in the value of a college education than are low-income whites." Through all their tribulation they are slowly starting to gain equal footing with White's, even though the system is designed against them. This constant progression tends to leave middle-aged, low-educated White people fearing that the roles will switch and they will end up with nothing.
It's not all Red States
It may be tempting to see as only white individuals in Red States that are decreasing in health, but it is still nuanced and many other groups that have decreasing health. One example is deaths of despair within the Black community. I talked about this in Trauma and Mental Health, but with increasing police brutality and open racism, mental health of Black individuals has worsened. "There is also a phenomenon among urban Black males that has to do with longer term despair: nothing to lose". Black males feel that they have already reached rock bottom.
Differences in Race
Lindsey Jeanne Leininger in a 2014 study found that Black individuals experience macroeconomic shocks much differently than their White counterparts. Even in the face of recession, Black's were far more optimistic about the future. Many statistics from Pew and other sources have showed the disparity in suffering between different races.
| Question | Yes % Whites | Yes % Blacks |
|---|---|---|
| Will your children’s future standard of living be better or worse than yours? | 38% | 69% |
| America will always continue to be prosperous and make economic progress? | 59% | 81% |
Other measures of despair have confirmed these findings among white, low-education, middle-aged citizens.
Social Determinants
These deaths of despair are targeted in white, low-education, middle-aged citizens. We can see that during COVID it was this group of people who had statistically lower amounts of social distancing and looking for information. Education is starting to divide access to the labor market, institutions, and even health. Based on structural factors such as education, minimal support for elderly, and poor mental health, these people are stuck and have diminishing health.
The Inn Between
The Inn Between was specifically created to help some of these outcomes in the elderly. It doesn't support as many middle-aged people, but it gives elderly people who never had the opportunity for education, adverse childhood experiences, and spent many days in the E.R., the ability to improve in health or at least have a good death. Focusing just on the new generation will eventually have a positive outcome, but it is always important to give everyone the ability to improve their health. Improving health helps a lot of people and a lot of fields.