The 'Condition of America' Question

The National Academy of Sciences released a stunning report in December 2015. Coauthored by Princeton economists Anne Case and Angus Deaton, the paper revealed “a marked increase" in the mortality rate of middle-aged non-Hispanic white Americans between 1999 and 2013--a departure from "decades of progress" in which the mortality of this demographic had improved. The increase, Case and Deaton said, could be attributed to suicide, liver disease and cirrhosis, drug and alcohol poisoning, and other related effects of drug and alcohol abuse.

"Self-reported declines in health, mental health, and ability to conduct activities of daily living," they wrote, "and increases in chronic pain and inability to work, as well as clinically measured deteriorations in liver function, all point to growing distress in this population." The trend was visible among all non-Hispanic whites but most pronounced in those with less schooling. No other U.S. ethnic group, and no other country, experienced such a dramatic reversal of fortune.

These findings complemented the work of social scientist Charles Murray, whose 2012 book Coming Apart chronicled the immiseration of whites without college degrees and the emergence of a new upper class based on education level. Case and Deaton, like Murray, looked for economic explanations of the data, while noting the increasing availability and use of opioid pain medication.

"Median household incomes of white non-Hispanics began falling in the late 1990s," wrote Case and Deaton, "and the wage stagnation that began with the economic slowdown of the 1970s continues to hit especially hard those with a high school or less education." Murray has stated the matter more bluntly: "The real family income of people in the bottom half of the income distribution hasn't increased since the late 1960s."

Published a month before presidential caucuses and primaries, the Princeton data unsurprisingly became politicized. Yet the debate about the rising mortality of non-Hispanic whites was framed almost entirely in economic terms. Donald Trump blamed trade deals and illegal immigration for joblessness and addiction. Hillary Clinton said income inequality and congressional obstruction of President Obama's economic policies had harmed the middle class. Both candidates pledged to grow incomes and create jobs, assuming or perhaps just hoping that an improvement of material conditions would counteract harmful social trends.