Working Paper: NBER ID: w29241
Authors: Anne Case; Angus Deaton
Abstract: Deaths of despair, morbidity and emotional distress continue to rise in the US. The increases are largely borne by those without a four-year college degree—the majority of American adults. For many less-educated Americans, the economy and society are no longer providing the basis for a good life. Concurrently, all-cause mortality in the US is diverging by education—falling for the college-educated and rising for those without a degree—something not seen in other rich countries. We review the rising prevalence of pain, despair, and suicide among Americans without a BA. Pain and despair created a baseline demand for opioids, but the escalation of addiction came from pharma and its political enablers. We examine “the politics of despair,” how less-educated people have abandoned and been abandoned by the Democratic Party. While healthier states once voted Republican in presidential elections, now the least-healthy states do. We review the evidence on whether or not deaths of despair have risen during the COVID pandemic. More broadly, excess mortality from COVID has not increased the ratio of all-cause mortality rates for those with and without a four-year degree, but has instead replicated the pre-existing mortality ratio.
Keywords: Mortality; Despair; Education; COVID-19; Socioeconomic Status
JEL Codes: I0; J1
Edges that are evidenced by causal inference methods are in orange, and the rest are in light blue.
| Cause | Effect |
|---|---|
| Low educational attainment (I24) | Increased despair (I32) |
| Increased despair (I32) | Rising mortality rates (J11) |
| Low educational attainment (I24) | Rising mortality rates (J11) |
| Declining wages (J31) | Increased despair (I32) |
| Employment opportunities (J68) | Increased despair (I32) |
| Lack of social respect (Z13) | Increased despair (I32) |
| Increased despair (I32) | Exacerbation of the opioid crisis (H84) |
| Political disenfranchisement (K16) | Increased despair (I32) |
| Political disenfranchisement (K16) | Rising mortality rates (J11) |