The costs of social breakdown, anomie, despair?

Who knows what’s driving these graphs, but it’s quite a piece of work for the latest Nobel laureate to drop into our consciousness. The paper’s here.

USW Deaths

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Tyler
Tyler
6 years ago

The contrast to all the others has me stumped though. I mean all the usual suspects you’d point to, increasing divorce and related social isolation, economic uncertainty, unemployment, difficulty adapting to changing workforce requirements etc etc all exist to a similar or greater extent in places like France, Australia, Canada etc. Hell even the easy assumption that it has something to do with their ridiculous health system falls over when you put it next to the Hispanics figure.

At any rate it’s deeply disturbing

John walker
6 years ago
Reply to  Tyler

Do Hispanics have lower divorce rates?

Interesting how we were aparently doing a bit better than Sweden untill about 2006 to 09 and now seem to be resuming a downward drop.

Factory
Factory
6 years ago

Cherry picking an outlier? ( I haven’t actually read the paper)

John Walker
John Walker
6 years ago

Hmm New Scientist this week reports tha since 1969 “death rates in the USA gave fallen by 43%” and deaths from cardio related causes have dropped by “77 and 68 percent” .

Patrick
Patrick
6 years ago

And already contested: https://t.co/uuKWhclqPg

Apparently, the difference is due mainly to the actual average age within that bracket getting older!!

john Walker
john Walker(@johnrwalker)
6 years ago
Reply to  Nicholas Gruen

Assuming Anne Case and Angus Deaton are correct
and therefore the USW line should be flat, it is still a big difference. The effect seems to have kicked in in about 1998, any ideas

GrueBleen
GrueBleen
6 years ago
Reply to  Nicholas Gruen

Why would you “imagine” that ? Isn’t the Baby Boomer wave common to Anglo and Euro countries ?

Not that age 45-54 now would exactly be the peak of the BBW, I suppose, but it could be the last trailing edge – and therefore the least privileged of the Baby Boomers. And therefore maybe the lot most inclined to just lay down and die.

Unless it’s some kind of hidden epidemic, of course.

John Walker
John Walker
6 years ago
Reply to  GrueBleen

That itsuhould be common to many countries, is what he “imagined”

GrueBleen
GrueBleen
6 years ago
Reply to  GrueBleen

Most illuminating, John. Thank you.

But you haven’t actually explained why it was necessary to “imagine” something that it appears is clearly “known”.

So perhaps we should just ignore what Nicholas said because he hasn’t fact checked his “imagination” (you can consult with Paul Frijters as to how bad that is.

Nicholas Gruen
6 years ago
Reply to  GrueBleen

GB – you seem to be agreeing with me. There isn’t a reason to believe that the demographics of all the other examples are different. Not that I know of anyway. Many of the other countries are ageing faster than US whites I would “imagine”. Like in the European countries that are ageing faster than the US.

GrueBleen
GrueBleen
6 years ago
Reply to  GrueBleen

“GB – you seem to be agreeing with me.”

I Know. Isn’t it just terrible ? I try hards to retain my unique individuality, but all I end up doing is agreeing with people. All sorts of people. :-)

I guess it’s just that there’s only so many (or few) uniquely individual positions that can be held on any given issue.

al loomis
6 years ago

quite easy, really. pale yanks have realized god hates them, for good cause. this leads to drink, drugs and unhealthy eating.
the concept of justice arises from society taking note of these trends and explaining them to their children.

conrad
conrad
6 years ago

Perhaps it’s a psychological thing — basically loss of priviledge. That’s a group that would have thought they were basically on top of the world in their younger years, and many would have found out the world was going to change versus their ideals, and by the time they reach these age groups, they would have realized the reality of it all (now they probably vote for Donald Trump in delusional hope). Afro-Americans and Hispanics come from such a low base many wouldn’t need to booze away their lower place in society. The Aus equivalent would be all those males that used to work in manufacturing and now live on ill-health related pensions, except our healthcare and pensions are better.

Also, its not just white males — low SES white females have a declining life expectancy in the US also.

John walker
6 years ago
Reply to  conrad

Sounds very likely.
Was wondering if you did a similar break up of Northern UK vs Southern UK, what would it look like?
And could the U.S. figures be related to the high frequency of guns re ease of both murder and suicide ?

GrueBleen
GrueBleen
6 years ago
Reply to  John walker

Why does that sound likely ? What are you suggesting – that a whole bunch of middle-aged American white males just lay down and died because they couldn’t get Those People offof their lawns ? Or that many of them have committed suicide (or got shot by their 3yo kids maybe :-).

conrad
conrad
6 years ago
Reply to  GrueBleen

No, because they failed to meet their own social expectations of themselves, and realized that they were going to live the rest of their lives in poverty and often by themselves, and that there is nothing much they can do about it. In the US, where unemployment benefits run out after 6 weeks, that often also means homelessness.

It’s not a whole bunch incidentally. The numbers look large because of the graph, but relatively they are small since comparatively few people die in that age group. So it is not an explanation for vast numbers, it is an explanation for the differential.

GrueBleen
GrueBleen
6 years ago
Reply to  GrueBleen

Nice try, Conrad, but perhaps you could also explain why the conditions you’ve expounded have applied in the USA for many, many years but the USW have only started to really do themselves in in increasing numbers since 1998 – which is even before the GFC exacerbated the American failure.

conrad
conrad
6 years ago
Reply to  GrueBleen

My explanation is more or less the same as Chris B below, but less sociology :). In 1998, someone who was in the 45-54 year old age group were born between 1944-1953, so actually, if you consider when people grew up, there was a big difference in prevailing attitudes as that was the beginning of the baby boomers and a great time to be a white male (at least based on that groups biased reminiscing about it).

You can also look at the decline of manufacturing in the US. Who knows where the inflection point is, but the end of the 90s were when globalization was really taking off and so US manufacturing declined. If you look up the figures, the number of employees peaks in 1980, then drops until about 2000, and then falls off the cliff. If I was a male who had worked in manufacturing for 20-30 years and had no other skills, it could well be depressing. This would be made worse because after 20-30 years of building stuff, I might well have health problems and not have enough money to see a doctor in the US. So I probably would just self medicate.

conrad
conrad
6 years ago
Reply to  GrueBleen

Here is the graph of US manufacturing for you: http://delong.typepad.com/sdj/2011/05/us-manufacturing-employment.html

GrueBleen
GrueBleen
6 years ago
Reply to  GrueBleen

PS Conrad: USA unemployment insurance lasts for 26 weeks (normal) with the possibility of ‘abnormal’ extensions (as was done during the recent GFC).

john Walker
john Walker(@johnrwalker)
6 years ago
Reply to  John walker

Conrad , if the numbers involve a difference of comparatively few people ( either way) then perhaps it might be simply that there is less stigma attached to reporting suicide, as suicide these days?

conrad
conrad
6 years ago
Reply to  john Walker

Could be.

GrueBleen
GrueBleen
6 years ago
Reply to  john Walker

I don’t think so, John. Even in the USA people got over the Sweden Syndrome a long time ago.

conrad
conrad
6 years ago
Reply to  john Walker

I disagree with that GB — suicide is still not reported as commonly as it occurs in some groups. I think one of the basic problems (this is a problem for the ABS which they note in some of their work) is that you often can hit multiple categories and it often is not clear which you belong to (possibly both). Drug overdose is a clear example of this, where there is often ambiguity in whether was deliberate or not. Self harm is too — if you die from this, was it suicide or just going too far? This inflates the suicide rate in the US compared to other countries because people there use predominantly shooting or asphysixation, for which there is little ambiguity, unlike overdose.

You can look at the alternative side too. If you kill yourself, it’s always considered suicide. But it’s clear in really old groups, these are often just people ending their life a bit early because their lives are a medical misery. I’d personally consider that self-euthanasia, but in any case, the reason is different to younger groups.

Even in the age groups we are talking about, the attribution is important. If you have people killing themselves to get out of chronic pain which would be treated in many countries with free healthcare, should the attribution really go to sociological/psychological factors of the individual or a health system that doesn’t work well?

GrueBleen
GrueBleen
6 years ago
Reply to  john Walker

Hmmm, well I think your categories of doubt analysis isn’t quite the same as John’s “stigma attached to reporting suicide” which is what the Sweden Syndrome was all about: the considerable stigma attached to reporting suicides (except in Sweden) led to a lot of “death by misadventure” verdicts in places such as Australia and the USA. A lot more, I believe, than we get now that the ‘suicide stigma’ has been significantly reduced.

Besides, you argue against yourself by declaring that ambiguity is noticeably less in the USA due to the use, frequently, of firearms (etc).

ChrisB
6 years ago

I’d give a big proportion of the problem to lack of meaning in life, on the grounds that it’s what happened to the Russians when the USSR folded; the death rate shot up unbelievably, largely due to vodka, which is how the end of exceptionalism manifests itself. The American century ended and the people who couldn’t live without that increment in their self-worth went out and got drunk.

ChrisB
6 years ago

And on Vox, Deaton seems to agree;
Deaton thinks middle-aged white Americans have “lost the narrative of their lives”
But what’s behind the substance abuse? One possible factor here: This demographic group has faced a rise in economic insecurity over the past decade, driven by things like the financial crisis and the collapse of manufacturing.
Still, it’s difficult to put together a full story of what’s going on. After all, if the recession or decline of manufacturing was the only factor, we might expect to see a similar uptick in mortality rates among middle-aged people in places such as Europe. But America seems to be unique in this regard.
“An anthropologist friend here says that [white, middle-age Americans] have lost the narrative of their lives — meaning something like a loss of hope, a loss of expectations of progress,” he explained.
Though African Americans as a group are still worse off overall, Deaton added, their quality of life has improved over the past several decades. “And when Hispanics look back, they may look back to where they came from, or what their parents or grandparents had,” he continued.
So Deaton says this particular group of middle-aged white Americans may have had higher expectations than others when it comes to steady employment and a bright future, and the stress of losing that could well be driving their deadly behaviors.
“The white non-Hispanics may be more susceptible to despair, and perhaps to the alcohol or drug ‘solution,’ especially those with less education,” he said. “And then there is the availability of opioids and of heroin.”

Bruce Bradbury
Bruce Bradbury(@bruce-bradbury)
6 years ago

Cherlin’s recent book Labor’s Love Lost: The Rise and Fall of the Working-Class Family in America echoes similar themes about the crisis in the US white working class. “Labor’s Love Lost shows that the primary problem of the fall of the working-class family from its mid-twentieth century peak is not that the male-breadwinner family has declined, but that nothing stable has replaced it”.

john Walker
john Walker(@johnrwalker)
6 years ago

BTW The NY times has a piece on this . It states that the Deaton and Case stumbled on their finding by accident:

“Dr. Deaton was looking at statistics on suicide and happiness, skeptical about whether states with a high happiness level have a low suicide rate. (They do not, he discovered; in fact, the opposite is true.) ??

John Walker
John Walker
6 years ago

Conrad , Nicholas Realy do not understand:
high levels of ‘happiness’ maping to higher levels of suicide.What is this, happiness that us being measured?

John walker
6 years ago
Reply to  John Walker

Conrad
The OECD measure of happiness, http://theweek.com/articles/463919/how-measure-countrys-happiness
has exactly what you’d expect- ok housing ,job, friends etc
Yet that aparently maps to higher rates of suicide. Could it be that these days more people with terminal conditions can access the needed drugs, online- after all it is in about 1998 to 2000 that the web and America online really started to kick in?

conrad
conrad
6 years ago
Reply to  John walker

It’s not clear to me why the mean scores should predict suicide rates well — you would want to see the spread of the distribution. For example, Sydney is an extremely rich place and has lots of factors that would put it high on a happiness scale like that one. But that doesn’t mean being poor there isn’t crappy, especially because many people see things comparatively and some things really are comparative (e.g., rent). It’s also a very angry place because of it. Alternatively, Adelaide is only moderately rich and has less things that would put it high on those scales, but I’m willing to bet the distribution of happiness is less extreme than Sydney because you can be poor and have an easier life there, and you don’t have to put up with tasteless rich people flashing their wealth at you. So there is less comparative stuff going on.

It reminds me when I travelled from Beijing after working there for a while to Nepal where the cultural factors were even more obvious. In this case, Beijing is clearly a better place than Nepal on many measures. It’s comparatively rich, there are hospitals if you have the money, universities that are actually quite reasonable etc. , but people seem shitted off. Alternatively, Nepal is dirt poor, and there are even more endless social problems than Beijing. But people seemed happier there.

At least to me this suggests there are problems with the validity of these sorts of measure and real happiness which presumably has a big cultural component, as well as interpreting results from simple correlations from the means.

conrad
conrad
6 years ago
Reply to  John walker

Another way to look at is just to look at people’s perceptions versus reality. Australia is a mind-boggling rich place compared to most of the world, but most people don’t think they are rich, including those that are, which is most Australians if you don’t think of things comparatively (e.g., http://www.crikey.com.au/2014/12/11/so-you-think-youre-middle-class/).

To me what this tells you is that people’s perceptions often matter a lot more than the actual reality (which this index is created from). For example, you might be pissed off because the government didn’t say, pay for a hip operation, but your equivalent in Nepal would have probably been happy to get some antibiotics.

John walker
6 years ago
Reply to  conrad

We spent a month based in a ( really good) small town in Vietnam, last jan. After a week or so ,suddenly thought, Jee it’s wonderful to not be surrounded by ‘neurotic ‘ Australians.

conrad
conrad
6 years ago

Here are a few random things I have picked working in a psych department.

1) There is a group of middle-aged men that commit suicide despite not showing obvious signs of depression like younger groups. Basically, these are normal seeming people that get to middle age and just kill themselves for reasons which appear qualitatively different to your “I’m depressed and can’t handle it anymore” group. It is not clear to me people know how to identify them, which suggests that they are not sure really why they do it.

2) Males between 40-50 have comparatively high suicide rates, presumably in part because of (1). Apparently this is also one of unhappiest times in peoples lives if you look at overall happiness.

2) There are reasonable cultural affects on suicide. This occurs on a general scale (e.g., some aspects of Japan culture most people are familiar with) but also within smaller groups (e.g., knowing someone else that has done it). So a change in culture could lead to higher suicide rates, everything else being equal.

3) I seem to remember possibly incorrectly that suicidal ideation is a better predictor (or at least somewhat independent predictor) of actual suicide than things like depression measures, let alone more generic happiness measures.

4) Sometimes people report higher levels of happiness lead to suicide and it can be incorrect if not in context. The context is that supposedly people at the bottom of the depression scale don’t commit suicide as much as people that are somewhat happier. Basically, you need to be slightly less depressed to get the motivation to kill yourself than rock bottom.

5) I’m not sure how robust (4) is. I would like to see big healthy samples that could be believed from multiple groups.

GrueBleen
GrueBleen
6 years ago
Reply to  conrad

I presume that, unlike Socrates, we aren’t dealing with people who really believe that, because of their immortal soul, they aren’t actually going to die, but just ascend to a far better life inheaven.

Unless suicide really is a mortal (Christian) sin.

Peter WARWICK
Peter WARWICK
6 years ago
Reply to  conrad

Conrad, this is interesting.

At my age I see a lot of males (and some females) suffering the “Tired of Life” syndrome. They are seemingly happy, but would very gladly go “off”, and some are members of Exit International. They abhor the thought of hanging, jumping in front of trains, jumping from tall structures etc, since they find those methods extremely ghastly, and there is a chance of survival, which is what they do not want.

They have run their races in life, some races have been won, and some were also rans, and there can be an underlying bitterness (“I should have been promoted to that top job, but that bastard stabbed me in the back”, “My son/ daughter could have married better – I told him/ her that that tart/ lazy layabout was no good”, “Why did I marry this man/ woman ?”), but they rarely speak of it. There can be family difficulties – estrangement of children etc, and they have no role to play as grandparents.

There can be financial disappointment (“I really wanted to build that beach house, but the arse fell out of the share market and we lost $200,000”), and medical difficulties which cannot be resolved.

So generally, they are very tired of life. Even food has lost its allure, and vegemite toast and a cup of tea is the fare for many a day. Some are tired of the Australian political scene. Some have told me of not wanting to read of the Canberra shenanigans any more – they are sick and “very tired” of it.

But these people are not depressed in the clinical sense – its just they a “very tired”. There is a parallel with “battle fatigue” – after some very heavy and prolonged battles, some soldiers just “give up” and are shipped back home. It did occur with some combatants in WW1, and some carried on “giving up” for the remainder of their lives.

Some resent being “out of the game”, consigned to watching the world pass by from a comfy chair on the verandah, and if they are sitting on the verandah of a standard suburban house, there is not a lot of the world passing by.

Medical science has been able to extend life to an excruciating point. Many a GP has stated that what they are doing with geriatrics is giving them “more old age”. They cannot give them their youth back, so its more and more analgesics.

Let me recount a personal experience:

My mother was suffering with severe ovarian cancer. When diagnosed, the cancer was advancing rapidly. She was admitted to a veterans hospital (she was ex WRAAF), and given controlled morphine, which is always administered by two nurses –one to check the calculations, and one to press the green button on the administration machine, each nurse observing the other. While she was in no pain, was lucid and chirpy, she really looked like a bag of bones held together by tight skin. After some weeks, she called me to her bedside, and said:

“Peter, I know I am getting the best of treatment for which I am so grateful, but my end is nigh and I am more than ready to go. I have made peace with my Maker, have had a wonderful life, a superb husband and children. Peter, should the good nurses make a silly arithmetic error, and move the decimal point three places to the right, tell them not to worry”.

The next day, the family met with her oncologist, and I told him of what Mum had said. The oncologist told us that Mum had a 60% chance of dying in the next three months, and 95% chance of dying in the next six months.

He told us that he gets three requests to overdose cancer patients a day, and while he was not stridently opposed to such requests, he could not assist, as he was at the height of his profession, had a successful and happy personal life, and did not want to arrive home to tell his family that he had been arrested for complicity in a murder.

But he did say that the nurses sometimes do it. If a patient persists with such a request, is lucid, and is rational, then the drug register is manipulated, and with a nudge and a wink, the patient is slowly overdosed with morphine. The oncologist had no direct evidence (and did not want to be provided with any direct evidence), but there was sufficient anecdotal evidence to assume it was happening.

John Walker
John Walker
6 years ago

Nasty creepy , GB it is about suffering.

GrueBleen
GrueBleen
6 years ago
Reply to  John Walker

Sometimes, John, and sometimes it is about Jonestown or Heaven’s Gate.

After all, who would want to live on in suffering and misery when they could trip off to heaven any time of their choice ? And maybe that is why suicide is a mortal Christian sin.

Peter WARWICK
Peter WARWICK
6 years ago
Reply to  GrueBleen

GB, suicide is a mortal sin for Christians, but not everyone is Christian.

GrueBleen
GrueBleen
6 years ago
Reply to  Peter WARWICK

Ah yes, thanks for the reminder, Peter. It’s too easy just to think that all white Americans are Christian.

John walker
6 years ago
Reply to  Peter WARWICK

Positions on sucide and ” mortal sin “vary quite a bit, within and between various church groups. For example many believe that sucide by somebody who is mentally ill , has clinical depression for example, is not a mortal sin, rather its a death caused by an illness. And obviously that aproach could be extended to most, if not all cases of suicide.
It is certainly the case that church funerals for suicides are not that unusual these days.

ChrisB
6 years ago

Well, they let Ophelia be buried in consecrated ground, despite some complaints recorded from pedants.

John walker
6 years ago
Reply to  ChrisB

Chris
There is something a bit odd about the figures, not sure what. Am told that abuse of prescription drugs in Australia is at a twenty year high, type 2 diabetes and obesity is running at record levels and that tends to really kick in in the 45 to 55 age groupgrowing, yet our figures are only a tad above Swedens?

conrad
conrad
6 years ago
Reply to  John walker

It shows that modern medicine is wonderful, at least for keeping you alive (if you have a socialized system and thus everyone has access to it). Alternatively, things like quality of life are really important too but often ignored because the measures of them are not definitive. I doubt it’s fun to be obese for decades.

ChrisB
6 years ago

Yes. The moral panic about Australian health being flushed down the drain is hysterically overblown. Our life expectancy is going up by a couple of months a year as it has since 1888 (except for a slight glitch in the sixties, don’t know why). Our chronic flaws may be preventing us living even longer, but they’re not making us worse.