Deaths of Despair and the Future of Capitalism | Anne Case

Summary of: Deaths of Despair and the Future of Capitalism
By: Anne Case


In ‘Deaths of Despair and the Future of Capitalism’, Anne Case examines the harsh reality many uneducated white American workers face today. The book delves into the negative consequences that the shrinking labor market has created for this demographic, including a decline in wages, social standing, and mental health. Case reveals how medical advances of the 20th century contributed to an upward trend in lifespan, wealth, and education, only for this to reverse disappointingly after 2000. The summary provided explores alarming statistics related to education, health, mortality rates, and the American economic system, attempting to make sense of these distressing trends that ultimately lead to so-called ‘deaths of despair’.

Uneducated Workers Left Behind

The American labor market is becoming increasingly difficult for uneducated workers. Even though 16 million jobs were created from 2010 to 2019, less than three million went to those without degrees. White men without bachelor’s degrees saw a 13% fall in wages from 1979 to 2017, creating real-world implications. Work not only provides money but also ritual, customs, and routines that contribute to a sense of identity and dignity. Many workers’ ties to their communities have weakened as manual labor jobs have disappeared, and unemployed white men have experienced difficulty finding partners, negatively impacting their mental health.

Reversal of an Era

For years, medical advancements led to an increase in life expectancy, wealth, and education levels in America. However, the trend has suddenly reversed as mortality rates for white Americans aged 45 to 54 went up, and overall life expectancy declined for three consecutive years. This unexpected shift has been attributed to the narrowing opportunities for less educated workers. States with lower educational attainment have shown a significant increase in mortality rates, while those with higher education levels managed to buck the trend. The more educated states include California, New York, New Jersey, and Illinois. The decline in life expectancy and mortality rate increase marks a significant departure from the trend of the past 100 years.

The Unequal Burden of Deaths of Despair

A rise in mortality rates among white Americans from deaths of despair is primarily affecting those without college degrees due to risky health behaviors such as smoking and obesity.

While white Americans face various health threats, the rise in mortality rates from deaths of despair (suicide, drug overdose, or alcohol-related liver disease) is primarily affecting those without college degrees. Factors such as accidental poisoning and underreporting of alcohol-induced fatalities might also contribute to the statistics. In Kentucky, for instance, deaths of despair have surged among people aged 45 to 54 without college degrees, but have remained stable among their counterparts with degrees. Risky health behaviors are more prevalent among less educated Americans, with smoking rates of just 7% among white Americans with college degrees compared to 29% among those without diplomas. Similarly, obesity rates are higher among those without degrees. Ultimately, the rise in mortality rates from deaths of despair predominantly affects the less educated population, highlighting the unequal burden of health issues in America. As one quote in the book says, “parents should not have to watch their children die. It is a reversal of the normal order of things.”

Education and Inequality

Education is key to a prosperous life, but societal rewards are distributed unevenly. Americans who complete university degrees earn more, have higher quality of life, and tend to marry similar partners. Unfortunately, college degrees have also become prerequisites for many high-paying jobs, leading to an opportunity gap between the educated and non-educated. Wealthy parents can game the system using their resources, leading to questions about the value of meritocracy. The college admissions scandal is a severe expression of this inequality. Without action, unequal rewards could degrade the meritocracy in society.

Deaths of Despair and Racial Disparities

The book delves into the issue of deaths of despair that have accelerated in recent years and how it varies with demographics. The mortality rates of White Americans who didn’t complete college education due to suicide, opioid overdose, and alcoholism are on the rise. Suicide rates also vary by geography, with states having low population density and high gun ownership at higher risk. In contrast, Black Americans’ mortality rates have continued to improve despite economic struggles and the crack cocaine scourge. Although Black Americans are less prone to dying by suicide than their White counterparts, the reasons are unclear.

The book’s central message is that deaths of despair are not independent outcomes but largely dependent on the environment and circumstances that individuals are exposed to during their life course. The author highlights how people’s fate largely depends on their birth, education, and work history, indicating that these factors are critical determinants of mortality rates. Although the reasons behind the racial differences in mortality rates are still unclear, the book suggests that the history of economic struggles and different patterns of addiction may play a role. The book prompts readers to understand the importance of addressing the underlying social and economic factors that lead to higher mortality rates in certain demographics to achieve a fair and just society.

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