1 00:00:00,240 --> 00:00:05,240 Speaker 1: White working class Americans are dying. If there's one socio 2 00:00:05,280 --> 00:00:08,560 Speaker 1: economic issue that cuts hard into the socio part of 3 00:00:08,600 --> 00:00:11,960 Speaker 1: that word and also probably played a key role in 4 00:00:12,039 --> 00:00:16,920 Speaker 1: electing Donald Trump as president, this is it. And Case 5 00:00:17,000 --> 00:00:20,480 Speaker 1: and Angus Deaton, the married academic couple who brought this 6 00:00:20,560 --> 00:00:23,720 Speaker 1: issue to the forefront, have just issued a follow up 7 00:00:23,720 --> 00:00:27,000 Speaker 1: paper that tries to provide some answers on why death 8 00:00:27,120 --> 00:00:31,800 Speaker 1: rates among less educated white Americans have skyrocketed in the 9 00:00:31,880 --> 00:00:35,000 Speaker 1: past fifteen years. That's right, and we're about to speak 10 00:00:35,040 --> 00:00:37,839 Speaker 1: with Professor Case to discuss her work. You know, we 11 00:00:38,000 --> 00:00:41,720 Speaker 1: usually don't think about economics as a life or death matter, 12 00:00:42,240 --> 00:00:45,040 Speaker 1: but for a large group of Americans, there's no other 13 00:00:45,040 --> 00:00:57,920 Speaker 1: way to describe it. It's Bloomberg Benchmark, a podcast about 14 00:00:57,920 --> 00:01:02,120 Speaker 1: the global economy. I'm Daniel Moss, executive editor for Economics 15 00:01:02,160 --> 00:01:05,120 Speaker 1: at Bloomberg in New York, and I'm Scott Lanman and 16 00:01:05,240 --> 00:01:09,360 Speaker 1: economics editor with Bloomberg News in Washington. Dan, you know, 17 00:01:09,440 --> 00:01:12,080 Speaker 1: we've covered this issue several times before, and it really 18 00:01:12,240 --> 00:01:15,440 Speaker 1: is one of the most important issues that we can 19 00:01:15,600 --> 00:01:19,760 Speaker 1: discuss in our roles as economic journalists. We've done the 20 00:01:19,840 --> 00:01:23,720 Speaker 1: micro version of this issue with our interview with J. D. Vance, 21 00:01:23,760 --> 00:01:27,200 Speaker 1: the author of Hillbilly Elegy. We've even had our guest 22 00:01:27,360 --> 00:01:31,120 Speaker 1: and case on the show before, but it's really worthy 23 00:01:31,240 --> 00:01:34,320 Speaker 1: of returning now to the macro issue that she and 24 00:01:34,360 --> 00:01:37,199 Speaker 1: her husband have studied so well, and Scott we haven't 25 00:01:37,240 --> 00:01:39,200 Speaker 1: heard the end of it. J D. E. Vance was 26 00:01:39,240 --> 00:01:43,319 Speaker 1: in the news just recently. He's returning to a hire 27 00:01:43,480 --> 00:01:45,680 Speaker 1: where much of the book is set, where it's going 28 00:01:45,720 --> 00:01:49,120 Speaker 1: to be involved in, among other things, looking for venture 29 00:01:49,200 --> 00:01:53,080 Speaker 1: capital ideas from the local community. All right, Well, now 30 00:01:53,120 --> 00:01:56,480 Speaker 1: to our guest and case as Professor of Economics and 31 00:01:56,560 --> 00:02:00,440 Speaker 1: Public Affairs at Princeton University, where she is the rector 32 00:02:00,480 --> 00:02:04,000 Speaker 1: of the Research Program in Development Studies. Among her many 33 00:02:04,040 --> 00:02:06,760 Speaker 1: honors is being awarded the Kenneth j. Arrow Prize and 34 00:02:06,800 --> 00:02:11,760 Speaker 1: Health Economics from the International Health Economics Association. As we mentioned, 35 00:02:11,760 --> 00:02:14,360 Speaker 1: she was on our podcast almost a year ago, and 36 00:02:14,480 --> 00:02:17,560 Speaker 1: we're very glad to have her back again today joining 37 00:02:17,639 --> 00:02:20,880 Speaker 1: us from Princeton, New Jersey. Hello. Anne, Hi, it's good 38 00:02:20,919 --> 00:02:25,000 Speaker 1: to be with you. So you finished the previous paper 39 00:02:25,120 --> 00:02:28,520 Speaker 1: on this topic, I think almost two years ago. What 40 00:02:28,639 --> 00:02:31,720 Speaker 1: kinds of findings do you have now that you didn't 41 00:02:31,800 --> 00:02:36,280 Speaker 1: have before? We really wanted to drill down UM into 42 00:02:36,320 --> 00:02:40,080 Speaker 1: the into the question of what is it that is 43 00:02:40,160 --> 00:02:44,840 Speaker 1: killing these people either slowly with alcohol or with drugs, 44 00:02:44,960 --> 00:02:48,720 Speaker 1: or quickly with a gun. And UM, what we found 45 00:02:48,800 --> 00:02:53,920 Speaker 1: was a really strong UM synchronization between these death rates 46 00:02:54,560 --> 00:02:58,639 Speaker 1: and all sorts of other dysfunction for whites with less 47 00:02:58,639 --> 00:03:01,320 Speaker 1: than a college degree. So I think the first the 48 00:03:01,360 --> 00:03:05,519 Speaker 1: first big difference is that we've actually focused a lot 49 00:03:05,560 --> 00:03:10,359 Speaker 1: more of our attention to people who haven't gone to college. UM. 50 00:03:10,480 --> 00:03:13,320 Speaker 1: People with the B A are continuing to see their 51 00:03:13,720 --> 00:03:18,200 Speaker 1: UM mortality rates drop UM, while people with less than 52 00:03:18,240 --> 00:03:20,720 Speaker 1: a B A. So that's even people with some college 53 00:03:20,760 --> 00:03:24,480 Speaker 1: but not a four year degree, are having a much 54 00:03:24,520 --> 00:03:28,440 Speaker 1: harder time. They report poorer health, they report more pain, 55 00:03:29,080 --> 00:03:33,440 Speaker 1: the report that UM, they have a lot more social anxiety. 56 00:03:33,600 --> 00:03:37,400 Speaker 1: They're a lot less likely to get married. UH. They 57 00:03:37,440 --> 00:03:42,720 Speaker 1: their cohabitations are are fragile. UM. And we think though 58 00:03:42,760 --> 00:03:46,040 Speaker 1: the root cause of this could be and this is again, 59 00:03:46,280 --> 00:03:48,680 Speaker 1: you know, this is just that it's consistent with the 60 00:03:48,760 --> 00:03:54,040 Speaker 1: evidence that from the time they left high school and 61 00:03:54,320 --> 00:03:58,560 Speaker 1: entered the labor market, their labor market opportunities are really 62 00:03:58,720 --> 00:04:03,240 Speaker 1: much poorer than the generation that came before, and professor case. 63 00:04:03,720 --> 00:04:08,000 Speaker 1: And we're not just talking about a mortality rate that's 64 00:04:08,200 --> 00:04:11,760 Speaker 1: rising while others in the United States fall. There's a 65 00:04:11,760 --> 00:04:16,440 Speaker 1: global phenomenon whereby mortality rates are falling in some of 66 00:04:16,440 --> 00:04:19,840 Speaker 1: the most unlikely places. Yet for this group of Americans, 67 00:04:20,240 --> 00:04:23,120 Speaker 1: it's going in the wrong direction. Throughout the developing world, 68 00:04:23,160 --> 00:04:28,120 Speaker 1: mortality rates um are falling, income levels are by and 69 00:04:28,240 --> 00:04:31,679 Speaker 1: large rising. But it's just not this group is alone, 70 00:04:31,920 --> 00:04:35,359 Speaker 1: not just in the United States, but really in the planet, 71 00:04:36,040 --> 00:04:39,840 Speaker 1: well certainly in the rich world. Um. You could name 72 00:04:39,880 --> 00:04:42,680 Speaker 1: me your favorite European country and I could pretty much 73 00:04:42,720 --> 00:04:46,400 Speaker 1: guarantee you that over this period that mortality rates in 74 00:04:46,440 --> 00:04:49,279 Speaker 1: middle age were falling at about two percent a year. 75 00:04:50,000 --> 00:04:52,320 Speaker 1: And that's the that is the rate that used to 76 00:04:52,400 --> 00:04:56,840 Speaker 1: characterize the white working class that we're talking about. So 77 00:04:57,040 --> 00:05:01,920 Speaker 1: terrific progress against heart disease anti hypertensive has just made 78 00:05:01,960 --> 00:05:06,560 Speaker 1: a huge difference. People stopped smoking, so both heart disease 79 00:05:06,560 --> 00:05:10,320 Speaker 1: and cancer rates fell. But two things happened to this group. 80 00:05:10,720 --> 00:05:15,000 Speaker 1: One is that we stopped making progress on heart disease. 81 00:05:15,400 --> 00:05:22,480 Speaker 1: So heart disease mortality flatlined after decades of progress. And 82 00:05:22,640 --> 00:05:26,160 Speaker 1: because it flatlined, it brought to light the fact that 83 00:05:26,320 --> 00:05:30,440 Speaker 1: mortality from these causes causes that the medical community has 84 00:05:30,480 --> 00:05:33,760 Speaker 1: a much harder time knowing how to deal with. UM 85 00:05:33,960 --> 00:05:39,760 Speaker 1: actually drove mortality rates overall up, and life expectancy came 86 00:05:39,800 --> 00:05:42,560 Speaker 1: down in the US, and it came down because of 87 00:05:42,640 --> 00:05:46,800 Speaker 1: this group. Children are doing well, the elderly are doing well, 88 00:05:46,960 --> 00:05:51,640 Speaker 1: but middle aged whites are actually having a hard enough 89 00:05:51,680 --> 00:05:56,760 Speaker 1: time now that it's UM affected overall life expectancy. Now, 90 00:05:56,800 --> 00:05:59,400 Speaker 1: one thing you do in your latest paper that wasn't 91 00:05:59,480 --> 00:06:03,200 Speaker 1: in the previous one is, uh, look around the United 92 00:06:03,240 --> 00:06:07,839 Speaker 1: States and talk about how this phenomenon is common across 93 00:06:07,920 --> 00:06:13,839 Speaker 1: almost all geographies in the United States, with white Americans 94 00:06:14,080 --> 00:06:18,040 Speaker 1: with less than a bachelor degree having higher death rates 95 00:06:18,760 --> 00:06:23,120 Speaker 1: than before. Is it possible to disaggregate this phenomenon from 96 00:06:23,160 --> 00:06:26,480 Speaker 1: geography at all? Is there any difference in mortality rates 97 00:06:26,520 --> 00:06:31,039 Speaker 1: between urban and rural areas. I know, Uh, there's a 98 00:06:31,120 --> 00:06:36,760 Speaker 1: handful of exceptions to this trend, as you pointed out, Scott, 99 00:06:36,760 --> 00:06:42,400 Speaker 1: Are you really asking whether it's concentrated in Wisconsin, Ohio, Pennsylvania, 100 00:06:42,440 --> 00:06:45,440 Speaker 1: and Michigan. Well, it's really the it's most those happened 101 00:06:45,440 --> 00:06:47,640 Speaker 1: to be Trump states, but it's really all over the country. 102 00:06:47,680 --> 00:06:50,280 Speaker 1: I mean, you pointed out Utah, but was there any 103 00:06:50,320 --> 00:06:53,800 Speaker 1: any differences that you could tell. It's interesting because the 104 00:06:53,839 --> 00:06:57,200 Speaker 1: press is picked it up in different ways. UM let 105 00:06:57,240 --> 00:07:00,120 Speaker 1: me let me not answer the question immediately, but is 106 00:07:00,200 --> 00:07:03,240 Speaker 1: to say that, um, a lot of the headlines are 107 00:07:03,520 --> 00:07:07,400 Speaker 1: dying white men, and indeed that is true. Some of 108 00:07:07,400 --> 00:07:09,520 Speaker 1: the headlines want to focus on the fact that it's 109 00:07:09,560 --> 00:07:12,600 Speaker 1: happening to women, and that's happening too, but it's it's 110 00:07:12,680 --> 00:07:16,040 Speaker 1: really not a difference between men and women. It's really 111 00:07:16,080 --> 00:07:20,920 Speaker 1: the difference cuts between education groups and and some of 112 00:07:20,960 --> 00:07:24,480 Speaker 1: the headlines also want to make it a story about Appalachia, 113 00:07:24,720 --> 00:07:27,440 Speaker 1: and it's certainly happening there. But there's no part of 114 00:07:27,480 --> 00:07:31,160 Speaker 1: the country that has not been touched by this. And 115 00:07:31,240 --> 00:07:34,200 Speaker 1: so we are hoping in the next ranche of research 116 00:07:34,280 --> 00:07:36,720 Speaker 1: that we do to use the fact that we've divided 117 00:07:36,720 --> 00:07:40,560 Speaker 1: the country up into about a thousand small areas, and 118 00:07:40,600 --> 00:07:43,560 Speaker 1: we're hoping that we can piece this together better in 119 00:07:43,680 --> 00:07:47,560 Speaker 1: terms of local economic conditions. That work still remains to 120 00:07:47,600 --> 00:07:49,800 Speaker 1: be done, but I can I can tell you that 121 00:07:49,920 --> 00:07:53,800 Speaker 1: for say, whites in age forty five to fifty four, 122 00:07:53,920 --> 00:07:56,520 Speaker 1: there are only three states in the country where mortality 123 00:07:56,640 --> 00:08:02,440 Speaker 1: rates fell between say, and those were California, New York, 124 00:08:02,440 --> 00:08:05,040 Speaker 1: and New Jersey. Was there any reason for that that 125 00:08:05,080 --> 00:08:07,000 Speaker 1: you figured out yet or is that for your next 126 00:08:07,120 --> 00:08:09,960 Speaker 1: part of research. There's more work to be done on that. 127 00:08:10,320 --> 00:08:16,520 Speaker 1: There's also a small piece of the corridor between Dan 128 00:08:16,640 --> 00:08:19,880 Speaker 1: and Washington, UM that goes all the way through New 129 00:08:19,960 --> 00:08:22,800 Speaker 1: York and up to Boston, and we think that that's 130 00:08:22,840 --> 00:08:27,120 Speaker 1: been protected by the fact that along that Northeast corridor 131 00:08:28,200 --> 00:08:31,880 Speaker 1: educational attainment is much higher. But I want to go 132 00:08:31,920 --> 00:08:35,680 Speaker 1: back also to the question about Europe, because UM, many 133 00:08:35,720 --> 00:08:38,920 Speaker 1: countries in Europe were terribly hit by the Great Recession, 134 00:08:39,559 --> 00:08:43,320 Speaker 1: right we think about Spain UM being so hard hit. 135 00:08:43,960 --> 00:08:47,160 Speaker 1: But during the recession and to the end of the recession, 136 00:08:47,400 --> 00:08:52,920 Speaker 1: actually mortality rates fell in Spain and in Italy and 137 00:08:53,040 --> 00:08:56,480 Speaker 1: in Greece, and they fell in the countries that weren't 138 00:08:56,520 --> 00:09:01,400 Speaker 1: hard hit too. So UM doesn't look like the Great 139 00:09:01,440 --> 00:09:05,720 Speaker 1: Recession actually had the kind of um effect that we 140 00:09:05,800 --> 00:09:08,440 Speaker 1: saw in the US. But actually it was. It was 141 00:09:08,480 --> 00:09:11,400 Speaker 1: already well entrenched in the US before the Great Recession 142 00:09:11,400 --> 00:09:15,640 Speaker 1: ever hit. What role does the expanded social safety net 143 00:09:15,880 --> 00:09:19,719 Speaker 1: that many people associated with Western European countries played in 144 00:09:19,760 --> 00:09:24,040 Speaker 1: that divergence. That is a very good question, and again 145 00:09:24,080 --> 00:09:27,160 Speaker 1: this is something that's going to be a focus of 146 00:09:27,160 --> 00:09:29,440 Speaker 1: our attention and the next part of the work here. 147 00:09:30,360 --> 00:09:33,440 Speaker 1: I don't have a good answer for you yet. It 148 00:09:33,520 --> 00:09:37,760 Speaker 1: could be some combination of universal healthcare and stronger safety 149 00:09:37,760 --> 00:09:41,160 Speaker 1: nets that protect people when they lose their jobs, UM, 150 00:09:41,320 --> 00:09:44,199 Speaker 1: that actually make sure that there's money to keep body 151 00:09:44,200 --> 00:09:48,559 Speaker 1: and sold together. UM. It could be that that's why 152 00:09:48,760 --> 00:09:51,440 Speaker 1: when the Great Recession hit Europe, we didn't see the 153 00:09:51,480 --> 00:09:56,040 Speaker 1: same thing happen. But I can't tell you that that's 154 00:09:56,040 --> 00:09:58,600 Speaker 1: what happened for sure, because if you look in the US, 155 00:09:59,120 --> 00:10:02,040 Speaker 1: blacks and a spa annex face the same social safety 156 00:10:02,080 --> 00:10:05,400 Speaker 1: net that whites do, and yet mortality rates continue to 157 00:10:05,400 --> 00:10:08,280 Speaker 1: fall for blacks and Hispanics in the US. Do other 158 00:10:08,320 --> 00:10:11,679 Speaker 1: countries have the same prevalence of the opioid epidemic that 159 00:10:11,720 --> 00:10:15,120 Speaker 1: we have in the States? No, indeed, I mean, and 160 00:10:15,200 --> 00:10:17,719 Speaker 1: that's we think of the opioids as being a real 161 00:10:17,800 --> 00:10:22,280 Speaker 1: accelerant to what happened. Although death rates were rising from suicide, 162 00:10:22,360 --> 00:10:28,679 Speaker 1: drug overdose, and alcohol related liver diseases well before the 163 00:10:28,720 --> 00:10:35,000 Speaker 1: introduction of very strong um prescription opioids in the US market, 164 00:10:35,720 --> 00:10:37,760 Speaker 1: so we can we can go all the way back 165 00:10:37,800 --> 00:10:42,080 Speaker 1: to and look what was happening, and the trend really 166 00:10:42,120 --> 00:10:45,719 Speaker 1: didn't change much with the introduction, for example, of OxyContin, 167 00:10:46,160 --> 00:10:49,400 Speaker 1: although it did pick up some. So we do think 168 00:10:49,400 --> 00:10:52,160 Speaker 1: that it's an accelerant, but we don't think it's a 169 00:10:52,240 --> 00:10:54,600 Speaker 1: root cause of what's going on. I was in the 170 00:10:54,600 --> 00:10:59,040 Speaker 1: audience when Professor Dayton presented to the National Association for 171 00:10:59,120 --> 00:11:03,880 Speaker 1: Business ECONOLS in d C earlier this month. He highlighted 172 00:11:03,920 --> 00:11:08,280 Speaker 1: the relative decline in the strength of trade unionism and 173 00:11:08,360 --> 00:11:14,040 Speaker 1: in traditional religion meaning Catholic Church, the Protestant Church versus 174 00:11:14,120 --> 00:11:17,160 Speaker 1: a new wave of religion that was very individual in 175 00:11:17,240 --> 00:11:20,400 Speaker 1: its focus. Can you talk a bit about that. Yeah, 176 00:11:20,480 --> 00:11:24,840 Speaker 1: we're we're actually looking at what gives structure to people's lives. 177 00:11:25,520 --> 00:11:29,120 Speaker 1: And historically it would be the case that a man 178 00:11:29,320 --> 00:11:31,720 Speaker 1: might be able to follow his father and his grandfather 179 00:11:31,840 --> 00:11:34,960 Speaker 1: into a trade and it would be a trade where 180 00:11:35,960 --> 00:11:39,560 Speaker 1: the pay was good, the benefits were good. There was 181 00:11:39,600 --> 00:11:42,200 Speaker 1: on the job training, if you work hard, you could 182 00:11:42,200 --> 00:11:44,240 Speaker 1: move up, You could have a middle class life for 183 00:11:44,320 --> 00:11:48,120 Speaker 1: your family. Those sorts of jobs are gone. On the 184 00:11:48,160 --> 00:11:51,640 Speaker 1: religion side, the legacy churches, it's not that people are 185 00:11:51,679 --> 00:11:55,000 Speaker 1: are less likely to report a religion. But the legacy 186 00:11:55,080 --> 00:11:58,280 Speaker 1: churches the ones who mentioned Catholic Church or Protestant churches 187 00:11:58,720 --> 00:12:02,520 Speaker 1: have given way to more seeking churches, which are much 188 00:12:02,520 --> 00:12:08,600 Speaker 1: more individual oriented but provide less structure. And then marriages. Um, 189 00:12:09,480 --> 00:12:12,440 Speaker 1: if you look at the birth cohort of nineteen fifty, 190 00:12:12,600 --> 00:12:16,040 Speaker 1: two thirds of them were married by age thirty. If 191 00:12:16,040 --> 00:12:19,040 Speaker 1: you go then to the birth cohort of nineteen sixty only, 192 00:12:19,840 --> 00:12:23,800 Speaker 1: um no, I'm sorry, the ones born in nineteen fifty 193 00:12:24,480 --> 00:12:27,199 Speaker 1: two thirds of the ones born in nineteen sixty. Only 194 00:12:27,280 --> 00:12:30,079 Speaker 1: half of the cohort born in nineteen seventy is married 195 00:12:30,080 --> 00:12:34,080 Speaker 1: at age thirty. So like if you think of marriage, job, 196 00:12:34,240 --> 00:12:37,720 Speaker 1: religion is giving people structure in their lives, all of 197 00:12:37,760 --> 00:12:42,560 Speaker 1: those have have sort of collapsed. Um, and we think 198 00:12:42,600 --> 00:12:47,320 Speaker 1: that that leaves people vulnerable as well to despair and 199 00:12:47,720 --> 00:12:51,160 Speaker 1: so much of what you just said it sounds a 200 00:12:51,240 --> 00:12:55,640 Speaker 1: lot like the economic side of what J. D. Vance 201 00:12:55,679 --> 00:12:58,920 Speaker 1: talks about in his personal story that he shares in 202 00:12:59,000 --> 00:13:04,080 Speaker 1: Hillbilly LG. Obviously, he his book has gotten pretty wide play, 203 00:13:04,160 --> 00:13:07,839 Speaker 1: been widely recognized. I'm curious if you've had a chance 204 00:13:07,880 --> 00:13:12,439 Speaker 1: to read the book or uh meet Mr Vance or 205 00:13:12,800 --> 00:13:14,760 Speaker 1: talk with him what you think of his story and 206 00:13:14,760 --> 00:13:17,839 Speaker 1: how that connects with the research that you've been doing. 207 00:13:18,520 --> 00:13:21,640 Speaker 1: I think it. I think it connects quite strongly. And 208 00:13:21,720 --> 00:13:25,880 Speaker 1: I I read with a lot of interest that he's 209 00:13:25,960 --> 00:13:32,120 Speaker 1: moving back to Columbus, Ohio and wants to actually put 210 00:13:32,200 --> 00:13:37,280 Speaker 1: his body and his family um in the sort of 211 00:13:37,320 --> 00:13:40,320 Speaker 1: where the heart of the problem is. I think that's 212 00:13:40,320 --> 00:13:44,600 Speaker 1: that's really noble, and that's really brave, um, because we 213 00:13:45,400 --> 00:13:49,760 Speaker 1: currently don't know how this is going to end. I 214 00:13:49,840 --> 00:13:53,600 Speaker 1: don't have for you, aside from turn off that tap 215 00:13:53,720 --> 00:13:58,800 Speaker 1: for strong opioids for chronic pain, you know, I don't 216 00:13:58,920 --> 00:14:02,360 Speaker 1: have like checklist of things that if we do this, 217 00:14:03,120 --> 00:14:07,760 Speaker 1: we can actually turn this problem around. And it's essential 218 00:14:08,040 --> 00:14:12,080 Speaker 1: that we do that. And I think g. D. Van's 219 00:14:12,120 --> 00:14:15,840 Speaker 1: being willing to put himself in the line and say, 220 00:14:16,040 --> 00:14:21,040 Speaker 1: let me see what I can do is a terrific thing, 221 00:14:21,120 --> 00:14:26,560 Speaker 1: and I would encourage more people to do that. Aside 222 00:14:26,560 --> 00:14:29,280 Speaker 1: from being a great read, one of the reasons j 223 00:14:29,480 --> 00:14:33,480 Speaker 1: D's book got such buzz was people were trying to 224 00:14:33,680 --> 00:14:38,360 Speaker 1: explain the economic roots of Donald Trump's support in states 225 00:14:38,560 --> 00:14:44,040 Speaker 1: not normally associated with going Republican at the presidential level. So, 226 00:14:44,160 --> 00:14:48,440 Speaker 1: and Paul Krugman would put this rather bluntly, so I 227 00:14:48,480 --> 00:14:51,360 Speaker 1: guess I'll just paraphrase him. And he said this publicly. 228 00:14:52,000 --> 00:14:56,800 Speaker 1: Why then, if a social safety net is so important 229 00:14:57,000 --> 00:15:01,080 Speaker 1: and unions are so important, why did these people then 230 00:15:01,280 --> 00:15:05,600 Speaker 1: vote against their own economic self interest. I think that 231 00:15:05,720 --> 00:15:08,560 Speaker 1: Bernie Sanders on the left and Donald Trump on the 232 00:15:08,640 --> 00:15:16,840 Speaker 1: right recognized that slowly working class America was collapsing and 233 00:15:16,960 --> 00:15:21,560 Speaker 1: that no one in Washington was representing their interests. So 234 00:15:21,640 --> 00:15:25,160 Speaker 1: I think that both the Bernie Sanders phenomenon and the 235 00:15:25,160 --> 00:15:29,360 Speaker 1: Trump phenomenon are about people pulling a lever to say, 236 00:15:31,360 --> 00:15:36,560 Speaker 1: we're not being heard, We're not being recognized. Um are 237 00:15:36,560 --> 00:15:40,880 Speaker 1: our wages have been falling, We're not seeing a ladder 238 00:15:41,000 --> 00:15:45,880 Speaker 1: up for our children, and we this is what this 239 00:15:45,960 --> 00:15:49,400 Speaker 1: is the way in which we think we can um 240 00:15:49,840 --> 00:15:53,040 Speaker 1: let people in Washington know that this is not working 241 00:15:53,080 --> 00:15:56,520 Speaker 1: for us. Well, they both certainly identified an issue, though 242 00:15:56,560 --> 00:16:00,680 Speaker 1: their prescriptions were quite different, but they were both out 243 00:16:00,720 --> 00:16:03,920 Speaker 1: to protect the working class. I think. Yet there was 244 00:16:03,960 --> 00:16:09,680 Speaker 1: also a platform that specifically said repeal and replace again. 245 00:16:10,240 --> 00:16:15,120 Speaker 1: Why would these people vote, as Krugman asks, to lose 246 00:16:15,120 --> 00:16:17,720 Speaker 1: a health insurance? Why would they do that? I think 247 00:16:17,760 --> 00:16:21,280 Speaker 1: it's the same reason why just having a social safety 248 00:16:21,320 --> 00:16:24,280 Speaker 1: net in the US that resembled that in Western Europe 249 00:16:24,920 --> 00:16:31,080 Speaker 1: may not work here. Um, the US is a country 250 00:16:31,120 --> 00:16:34,720 Speaker 1: I think where there's a large number of people who 251 00:16:34,760 --> 00:16:38,440 Speaker 1: believe that it's up to me to take care of 252 00:16:38,520 --> 00:16:41,000 Speaker 1: my family and it's up to my neighbor to do 253 00:16:41,080 --> 00:16:45,560 Speaker 1: the same for his, and that we don't want to 254 00:16:45,640 --> 00:16:49,080 Speaker 1: hand out. I mean, we have a just we have 255 00:16:49,120 --> 00:16:51,840 Speaker 1: a fishing guide in Montana where we go every summer 256 00:16:52,240 --> 00:16:56,040 Speaker 1: who is a veteran who fought in the Iraq the 257 00:16:56,080 --> 00:17:00,320 Speaker 1: Second Iraq War, and um, he needs medical care, but 258 00:17:00,400 --> 00:17:03,960 Speaker 1: he won't go to the VA hospital. And we asked whine. 259 00:17:04,040 --> 00:17:07,080 Speaker 1: He said, well, around here, we don't take hand doubts 260 00:17:08,040 --> 00:17:10,480 Speaker 1: and even and I was just a gas And I 261 00:17:10,520 --> 00:17:14,120 Speaker 1: mean we said, even though you fought for this country 262 00:17:14,160 --> 00:17:17,040 Speaker 1: and these are benefits that you deserve, and said down, 263 00:17:17,280 --> 00:17:22,440 Speaker 1: we don't take charity. So I think there's actually, um 264 00:17:22,480 --> 00:17:27,359 Speaker 1: a lot of resistance about giving up the you know, 265 00:17:27,800 --> 00:17:34,080 Speaker 1: individual sense of of self and purpose uh to a collective. 266 00:17:34,640 --> 00:17:38,320 Speaker 1: And I think that that is a block we're going 267 00:17:38,400 --> 00:17:41,399 Speaker 1: to come up against over and over. It really is 268 00:17:41,440 --> 00:17:45,440 Speaker 1: a hallmark of how a large number of Americans think 269 00:17:45,640 --> 00:17:50,159 Speaker 1: and behave so on the election issue, have you or 270 00:17:50,440 --> 00:17:54,120 Speaker 1: or are you going to cross reference some of your 271 00:17:54,200 --> 00:17:59,720 Speaker 1: geographic results with the vote count in to see if 272 00:17:59,760 --> 00:18:04,520 Speaker 1: the death rates correlate in any way with voting for 273 00:18:04,920 --> 00:18:07,879 Speaker 1: Trump por Clinton. I have to say, the day after 274 00:18:07,960 --> 00:18:12,920 Speaker 1: the election, I pulled down the county level um votes 275 00:18:13,000 --> 00:18:20,080 Speaker 1: for Clinton versus Trump, and they correlate extremely strongly. Point 276 00:18:20,160 --> 00:18:25,639 Speaker 1: for two. If that means anything to with mortality rates 277 00:18:25,680 --> 00:18:29,720 Speaker 1: of whites in middle age, one being the perfect correlation, 278 00:18:30,160 --> 00:18:33,400 Speaker 1: one being the perfect correlation, but point forward to being 279 00:18:33,840 --> 00:18:38,240 Speaker 1: very strong in any thing that looks in a cross section. 280 00:18:38,920 --> 00:18:41,720 Speaker 1: But a lot of people have correlated Trump votes with 281 00:18:42,680 --> 00:18:46,640 Speaker 1: things that are also related, you know, uh, the extent 282 00:18:46,720 --> 00:18:52,760 Speaker 1: to which manufacturing jobs are lost, for example, and I 283 00:18:52,800 --> 00:18:55,879 Speaker 1: think they're that's all of a piece. One of the 284 00:18:56,040 --> 00:18:59,760 Speaker 1: disturbing things we're finding is that this is a problem 285 00:18:59,840 --> 00:19:04,160 Speaker 1: that it's getting worse with every successive birth cohort. So 286 00:19:04,240 --> 00:19:07,680 Speaker 1: it's so the people born in nine eighty are having 287 00:19:07,680 --> 00:19:10,400 Speaker 1: a harder time than people born in nineteen seventy, who 288 00:19:10,440 --> 00:19:13,560 Speaker 1: are having a harder time than people born in nineteen sixty. 289 00:19:13,640 --> 00:19:17,560 Speaker 1: So it's not just the baby boomers moving through and 290 00:19:17,560 --> 00:19:20,159 Speaker 1: that everything's going to be fine. At the tail end 291 00:19:20,200 --> 00:19:24,040 Speaker 1: of that, it's it's way into gen X now as well, 292 00:19:24,640 --> 00:19:28,200 Speaker 1: and it doesn't show any signs of slowing down. The 293 00:19:28,520 --> 00:19:32,560 Speaker 1: phrase you use in your paper is cumulative disadvantage. These 294 00:19:32,560 --> 00:19:34,520 Speaker 1: are things that add up over the course of a 295 00:19:34,560 --> 00:19:38,399 Speaker 1: person's life, not getting a bachelor's degree, not getting a 296 00:19:38,440 --> 00:19:43,000 Speaker 1: good job, not getting married, and so on, until they 297 00:19:43,160 --> 00:19:47,760 Speaker 1: end in deaths of despair, as you call it. Is 298 00:19:47,800 --> 00:19:51,560 Speaker 1: the bottom line here that the US economy has been 299 00:19:51,720 --> 00:19:56,639 Speaker 1: changing dramatically, shifting away more and more from manufacturing to 300 00:19:56,720 --> 00:20:02,160 Speaker 1: a services oriented economy and to terms of education and skills. 301 00:20:02,480 --> 00:20:06,280 Speaker 1: That a certain cohort that just happens to be many 302 00:20:06,320 --> 00:20:11,200 Speaker 1: white working class Americans is not keeping up with these changes. 303 00:20:11,600 --> 00:20:16,320 Speaker 1: It's the data are entirely consistent with that story. So 304 00:20:16,920 --> 00:20:19,879 Speaker 1: we want to pull that apart further and see the 305 00:20:19,880 --> 00:20:22,840 Speaker 1: extent to which we can quantify that. But yes, i 306 00:20:23,160 --> 00:20:26,879 Speaker 1: the data. That's what the data seem to suggest. And 307 00:20:26,920 --> 00:20:30,159 Speaker 1: one of the things we've also found is that what 308 00:20:30,280 --> 00:20:33,760 Speaker 1: we call return to experience has fallen in the labor market. 309 00:20:34,480 --> 00:20:39,119 Speaker 1: That generally, the older you get, the more experience you have, 310 00:20:39,800 --> 00:20:43,240 Speaker 1: the more efficient you are your job, the higher your 311 00:20:43,240 --> 00:20:46,960 Speaker 1: wages become. And we're not seeing that same return to 312 00:20:47,080 --> 00:20:50,879 Speaker 1: experience for younger and younger birth cohorts. And I think 313 00:20:51,040 --> 00:20:54,040 Speaker 1: if you go to a service economy to a gig 314 00:20:54,040 --> 00:20:57,919 Speaker 1: economy where there's not that much experience necessary for some 315 00:20:58,040 --> 00:21:02,680 Speaker 1: of these jobs, UM, people don't see themselves in ten 316 00:21:02,760 --> 00:21:07,280 Speaker 1: years time having moved up the ladder. And that is 317 00:21:07,640 --> 00:21:11,439 Speaker 1: I think an incredibly serious problem. What what we do 318 00:21:11,480 --> 00:21:15,200 Speaker 1: about education. Not everybody wants to go to college, not everybody, 319 00:21:15,320 --> 00:21:19,120 Speaker 1: um has the wherewithal to go to college. But we've 320 00:21:19,160 --> 00:21:24,320 Speaker 1: got to change our education system in some way personal opinion, UM, 321 00:21:24,480 --> 00:21:29,520 Speaker 1: so that um we provide the skills for people that 322 00:21:29,520 --> 00:21:31,639 Speaker 1: that they'll be able to use in the twenty one 323 00:21:31,800 --> 00:21:37,080 Speaker 1: century economy. And I think the schools currently just aren't 324 00:21:37,119 --> 00:21:40,639 Speaker 1: keeping up with the changes that are necessary, you know, 325 00:21:40,800 --> 00:21:44,960 Speaker 1: and over the centuries, as you know, economic cycles rise 326 00:21:45,040 --> 00:21:51,600 Speaker 1: and full. If you take these manufacturing areas of Wisconsin, Michigan, Ohio, Pennsylvania, 327 00:21:51,960 --> 00:21:54,520 Speaker 1: three or four hundred years ago, it was all agriculture, 328 00:21:55,160 --> 00:21:59,200 Speaker 1: and before that land was owned by the indigenous inhabitants 329 00:21:59,240 --> 00:22:03,400 Speaker 1: of this continent. And similarly, when the Industrial Revolution came 330 00:22:03,440 --> 00:22:07,560 Speaker 1: to northeastern England. The cotton mill and the spinning wheel 331 00:22:07,680 --> 00:22:11,320 Speaker 1: was replaced Shore Luod. It's busted up a few workshops 332 00:22:11,320 --> 00:22:18,200 Speaker 1: in Manchester and Liverpool, but those cities rose again on steel, shipbuilding, 333 00:22:18,520 --> 00:22:23,600 Speaker 1: pop music. Why should we be so head up, wound 334 00:22:23,680 --> 00:22:28,520 Speaker 1: up and concerned about this group, this slice of industry, 335 00:22:28,720 --> 00:22:31,800 Speaker 1: in this portion of the country. I would say we 336 00:22:31,800 --> 00:22:34,480 Speaker 1: should be concerned because these people are dying in middle 337 00:22:34,480 --> 00:22:38,320 Speaker 1: ages where they have no business dying. Their despair is 338 00:22:38,359 --> 00:22:43,560 Speaker 1: actually palpable that at any given age, year on year 339 00:22:44,119 --> 00:22:49,560 Speaker 1: they report more mental distress, they report um, you know, 340 00:22:49,760 --> 00:22:57,240 Speaker 1: poor psychological health, and we I think if we want 341 00:22:57,320 --> 00:23:02,119 Speaker 1: to be a country, one country, we're going to have 342 00:23:02,240 --> 00:23:05,600 Speaker 1: to find a way to weave ourselves back together again. 343 00:23:06,680 --> 00:23:10,280 Speaker 1: And it's a depressing issue, but it's one that is 344 00:23:10,320 --> 00:23:14,000 Speaker 1: not going to be going away anytime soon and one 345 00:23:14,040 --> 00:23:18,120 Speaker 1: that we will surely be watching for years and generations 346 00:23:18,160 --> 00:23:20,760 Speaker 1: to come. Thank you so much for taking the time 347 00:23:20,800 --> 00:23:30,960 Speaker 1: again to be on benchmark today. Thank you so Dan. 348 00:23:31,880 --> 00:23:34,760 Speaker 1: Is this ever going to change? Is this issue? Is 349 00:23:34,800 --> 00:23:37,120 Speaker 1: there anything that you think can be done to actually 350 00:23:37,280 --> 00:23:42,560 Speaker 1: reverse this incredible increase in the death rate among white 351 00:23:42,560 --> 00:23:46,880 Speaker 1: working class Americans. The forces at work almost seem as 352 00:23:46,920 --> 00:23:51,520 Speaker 1: profound as the statistics that Anne cited. I try to 353 00:23:51,560 --> 00:23:54,800 Speaker 1: get her to talk a little bit about this issue. 354 00:23:54,880 --> 00:23:58,240 Speaker 1: She rised at the start where it might end, and 355 00:23:58,440 --> 00:24:00,600 Speaker 1: there was one thing she said just to the closing 356 00:24:00,680 --> 00:24:03,040 Speaker 1: there that stoffled me, and we should have it back 357 00:24:03,080 --> 00:24:05,840 Speaker 1: on to talk about this said, if we want to 358 00:24:05,880 --> 00:24:10,119 Speaker 1: remain one country. Did you notice that it now that 359 00:24:10,160 --> 00:24:13,560 Speaker 1: you're pointing at again, it is quite a profound statement. Yes, 360 00:24:14,800 --> 00:24:18,800 Speaker 1: implication being that this doesn't end will if you have 361 00:24:19,000 --> 00:24:24,040 Speaker 1: the death rate cleave off so so prominently from the 362 00:24:24,080 --> 00:24:27,479 Speaker 1: rest of the country. This is obviously more than just 363 00:24:27,720 --> 00:24:31,480 Speaker 1: an economic issue for our statistics. This is this is 364 00:24:31,520 --> 00:24:34,520 Speaker 1: life and death, and it could very well be a 365 00:24:35,400 --> 00:24:39,080 Speaker 1: change in the republic that makes news in more ways 366 00:24:39,160 --> 00:24:43,359 Speaker 1: beyond these statistics. Benchmark will be back next week and 367 00:24:43,480 --> 00:24:45,800 Speaker 1: until then, you can find us on the Bloomberg terminal, 368 00:24:45,840 --> 00:24:49,679 Speaker 1: Bloomberg dot Com, our Bloomberg app, as well as on iTunes, 369 00:24:49,840 --> 00:24:54,080 Speaker 1: pocket casts, and Stitcher, or wherever you might enjoy finding podcasts. 370 00:24:54,600 --> 00:24:56,679 Speaker 1: While you're there, take a minute to rate and review 371 00:24:56,680 --> 00:24:59,520 Speaker 1: the show so more listeners can find us and let 372 00:24:59,560 --> 00:25:01,359 Speaker 1: us know what thought of the show. You can follow 373 00:25:01,600 --> 00:25:05,400 Speaker 1: me on Twitter at at scott Landman Dan. You are 374 00:25:05,480 --> 00:25:10,520 Speaker 1: at at Moss Underscore. Echo Benchmark is produced by Sarah Patterson. 375 00:25:10,880 --> 00:25:14,200 Speaker 1: The head of podcast is Alec McCabe. Thanks for listening, 376 00:25:14,280 --> 00:25:15,240 Speaker 1: we'll see you next time.