Monday, November 30, 2020

Deaths of Despair

Something has gone horribly wrong in the US. Compared to other developed countries, it's not only unable to keep up with life expectancy improvements, but it appears to be regressing. This is despite the US badly outspending all other countries when it comes to healthcare, for outcomes that are worse.

When you break the problem into segments, it's clear where the problem is: whites with only highschool or less than highschool level education are faring very poorly. The data shows suicide, overdose and alcohol-related deaths in this group have been growing over the last 10-20 years. This is in stark contrast to what's been happening to almost everybody else, both inside and outside the United States.

In Deaths of Despair the authors first demonstrate this problem, take some educated guesses as to what the reasons for it are, and then offer some possible solutions.

This is a very big problem, and I appreciated learning more about it. I don't think the authors needed to spend so many pages to make a case that there is a problem, as it's very clear that there is one, but they go on and on about it anyway. Instead, I would have preferred more emphasis on solutions involving transitioning people from this under-educated group into educated groups. Something like only 1/3 of American 25 year olds have undergraduate degrees, which sounds abysmally low to me, considering the differences in earnings power between the groups. These differences have grown over time, suggesting education levels are not keeping pace with what the economy needs.

Instead, the authors focus on healthcare changes as a main solution. No doubt there are serious healthcare issues in the US, but I found this solution to be a bit ideological rather than directly related to helping reduce the problems this segment of the population faces. I also suspected ideological opinions at play when the authors negated illegal immigration as a cause of this group's lackluster earnings growth.

There are a lot of numbers thrown at you, which forces the reader to slow down and think but interrupts the flow. It took me a long time to get through it as a result! If the topic interests you, however, I do recommend the book.

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