The white working class, which usually inspires liberal concern only for its paradoxical, Republican-leaning voting habits, has recently become newsworthy for something else: according to economist Anne Case and Angus Deaton, the winner of the latest Nobel Prize in economics, its members in the 45- to 54-year-old age group are dying at an immoderate rate. While the lifespan of affluent whites continues to lengthen, the lifespan of poor whites has been shrinking. As a result, in just the last four years, the gap between poor white men and wealthier ones has widened by up to four years. The New York Times summed up the Deaton and Case study with this headline: “Income Gap, Meet the Longevity Gap.”
This was not supposed to happen. For almost a century, the comforting American narrative was that better nutrition and medical care would guarantee longer lives for all. So the great blue-collar die-off has come out of the blue and is, as The Wall Street Journal says, “startling.”
It was especially not supposed to happen to whites who, in relation to people of color, have long had the advantage of higher earnings, better access to health care, safer neighborhoods, and of course freedom from the daily insults and harms inflicted on the darker-skinned. There has also been a major racial gap in longevity—5.3 years between white and black men and 3.8 years between white and black women—though, hardly noticed, it has been narrowing for the last two decades. Only whites, however, are now dying off in unexpectedly large numbers in middle age, their excess deaths accounted for by suicide, alcoholism, and drug (usually opiate) addiction.
There are some practical reasons why whites are likely to be more efficient than blacks at killing themselves. For one thing, they are more likely to be gun-owners, and white men favor gunshots as a means of suicide. For another, doctors, undoubtedly acting in part on stereotypes of non-whites as drug addicts, are more likely to prescribe powerful opiate painkillers to whites than to people of color. (I’ve been offered enough oxycodone prescriptions over the years to stock a small illegal business.)
Manual labor—from waitressing to construction work—tends to wear the body down quickly, from knees to back and rotator cuffs, and when Tylenol fails, the doctor may opt for an opiate just to get you through the day.
The Wages of Despair
But something more profound is going on here, too. As New York Times columnist Paul Krugman puts it, the “diseases” leading to excess white working-class deaths are those of “despair,” and some of the obvious causes are economic. In the last few decades, things have not been going well for working-class people of any color.
I grew up in an America where a man with a strong back—and better yet, a strong union—could reasonably expect to support a family on his own without a college degree. In 2015, those jobs are long gone, leaving only the kind of work once relegated to women and people of color available in areas like retail, landscaping, and delivery-truck driving. This means that those in the bottom 20% of white income distribution face material circumstances like those long familiar to poor blacks, including erratic employment and crowded, hazardous living spaces.