Anne Case: So, we started sniffing around, I think, in 2013. Angus was writing a paper to see whether or not self-reported well-being held anything interesting in it. And so, he was looking over the country to see whether or not suicides correlated where people reported themselves to be their life evaluation was higher or lower. Turned out he found no correlation there at all. But what he saw was that suicides were going up.
And on the other side of the room, literally, I was looking at pain and that every year in the National Health Interview Survey, we get pretty good battery of questions on pain. And that from the 1990s onward, people were reporting more and more pain every year. And so, that was sort of the very beginning of it.
And then we thought, well, suicides are going up, but what's happening to mortality for people in midlife altogether? And then what we saw was that for whites, and was whites at that point because suicide was something that affects whites a lot more than any other race, suicides mortality for people in midlife was rising. And that was stunning. The idea that after a century of decline, we would actually see mortality rates going up, and it wasn't being reported.
We thought, well, maybe we did something wrong. Maybe we should recheck our numbers, which we did. We took them on the road. We took them to medical schools and talked to our favorite demographers. And this came as a surprise to everyone. So, then we really started to dig.
Angus Deaton: Right. And from that very early paper, in that first paper, we went back to the individual death certificates. You know, we got a record of every single death that had happened in all those years. And we were interested not only with what was killing people, but splitting up who was dying. And there was an early clue there that's in the original paper and much developed later. Turns out, if you've got a four-year BA, you're sort of protected against this.
So, the people who were dying were people who did not have a four-year BA. And it's very important to emphasize that's the majority of the population. So, as of now, about 60 percent of the population do not have a four-year college degree. And those are the people at risk.
And if you go back and look at their life expectancy or you look at life expectancy at 25, by which time most people have finished their education, then it turns out that the bad things had started happening much earlier. So, in fact, there's been really no increase in adult life expectancy for people without a BA since about 2009, which whereas those with a BA are, you know, just going on as before and getting longer and longer. All the things you so eloquently said ought to happen are happening to the educated minority.
So, you've got this great divide in American society, which of course parallels many other divides. The voting divides, the polarization between people with and without a college degree.
Chris Hayes: And I want to not linger too long on this somewhat nerdy side point, but it's a non-trivial statistical task that you set yourself to. Meaning, like, it wasn't like the data's just like there and it's like, why didn't people see this? When you talk about going to the death certificates, it's like, you had to go down the individual level and then aggregate back up --
Anne Case: Yes.
Chris Hayes: -- so that you can actually find the phenomenon, right? That's why no one had quite gotten it before, because whether people have a degree or not or where they are, under what conditions, there's broad public health data, but you were doing it in a much more sort of granular way.
Anne Case: Yeah, on our little computers, we have like 80 million death records for adults in America, going back to about 1990.
Chris Hayes: Wow.
Anne Case: In 1989, that was the year they put education on the standard U.S. death certificate.
Chris Hayes: Wow.
Anne Case: And it's really our only marker, which is why we started with that, and it actually turns out to be important across all these dysfunctions. But it's our only marker. We don't know income or occupation or whether your mother loved you. None of that is on your death record, but your education is.
So, that's how we started to try to like, pull the data apart. And actually, Angus said like, life expectancy for that group, the two-thirds of Americans without a BA, did start falling around 2009.
Anne Case: It's not just self-reports when we say that deaths from alcoholic liver disease are on an upward trend and have been so for people without a BA as far back as we have education on the death records.
Angus Deaton: But there's a nexus of all these things going together. I mean, one of the things when Anne and I were on different sides of the room back in 2013, which we covered fairly early on, was that across space, pain and suicide are very closely correlated with one another.
So, pain predicts suicide better than guns predicts suicide, for example --
Chris Hayes: Wow.
Angus Deaton: -- I mean. And so, that's a really big deal. And also, as Anne was saying there, there's this social pain. You know, I think the pain guys now don't think of it in this Cartesian way of, I hurt my foot. It's more of the all pain is in the brain and it can come from social exclusion and social distress just as much as it can come from physical injury.
And, you know, there's this other thing beyond the pain, when you begin to look at people's marriages, you know, you begin to look at their attachment to institutions like churches and so on. The whole decline, the Putnam stuff of the decline in social capital, that is all adversely affecting people at the same time, too.
So, you just get this horrible mess. And, you know, there are a lot of causal chains going on here. And some of it, of course, has got to be traceable back to the loss of employment opportunities, the loss of good jobs for people who don't have a college degree, for example.
Chris Hayes: Yeah, just one, and I know this is something you guys have addressed, but just if people are listening to this, tracking it, the sort of inflection point around '89 or '90, that's a little bit of a methodological artifact, right? Because that's when we get the death certificate data.
So, I guess the question is, do we know if there's a divergence prior to that or is that just an unanswerable question?
Anne Case: No, it's interesting. In the data, what I have in my memory bank is looking at women, right? And headline writers would say, white men dying, which was not right. It's men and women are dying at higher rates. If you go back far enough in the data, women didn't kill themselves in this way.
Chris Hayes: Right.
Anne Case: So, back in 1990, the suicide rate or the drug overdose death rate for women with and without a BA was identical. And that was the point at --
Chris Hayes: Wow.
Anne Case: -- which they actually diverged.
Chris Hayes: Wow.
https://www.msnbc.com/msnbc-podcast/why ... s-n1305967
What else started trending in 1990, as discussed previously.
Higgenbotham wrote: ↑Mon Jun 26, 2023 2:00 am
Here is some data on what has happened since Micron Technology was founded in 1978.
Under Ronald Reagan, who was in office from 1981 to 1989, there was a push to encourage small business formation, and the gap between the number of employees in small businesses versus large businesses widened to the widest gap on the chart in favor of small businesses. It remained approximately steady under George Bush. Once Clinton entered office in 1993, the gap completely closed and when Clinton left office more Americans worked for large businesses for the first time. Under the younger George Bush, once again, there was little change. When Obama entered office in 2009, once again, large businesses were favored and the gap widened even more in favor of large businesses to its widest gap on the chart in favor of large businesses.
Americans, in a generational reversal, are now more likely to work for a large employer than a small one, a shift that’s rippling through the economy.
By Theo Francis
Published April 6, 2017 at 10:45 a.m. ET
The United States has long held itself out as a nation driven by entrepreneurs and small businesses. Presidents and politicians still invoke that image, and for generations, it was largely accurate.
Today, the U.S. has become something different: a nation of employees working for large companies, often very large ones.
In the late 1970s, an American employee was more likely to work at a company with fewer than a hundred workers than one that employed 2,500 or more. Today, Americans are more likely to work for the larger firms.
More than a quarter of all U.S. employees worked at firms employing at least 10,000 people in 2014, the most recent year for which the Census Bureau has released comprehensive data.
Huge companies dominate American economic life well beyond employment. They ring up a disproportionate share of sales for goods and services, both to consumers and to other businesses.
Scale alone isn’t bad. It can bring substantial efficiencies. National cellular providers can spare customers the complexity and expense of roaming charges. At the same time, scale begets scale as big companies reinforce one another. Big retailers prefer big distributors. Big manufacturers need big suppliers.
Over time, economists say, nimble new companies should form to challenge sprawling incumbents. That isn’t happening as much these days. Young firms often fail or are absorbed by existing giants. The problem now is that business formation has slowed.
https://www.wsj.com/graphics/big-companies-get-bigger/
Angus Deaton: -- and put us on a better track. I think we're still on the bad track.
Anne Case: But one other little piece of the puzzle when we were pulling it apart was that these deaths from alcohol and deaths separately from suicide and deaths separately from drugs are much worse for birth cohorts that came up on later. So, people born in 1960 are at higher risk at any given age than people born in 1950. And those born in 1970 are in worse shape than those born in 1960 and so on.
So, we don't see this coming to an end. What we're seeing so far in the data is that younger people entering the labor market without much hope of finding a good job without a four-year degree, well, one thing that happens to them is they can't get married.
The marriage rates dropped. From 1980 to 1990, marriage rates dropped for people with and without a college degree. It was --
Angus Deaton: Yes.
Anne Case: -- just like people stopped getting married in quite as big numbers. But for people with a BA, now it's stable. For people without a BA, marriage rates continue to drop.
So, people don't have a stable home life. They'll cohabit, they'll have a kid, but then they split up. They may cohabit again, they may have another kid --
Chris Hayes: Yeah.
Anne Case: -- but none of it's very stable. And they've given up on organized religion, which regardless of what people think of organized religion, it's an institution that's been important in this country since its founding. If you needed --
Chris Hayes: Well, yes, and --
Anne Case: --solace --
Chris Hayes: -- and in human life, I mean --
Anne Case: Yes. It’s a --
Chris Hayes: -- not just here, obviously. Yeah.
Anne Case: It's a place where you go and people embrace you, and there's a certain amount of community you find there.
Chris Hayes: Yeah.
Anne Case: That's gone. Family life is gone. You don't have a good work life. So, going back to Durkheim, which is what it sent us back to, that's like a recipe for suicide. You know, the pillars that held you up are eroded, we think, because of a really bad job market.
Chris Hayes: Right. So, we've got a phenomenon here and then a sort of proximate cause, which is some sort of social unraveling, right? So, that people's connections both to each other, to institutions, to community, to family are coming apart. They are left lonelier and more alienated. And that loneliness and alienation are drivers of the kinds of behavior or actions that lead to this --
Anne Case: Yeah.
Chris Hayes: -- shorter life expectancy.
Higgenbotham wrote: ↑Sun Feb 05, 2023 12:21 pm
My number 1 indicator that the world has entered into a new dark age is the decline in life expectancy. Whether you need to look at every country is debatable. My belief is that looking at the hegemon is enough and probably the best indicator.
The "Putnam stuff of the decline in social capital" that he mentions was discussed starting here:
viewtopic.php?f=25&t=6249&p=77781&hilit=putnam#p77781
Higgenbotham wrote: ↑Wed Jun 14, 2023 1:58 am
As best as I can recall, life expectancy in the US first began declining on the periphery - for white women in rural counties across the South. Hundreds of counties. For these women, the forces that support human life were being overwhelmed by the forces that destroy human life. How long it takes for those forces to actually show up in the life expectancy numbers under those conditions is unknown to me. It might be 20 years, maybe longer. At the time, life expectancy in the country overall was still rising. Now it has fallen by a few years. For anyone wanting to do a deep dive, it would be my guess that life expectancy is still rising in the counties surrounding Washington, D.C., in Silicon Valley, and maybe a few other select places in the US, but not many. It would also be my guess that when the life expectancy in the cities does collapse suddenly, it will go below the worst areas on the periphery, then life expectancy on the periphery will actually stabilize or even rise for a time.
In any event, I think the forces that supported human life were still greater than the forces that destroyed human life in the first half of the 20th century and for many years beyond that virtually everywhere. That started to change a bit after the turn of the century in many places and has accelerated in the past 3 years.
It appears it really started to change around 1990 and that it took about 30 years to show up in the aggregated data.
In the interview, they also mention the collapse of the Soviet Union and how the data there parallels the data in the US. I've mentioned before that many feel the new dark age began in 1914 or thereabouts but that I didn't agree because it didn't show up in the life expectancy numbers until now and therefore the forces that supported human life were still greater from 1914 until, it appears, 1990. It's possible, though, that there is something objectively measurable that can be identified earlier that inevitably leads to a decline in the forces that support human life, but I'm not aware of what that would be.
Also, in the interview, they mention the possibility of Civil War in the US due to the class divide. I've previously said Civil War is not possible in the US due to the racial divide because experiences across the US are too variable. However, with regard to class, experiences are uniform across the US because they were deliberately engineered by the Clinton and Obama Democrats to be that way.
Angus Deaton: But, you know, all of that may or may not be true. But, you know, if you make two-thirds of your own population so angry with you that they're going to come for you with pitchforks, then what you do internationally is neither here nor there, because we're going to be in a civil war domestically.
So, those things just have to take priority over foreign aid or helping Chinese or helping Indians, all of which are great things in themselves. But we've got to find some way of attending to this domestic problem where we're going to tear ourselves apart.
Chris Hayes: Yeah. I mean, to me, I did a monologue on this before the president's State of the Union in which I said, if I were writing the State of the Union, I would announce a commission that was focused on this question on life expectancy and set a moon landing target.
We are going to increase life expectancy in this country, particularly for people without BAs in the next three years, whatever it is. And I want to report from you guys about, give me 10 things we can do to get there. Because it seems to me it has to be named and identified as an actual explicit metric --
Anne Case: Yeah.
Chris Hayes: -- as a governing score. I mean, to me, it's the score. If people are dying early, what are we doing? What's the whole point of all this? Really? Like, okay, we have cheap televisions. I don't know, like --
Anne Case: Right.
Chris Hayes: But the only resource that matters in the end is the one precious life that we have on this planet and some sense of joy and social solidarity and love and mutual recognition while we're here.
Angus Deaton: We're with you --