The study’s authors say that working-class whites have faced “a long-term process of decline, or of cumulative deprivation.” This process, they argue, started with “those leaving high school and entering the labor force after the early 1970s—the peak of working-class wages, and the beginning of the end of the ‘blue-collar aristocracy.’”

As economic opportunities have dwindled for those without higher education, marriage rates have declined and divorce rates have risen, causing more men to lose regular contact with their children. These social trends promote distress—and in many cases, the effects are fatal. Since 1999, middle-age white Americans with only a high-school degree have seen a steep increase in “deaths of despair”—suicide, drug overdose, or alcohol abuse. Although opioids are not the primary cause of rising mortality rates, the authors say they are certainly adding “fuel to the flames.” Additional research finds that half of all working-age, unemployed men in America are taking pain medication—and two-thirds of them are taking prescription painkillers. Meanwhile, for middle-age white Americans of all educational backgrounds the average mortality rates from heart disease and cancer have slowed to just 1 percent per year.

Overall, rising mortality rates were most pronounced in states with large rural populations like Alabama, Kentucky, Tennessee, and Mississippi, though the authors find this to be both a rural and urban phenomenon. It is also, for reasons uncertain, a racial phenomenon. The study finds a decline in mortality rates among black and Hispanic Americans, despite seeing little difference in their income profiles. The authors also discover a much different pattern in Europe than in the United States. Not only are Europe’s mortality rates declining for all education groups; they are declining the fastest among the less-educated residents.



The study spotlights just how precarious the lives of less-educated, white, middle-age Americans have become in recent decades—and how precarious they must perceive their lives to be.

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