From the NYT:

By ANDREW J. CHERLIN FEB. 22, 2016 315 COMMENTS IT’S disturbing and puzzling news: Death rates are rising for white, less-educated Americans. … Both studies attributed the higher death rates to increases in poisonings and chronic liver disease, which mainly reflect drug overdoses and alcohol abuse, and to suicides. In contrast, death rates fell overall for blacks and Hispanics. Why are whites overdosing or drinking themselves to death at higher rates than African-Americans and Hispanics in similar circumstances? Some observers have suggested that higher rates of chronic opioid prescriptions could be involved, along with whites’ greater pessimism about their finances. Yet I’d like to propose a different answer: what social scientists call reference group theory. The term “reference group” was pioneered by the social psychologist Herbert H. Hyman in 1942, and the theory was developed by the Columbia sociologist Robert K. Merton in the 1950s. It tells us that to comprehend how people think and behave, it’s important to understand the standards to which they compare themselves. How is your life going? For most of us, the answer to that question means comparing our lives to the lives our parents were able to lead. As children and adolescents, we closely observed our parents. They were our first reference group. And here is one solution to the death-rate conundrum: It’s likely that many non-college-educated whites are comparing themselves to a generation that had more opportunities than they have, whereas many blacks and Hispanics are comparing themselves to a generation that had fewer opportunities.

Perhaps, although the death rate among youngish blacks was sky-high around 1990, due to shooting each other over crack and dying of AIDS, which is hard to fit in with Cherlin’s economic generational theory. I’m not saying Cherlin’s wrong, just that specific causes of people dropping dead rather than theories of a general malaise also need to be looked at.

The general malaise idea would fit in with phenomena we’ve seen in other times and places, such as the sharp decline in male life expectancy in Russia with the breakup of Communism, or the ongoing problems on Indian reservations. These are more than just economic problems but extend to a sense of defeatedness. But we shouldn’t immediately leap to a Big Picture explanation if Small Picture explanations are more conducive to fixing the problems.

When whites without college degrees look back, they can often remember fathers who were sustained by the booming industrial economy of postwar America. Since then, however, the industrial job market has slowed significantly. The hourly wages of male high school graduates declined by 14 percent from 1973 to 2012, according to analysis of data from the Economic Policy Institute. Although high school educated white women haven’t experienced the same major reversal of the job market, they may look at their husbands — or, if they are single, to the men they choose not to marry — and reason that life was better when they were growing up. African-Americans, however, didn’t get a fair share of the blue-collar prosperity of the postwar period. They may look back to a time when discrimination deprived their parents of equal opportunities. Many Hispanics may look back to the lower standard of living their parents experienced in their countries of origin. Whites are likely to compare themselves to a reference group that leads them to feel worse off. Blacks and Hispanics compare themselves to reference groups that may make them feel better off. The sociologist Timothy Nelson and I observed this phenomenon in interviews with high-school-educated young adult men in 2012 and 2013. A 35-year-old white man who did construction jobs said, “It’s much harder for me as a grown man than it was for my father.” He remembered his father saying that back when he was 35, “‘I had a house and I had five kids or four kids.’ You know, ‘Look where I was at.’ And I’m like, ‘Well, Dad, things have changed.’” African-American men were more upbeat. One said: “I think there are better opportunities now because first of all, the economy’s changing. The color barrier is not as harsh as it was back then.”

This is a good example of how these days you’re not supposed to remember how long ago the Civil Rights Era was. A 35 year old man in 2013 would have been born in about 1978 and have memories of growing up from about 1982. The color barrier was not all that harsh in the 1980s, but critical thinking about history using arithmetic to figure out how long ago things happened isn’t fashionable.

In addition, national surveys show striking racial and ethnic differences in satisfaction with one’s social standing relative to one’s parents. The General Social Survey conducted by the research organization NORC at the University of Chicago has asked Americans in its biennial surveys to compare their standard of living to that of their parents. In 2014, according to my analysis, among 25- to 54-year-olds without college degrees, blacks and Hispanics were much more positive than whites: 67 percent of African-Americans and 68 percent of Hispanics responded “much better” or “somewhat better,” compared with 47 percent of whites. Those figures represent a reversal from 2000, when whites were more positive than blacks, 64 percent to 60 percent. (Hispanics were the most positive in nearly all years.) But we size ourselves up based on more than just our parents. White workers historically have compared themselves against black workers, taking some comfort in seeing a group that was doing worse than them. Now, however, the decline of racial restrictions in the labor market and the spread of affirmative action have changed that. Non-college-graduate whites in the General Social Survey are more likely to agree that “conditions for black people have improved” than are comparable blacks themselves, 68 percent to 53 percent. Reference group theory explains why people who have more may feel that they have less. What matters is to whom you are comparing yourself. It’s not that white workers are doing worse than African-Americans or Hispanics. In the fourth quarter of 2015, the median weekly earnings of white men aged 25 to 54 were $950, well above the same figure for black men ($703) and Hispanic men ($701). But for some whites — perhaps the ones who account for the increasing death rate — that may be beside the point. Their main reference group is their parents’ generation, and by that standard they have little to look forward to and a lot to lament. Andrew J. Cherlin is a sociologist at Johns Hopkins University and the author of “Labor’s Love Lost: The Rise and Fall of the Working-Class Family in America.”

This is not to say that this model is wrong. But in thinking about the White Death, I’ve been encouraging a multiplicity of hypotheses rather than risk settling onto a single model too soon.

So, here’s another model: the White Death is less demand-driven, more supply-driven by innovations in first, providing pain pills, then in Mexican black tar heroin gangs marketing at the retail level to whites in obscure parts of the country.

Former L.A. Times reporter Sam Quinones has a book out called Dreamland on his reporting in places like southern Ohio. He argues that once the liberalization of opioid prescriptions in the early 2000s started getting more people hooked on legal pain pills, attempts to crack down on them played into the hands of a new model of Mexican heroin retailing. Last April, Quinones explained in the NYT:

Most of our heroin now comes not from Asia, but from Latin America, particularly Mexico, where poppies grow well in the mountains along the Pacific Coast. … The most important traffickers in this story hail from Xalisco, a county of 49,000 people near the Pacific Coast. They have devised a system for selling heroin across the United States that resembles pizza delivery. Dealers circulate a number around town. An addict calls, and an operator directs him to an intersection or a parking lot. The operator dispatches a driver, who tools around town, his mouth full of tiny balloons of heroin, with a bottle of water nearby to swig them down with if cops stop him. (“It’s amazing how many balloons you can learn to carry in your mouth,” said one dealer, who told me he could fit more than 30.) The driver meets the addict, spits out the required balloons, takes the money and that’s that. It happens every day — from 7 a.m. to 7 p.m., because these guys keep business hours. The Xalisco Boys, as one cop I know has nicknamed them, are far from our only heroin traffickers. But they may be our most prolific. As relentless as Amway salesmen, they embody our new drug-plague paradigm. Xalisco dealers are low profile — the anti-Scarface. Back home they are bakers, butchers and farm workers, part of a vast labor pool in Xalisco and surrounding towns, who hire on as heroin drivers for $300 to $500 a week. The drug trade offers them a shot at their own business, or simply a chance to make some money to show off back home — kings until the cash goes. Meanwhile, in the United States, they drive old cars with their cheeks packed like chipmunks’, and dress like the day workers in front of your Home Depot. The heroin delivery system appeals to them mainly because there is no cartel kingpin, no jefe máximo. It is meritocratic — so unlike Mexico. They are “people acting as individuals who are doing it on their own: micro-entrepreneurs,” said one phone operator for a crew who I interviewed while he was in prison. They are “looking for places where there’s no people, no competition,” he said. “Anyone can be boss of a network.” Thus the system distills what appeals to immigrants generally about America: It is a way to translate wits and hard work into real economic gain. … They are decidedly nonviolent — terrified, in fact, of battles for street corners with armed gangs. They don’t carry guns. They also have rules against selling to African-Americans because, as one dealer put it, “they’ll steal from you, and beat you.” The Boys started out on the fringes of the drug world in West Coast cities. In the late 1990s, they moved east in search of virgin territory. They avoided New York City, the country’s traditional center of heroin, because the market was already run by entrenched gangs. … They also skipped cities like Philadelphia and Baltimore, where black gangs control distribution. The Xalisco Boys migrated instead to prosperous midsize cities. These cities were predominantly white, but had large Mexican populations where the Boys could blend in. They were the first to open these markets to cheap, potent black-tar heroin in a sustained way. The map of their outposts amounts to a tour through our new heroin hubs: Nashville, Columbus and Charlotte, as well as Salt Lake City, Portland and Denver. THEY arrived in the Midwest just as a revolution in American medicine was underway, and an epidemic of pain-pill abuse was spreading over that region.

I’m reminded of Walmart’s strategy in the 1960s through the 1980s of avoiding obviously appealing but highly competitive retail markets like Southern California in favor of obscure, unfashionable locales underserved by metropolitan-oriented retailers.

This might help explain certain anomalies in where the White Death is bad (Appalachia) and not bad (Northern Plains). It could be that the Northern Plains haven’t succumbed as badly due to the more prosperous economy there. On the other hand, it could be that the Mexican retailers just haven’t expanded there yet.