9 ms·

Anatomists of Melancholy in the Age of Coronavirus

64 points by andrewl 7y ago

drpgq 7y ago
I would be curious to see death statistics for people with a college degree across majors.
- insideBig3 7y ago
  This was my first thought. But I can imagine that even having an art degree would give you confidence.
  - patcon 7y ago
    my assumption is that any degree is a marker of perseverance to people hiring. If you're hiring for an admin role, would you rather the person with the HS diploma or with the arts degree? I'm reluctant to admit I'd probably be pretty biased myself without great care (and most people are busy with their own concerns and prob don't care)
philshem 7y ago
Another review by Atul Gawande in the March 23, 2020 issue of the New Yorker https://www.newyorker.com/magazine/2020/03/23/why-americans-are-dying-from-despair https://www.newyorker.com/magazine/2020/03/23/why-americans-...
insideBig3 7y ago
(assuming Maslow's) Is the issue that (white) people are getting past love and belonging, and getting stuck at Esteem? Where people with degrees can work past this point? A restaurant worker will not be able to create a reputation/make a difference on the scale of a well paid or educated worker. Even if it's not the education that makes the difference, confidence is huge.
- JadeNB 7y ago
  > A restaurant worker will not be able to create a reputation/make a difference on the scale of a well paid or educated worker. I'm sure it's what you meant, but I'd like to clarify that this is a feeling, not a fact. It's entirely possible for a restaurant worker to make a difference, just like it's entirely possible for a well paid and well educated worker to make no difference at all. (That's entirely setting aside the fact that what you do and the change you cause with your life is in no way determined by the job you're paid for.) I think the point is that society tells our less well paid and well educated workers, explicitly and implicitly, that they are worth less and can contribute less, which is what gives rise to this feeling, but also why I think it's so important to clarify that it is a feeling and not a fact.
- cultus 7y ago
  There's plenty of educated and well paid workers doing useless, "bullshit" jobs [0]. Look in the admin buildings of any university, or any sclerotic military contractor. In comparison, a friendly waiter whom people like seeing could make a far greater real-world difference. [0] https://www.newyorker.com/books/under-review/the-bullshit-job-boom https://www.newyorker.com/books/under-review/the-bullshit-jo...
  - throwanem 7y ago
    Meanwhile, the bullshit job earns six figures, while the waiter's barely scraping by.
oDot 7y ago
They wrongly call the current economy in the US "capitalist". The US is less capitalist than ever.
- Torwald 7y ago
  what is your definition of a capitalist economy then?
  - som33 7y ago
    He's uneducated, capitalism as the upper class preaches from the universities has never existed. https://www.youtube.com/watch?v=WHj2GaPuEhY https://www.youtube.com/watch?v=WHj2GaPuEhY
    - oDot 7y ago
      You're attacking a straw man. I did not say pure capitalism existed before, but that the US is less capitalist today than before.
  - oDot 7y ago
    An economy that is void of coercion (in the sense of violence or threat of it) Clarification edit: Coercion in response to coercion is self-defense. If someone physically forced their way to your property, you have a right to defend yourself, and this should be enforced. We need some way make sure there's no coercion in the market.
    - som33 7y ago
      Property is naturally coercive, why don't we have the right to repair and own our software? The last 20 years has the videogame industry hacking and stealing videogames en mass since the rise of the internet. I know because I lived through it. Games before steam and client-server based rpg's that were designed to trick gullible consumers to give up PC game ownership.
      - 7y ago
tgafpc2 7y ago
"deadly despair that arises from the lack of a college degree" This is a joke right?
- raister 7y ago
  Have you read the article in its entirety? It takes them the full text to convey the major idea.
- hn_throwaway_99 7y ago
  I downvoted this comment, but I'll take the time to explain why I despise comments like this, and why I think HN should remain an oasis without these types of comments. I see this everywhere on places like FB, Twitter and Reddit where people take a single sentence or two and blatantly disregard its most obvious intended meaning, instead focusing on the words alone, with no context. I'm assuming you're imagining faces from the "first world problems" meme, crying that they don't have a college degree. Where a simpler and more generous explanation would be that people without a college degree have little hope of advancement in much of the US, and are stuck in dead-end jobs just at the time these jobs are becoming more precarious and lower paying, with a small health crisis all that is needed to drive one into bankruptcy. So I think we should interpret the most obvious intended meaning, "deadly despair that arises from the lack of opportunity and stability from not having a college degree", instead of making a lame non-joke joke.
  - WilliamEdward 7y ago
    Thanks for explaining and not just downvoting them. This is a serious socioeconomic issue.
generalpass 7y ago
Title is wrong. Should be: Anatomists of Melancholy in the Age of Coronavirus
JKCalhoun 7y ago
> "We don’t think [American capitalism] is working for people without a four-year college degree — and that’s two-thirds of Americans between the ages of 25 and 64." The coronavirus outbreak, the dire economic forecast, the millions of newly unemployed — all of these recent events raise the stakes of their research. These are sobering thoughts. To oversimplify, I feel we have sold off the blue-collar jobs to the lowest bidder nations and left nothing for, as the authors point out, "two-thirds of Americans between the ages of 25 and 64." There will be continued and perhaps a heightened social reckoning.
nickthemagicman 7y ago
I would like to see a control group of rich kids without college degrees to find out if it's actually the college degree or the money. I suspect it's not the college degree at all but money and people with college degrees make more money and have better opportunities on average.
- zamfi 7y ago
  They explicitly look at poverty. It doesn’t explain why these deaths happen among whites but not among non-whites, who have higher poverty rates.
  - pretendscholar 7y ago
    Maybe a difference in perceived career expectations
black_13 7y ago
so many jobs do not need college degree ... its not degree is a pay. all jobs should pay more if you brought the pay up the question of having a degree would be less important. i know this will be argued that it will cause inflation or why should someone without a degree make as much as me.
k__ 7y ago
Opioids, prisons, elections, healthcare, education... Man, what's happening over there?
- deleted 7y ago
  [deleted]
- WilliamEdward 7y ago
  Unregulated capitalism, their research suggests. Opioids have few regulations on how much are prescribed. This ties in directly to the healthcare issue. Private Prisons are run by using prisoners as workers for less than a dollar an hour. This is constitutionally legal. This means there is a financial incentive to imprison people. Elections are influenced by corporate lobbying. The state works for businesses at least as much as it works for the people, but guess who gets first preference. Healthcare is based on profit and not on saving lives. Self explanatory and this has been talked about countless times throughout the past 4 years. Education I don't know much about.
  - lukifer 7y ago
    Re: education, I think Bryan Caplan and Robin Hanson have got this one right: it's 80% about signaling and conformity, and only 20% educational payload (on average). As with so many bad systems, perverse incentives and social normalization prompts the vast majority of the participants to keep playing along, not despite the inefficiencies of busywork and administrative overhead, but precisely because of them. https://en.wikipedia.org/wiki/The_Case_Against_Education https://en.wikipedia.org/wiki/The_Case_Against_Education http://elephantinthebrain.com/ http://elephantinthebrain.com/
  - Nasrudith 7y ago
    Aside from the role of unethical opiod producers and marketers (which to be fair does fall under the umbrella of unregulated capitalism) weren't there plenty of preceding examples in Russia and even the USSR with first deaths by alcoholism and then later infamous krokodil deaths? The latter is more small scale addict enterprise even if it is again not exactly regulated capitalism. The point being that the system isn't the direct cause even if it allows it.
hhs 7y ago
Finished reading the book recently: it cites a range of economic research, if interested. They make the point that a weakening of labor unions over the years also contributed to this, referencing a paper called “Unions and Inequality Over the Twentieth Century” [0]. [0]: https://www.nber.org/papers/w24587 https://www.nber.org/papers/w24587
- spamizbad 7y ago
  There was a belief between the 70s and early 90s that less economic security among workers would not only make them less likely to strike but would also shape them behaviorally so they’d be more likely to get (And stay) married and attend church while being less likely to have children out of wedlock, gamble, and participate in anti-social risky behavior. The thinking at the time was the American worker was soft and decadent - thanks in part by the unions - and that was the ultimate cause of the social changes, unrest and malaise from the previous and current decade. It was a massive social engineering experiment that backfired spectacularly.
  - jacobolus 7y ago
    > There was a belief [...] Who had this belief? I have never in my life heard someone claim that economic insecurity leads to more marriages, more stable families, and less other risk taking. Who exactly was doing this “social engineering experiment”? My impression is rather that various corporate interests with influence in one major political party tried to cut down unions, labor laws, consumer protections, antitrust law, etc. as a way to save money and avoid legal liability, not really caring too much about the broader societal implications. Alongside that, there was also a “tough on crime” movement, and lots of racist/nativist agitation, because fear is an effective way to drive votes.
    - spamizbad 7y ago
      Who? A certain strain of Reagan/Bush conservative intellectuals of that era. David Frum’s 1994 book “Dead Right” talks about it briefly (he mostly lambasts it from the right). It should be mentioned this view fell into the memory hole of politics after Clinton’s victories in the 90s. For obvious reasons for being both wrong and politically toxic for supply-siders.
tengbretson 7y ago
> The state wields it's incredible power to shutdown nearly all free enterprise. > "Why would capitalism do this??"
weeksie 7y ago
Most of the surge in "deaths of despair" can be chalked up to opioids being far more powerful. Fentanyl and OxyContin are your bogeymen, the rest of the causal speculation is window dressing. Not that we shouldn't want a more equitable society, but closing the coal mine didn't kill those hillbillies, Purdue Pharma did.
- aspenmayer 7y ago
  Let’s not take it for granted that there are many external factors that cause people to use substances. It’s not ideal that people are hurt. If they still had their jobs maybe their insurance would have covered addiction treatment. It would be more ideal if healthcare were disincorporated from employment. We should do better and not accept these harms as inevitable. They are upsetting and we should be stirred to right action to change the system.
  - weeksie 7y ago
    People used drugs before.
    - aspenmayer 7y ago
      Yeah, probably before society even existed. They likely always will and that’s okay too. What’s your point?
      - weeksie 7y ago
        My point is that pet social projects are fine, and I would absolutely agree that we need a more equitable society, but the root cause of these deaths is that the drugs people use right now are far, far more deadly than they were before the turn of the century. Change that, you change the surge in deaths. We deindustrialized in the 80s and 90s. The spike didn't start until 2000, just after OxyContin came out. That's your guy.
        deleted 7y ago
        [deleted]
robomartin 7y ago
Interesting work. I’ll accept their conclusion without looking at the underlying data. That said, conclusions are only as good as the data and methods used to produce them. If we looked our physical world and universe and neglected to include the influence of gravity we would reach conclusions that could be valid in that context yet not so if gravity is considered. It is important to understand this for any study, not just this one. So, what’s the “gravity” missing from this study? The erosion (or disappearance really) of the industrial base in the US (and other parts of the world). The industrial base is where the people at the center of this study found employment, careers and the basis for a fulfilling family life. With that gone we have the reality rightly exposed by this study. Yet, the solution isn’t more college degrees. This virus has exposed a sad reality: That the industrial base in the west has been eroded down to the point where we can’t locally manufacture simple products like masks and gowns at scale. We can’t even manufacture the plastic vials, swabs, reagents and packaging for vital test kits at scale (just try to find somewhere where you can order a billion of these in the US or Europe). That, as the world know now, is a formula for disaster. And that is where the solution to the problem exposed by this paper lies. Put simply, the US and Europe need to invest heavily in taking back massive segments of the industrial base. This won’t be cheap, simple or fast, and yet I think everyone understands this must be done. We don’t need more degrees, we need to recover a portion of the economy that has evaporated over the last fifty years. The other missing elements in the study are: Europe and the rest of the world. Europe is an obvious place to ask: Does the same demographic have the same problems? The rest of the world is, in some way, the “placebo” for a study like this. The study says that non-US whites and other races in the US don’t seem to have this problem. The obvious question is: How do they do at their countries of origin? The answers to these basic questions would help frame the results and perhaps reveal some of the issues in the US. One of the questions I would ask is: What is the effect of the $15/hr minimum wage on this segment of society? I visited a friend’s factory in Los Angeles yesterday. Massive place. Imagine a Home Depot full of every type of manufacturing equipment you can imagine. We talked about why he can’t manufacture consumer goods in this factory. It came down to high minimum wage, high taxes and onerous regulatory burden. He could literally hire hundreds of people and make consumer goods at scale were it not for this framework that simple makes manufacturing of consumer goods at scale (include masks, gowns and test kits in that) in the US impossible. I am not n necessarily talking about simple products here. Phones, computers, graphics cards, displays, computer mice, tablets, watches, printers, tv’s, microwave ovens, refrigerators, clothes washers, grass mowers, etc. I could go on forever. Walk into a Home Depot or Best Buy. We can’t make anything sold in those stores (except for some of the construction materials at Home Depot). The problem isn’t the lack of college degrees. The problem isn’t even capitalism. The problem is a combination of failed international and domestic policies that allowed for the loss of a massive portion of the industrial base that employed tens of millions of people for decades. We can fix this.
Nasrudith 7y ago
I think there isn't enough emphasis on culture as a factor of deaths of despair. The fact it is restricted to being higher among whites as opposed to those even worse off. Not to victim blame but that the difference might be useful for uncovering the root cause. There likely dysfunctional elements enshrined that are individually found within - take anti-intellectualism which is not exclusive to them may arise more in fatal combinations. There are likely many in reality but a simple "fatal combination" may also suffice. Anti-intelletualism has always lead to bad outcomes really as a whole. There may even be toxic movements /within/ a given college culture but crucially there is always an element of self improvement there as a motivation. Even in the most degenerate stereotypical case of "learn nothing in four years to get the diploma for connections" they still have a goal even if they have latter regrets from doing things wrong. The crab-bucket mentality often found within looks down upon those who do anything to try to make more of themselves as it makes them feel bad to see others try when they do not. A third obvious ingredient is "lack of opportunity" which has synnergy with the first two - if they see opportunity but wind up in learned helplessness leaving it out of reach or fundamentally betraying who they are or degrading themselves. Combine the three and well it starts to become understandable how it becomes a fatal trap. But minority groups show it isn't so simple. Given the evidence has throughly shown people are people the difference is likely that they tend to more often have or develop some sort of support network because they feel the world or authorities are aligned against them. Even the long cast out from born family LGBT members who were (and sadly often still are) societally strongly encouraged to keep it secret. Sadly one outlier I am aware of are Native Americans who tend to have less than ideal situations with reservations to put it mildly. It might be a matter of magnitudes as well. Of course even if the hypothesis is correct there is still a matter of how to address each variable of the systems.
- hhs 7y ago
  > Anti-intelletualism has always lead to bad outcomes really as a whole There’s a book called “Anti-intellectualism in American Life” by Richard Hofstadter, which explores the history of this [0]. Useful talk on HN too [1]. [0]: https://en.wikipedia.org/wiki/Anti-intellectualism_in_American_Life https://en.wikipedia.org/wiki/Anti-intellectualism_in_Americ... [1]: https://news.ycombinator.com/item?id=20989342 https://news.ycombinator.com/item?id=20989342
pragmatic 7y ago
No mention of NAFTA and the elites of both parties selling out the working class? I was all for NAFTA at the time but then I saw the consequences. People forced to train their replacements for a chance at another month of pay. Plants going to Mexico, etc. The people of the Boomer, Xer generation were told to work hard and everything would work out. When you find your body wrecked from 12 hour shifts, your employment opportunities limited and as a cherry on top labelled "deplorable" in the popular media, is it hard to see why older white Americans with less education might be depressed? You don't need a PhD and a bowtie to figure this out.

64 points by andrewl 7y ago

drpgq 7y ago

I would be curious to see death statistics for people with a college degree across majors.

insideBig3 7y ago
This was my first thought. But I can imagine that even having an art degree would give you confidence.
- patcon 7y ago
  my assumption is that any degree is a marker of perseverance to people hiring. If you're hiring for an admin role, would you rather the person with the HS diploma or with the arts degree? I'm reluctant to admit I'd probably be pretty biased myself without great care (and most people are busy with their own concerns and prob don't care)

philshem 7y ago

Another review by Atul Gawande in the March 23, 2020 issue of the New Yorker https://www.newyorker.com/magazine/2020/03/23/why-americans-are-dying-from-despair https://www.newyorker.com/magazine/2020/03/23/why-americans-...

insideBig3 7y ago

(assuming Maslow's) Is the issue that (white) people are getting past love and belonging, and getting stuck at Esteem? Where people with degrees can work past this point? A restaurant worker will not be able to create a reputation/make a difference on the scale of a well paid or educated worker. Even if it's not the education that makes the difference, confidence is huge.

JadeNB 7y ago
> A restaurant worker will not be able to create a reputation/make a difference on the scale of a well paid or educated worker. I'm sure it's what you meant, but I'd like to clarify that this is a feeling, not a fact. It's entirely possible for a restaurant worker to make a difference, just like it's entirely possible for a well paid and well educated worker to make no difference at all. (That's entirely setting aside the fact that what you do and the change you cause with your life is in no way determined by the job you're paid for.) I think the point is that society tells our less well paid and well educated workers, explicitly and implicitly, that they are worth less and can contribute less, which is what gives rise to this feeling, but also why I think it's so important to clarify that it is a feeling and not a fact.
cultus 7y ago
There's plenty of educated and well paid workers doing useless, "bullshit" jobs [0]. Look in the admin buildings of any university, or any sclerotic military contractor. In comparison, a friendly waiter whom people like seeing could make a far greater real-world difference. [0] https://www.newyorker.com/books/under-review/the-bullshit-job-boom https://www.newyorker.com/books/under-review/the-bullshit-jo...
- throwanem 7y ago
  Meanwhile, the bullshit job earns six figures, while the waiter's barely scraping by.

oDot 7y ago

They wrongly call the current economy in the US "capitalist". The US is less capitalist than ever.

Torwald 7y ago
what is your definition of a capitalist economy then?
- som33 7y ago
  He's uneducated, capitalism as the upper class preaches from the universities has never existed. https://www.youtube.com/watch?v=WHj2GaPuEhY https://www.youtube.com/watch?v=WHj2GaPuEhY
  - oDot 7y ago
    You're attacking a straw man. I did not say pure capitalism existed before, but that the US is less capitalist today than before.
- oDot 7y ago
  An economy that is void of coercion (in the sense of violence or threat of it) Clarification edit: Coercion in response to coercion is self-defense. If someone physically forced their way to your property, you have a right to defend yourself, and this should be enforced. We need some way make sure there's no coercion in the market.
  - som33 7y ago
    Property is naturally coercive, why don't we have the right to repair and own our software? The last 20 years has the videogame industry hacking and stealing videogames en mass since the rise of the internet. I know because I lived through it. Games before steam and client-server based rpg's that were designed to trick gullible consumers to give up PC game ownership.
    - 7y ago

tgafpc2 7y ago

"deadly despair that arises from the lack of a college degree" This is a joke right?

raister 7y ago
Have you read the article in its entirety? It takes them the full text to convey the major idea.
hn_throwaway_99 7y ago
I downvoted this comment, but I'll take the time to explain why I despise comments like this, and why I think HN should remain an oasis without these types of comments. I see this everywhere on places like FB, Twitter and Reddit where people take a single sentence or two and blatantly disregard its most obvious intended meaning, instead focusing on the words alone, with no context. I'm assuming you're imagining faces from the "first world problems" meme, crying that they don't have a college degree. Where a simpler and more generous explanation would be that people without a college degree have little hope of advancement in much of the US, and are stuck in dead-end jobs just at the time these jobs are becoming more precarious and lower paying, with a small health crisis all that is needed to drive one into bankruptcy. So I think we should interpret the most obvious intended meaning, "deadly despair that arises from the lack of opportunity and stability from not having a college degree", instead of making a lame non-joke joke.
- WilliamEdward 7y ago
  Thanks for explaining and not just downvoting them. This is a serious socioeconomic issue.

generalpass 7y ago

Title is wrong. Should be: Anatomists of Melancholy in the Age of Coronavirus

JKCalhoun 7y ago

> "We don’t think [American capitalism] is working for people without a four-year college degree — and that’s two-thirds of Americans between the ages of 25 and 64." The coronavirus outbreak, the dire economic forecast, the millions of newly unemployed — all of these recent events raise the stakes of their research. These are sobering thoughts. To oversimplify, I feel we have sold off the blue-collar jobs to the lowest bidder nations and left nothing for, as the authors point out, "two-thirds of Americans between the ages of 25 and 64." There will be continued and perhaps a heightened social reckoning.

nickthemagicman 7y ago

I would like to see a control group of rich kids without college degrees to find out if it's actually the college degree or the money. I suspect it's not the college degree at all but money and people with college degrees make more money and have better opportunities on average.

zamfi 7y ago
They explicitly look at poverty. It doesn’t explain why these deaths happen among whites but not among non-whites, who have higher poverty rates.
- pretendscholar 7y ago
  Maybe a difference in perceived career expectations

black_13 7y ago

so many jobs do not need college degree ... its not degree is a pay. all jobs should pay more if you brought the pay up the question of having a degree would be less important. i know this will be argued that it will cause inflation or why should someone without a degree make as much as me.

k__ 7y ago

Opioids, prisons, elections, healthcare, education... Man, what's happening over there?

deleted 7y ago
[deleted]
WilliamEdward 7y ago
Unregulated capitalism, their research suggests. Opioids have few regulations on how much are prescribed. This ties in directly to the healthcare issue. Private Prisons are run by using prisoners as workers for less than a dollar an hour. This is constitutionally legal. This means there is a financial incentive to imprison people. Elections are influenced by corporate lobbying. The state works for businesses at least as much as it works for the people, but guess who gets first preference. Healthcare is based on profit and not on saving lives. Self explanatory and this has been talked about countless times throughout the past 4 years. Education I don't know much about.
- lukifer 7y ago
  Re: education, I think Bryan Caplan and Robin Hanson have got this one right: it's 80% about signaling and conformity, and only 20% educational payload (on average). As with so many bad systems, perverse incentives and social normalization prompts the vast majority of the participants to keep playing along, not despite the inefficiencies of busywork and administrative overhead, but precisely because of them. https://en.wikipedia.org/wiki/The_Case_Against_Education https://en.wikipedia.org/wiki/The_Case_Against_Education http://elephantinthebrain.com/ http://elephantinthebrain.com/
- Nasrudith 7y ago
  Aside from the role of unethical opiod producers and marketers (which to be fair does fall under the umbrella of unregulated capitalism) weren't there plenty of preceding examples in Russia and even the USSR with first deaths by alcoholism and then later infamous krokodil deaths? The latter is more small scale addict enterprise even if it is again not exactly regulated capitalism. The point being that the system isn't the direct cause even if it allows it.

hhs 7y ago

Finished reading the book recently: it cites a range of economic research, if interested. They make the point that a weakening of labor unions over the years also contributed to this, referencing a paper called “Unions and Inequality Over the Twentieth Century” [0]. [0]: https://www.nber.org/papers/w24587 https://www.nber.org/papers/w24587

spamizbad 7y ago
There was a belief between the 70s and early 90s that less economic security among workers would not only make them less likely to strike but would also shape them behaviorally so they’d be more likely to get (And stay) married and attend church while being less likely to have children out of wedlock, gamble, and participate in anti-social risky behavior. The thinking at the time was the American worker was soft and decadent - thanks in part by the unions - and that was the ultimate cause of the social changes, unrest and malaise from the previous and current decade. It was a massive social engineering experiment that backfired spectacularly.
- jacobolus 7y ago
  > There was a belief [...] Who had this belief? I have never in my life heard someone claim that economic insecurity leads to more marriages, more stable families, and less other risk taking. Who exactly was doing this “social engineering experiment”? My impression is rather that various corporate interests with influence in one major political party tried to cut down unions, labor laws, consumer protections, antitrust law, etc. as a way to save money and avoid legal liability, not really caring too much about the broader societal implications. Alongside that, there was also a “tough on crime” movement, and lots of racist/nativist agitation, because fear is an effective way to drive votes.
  - spamizbad 7y ago
    Who? A certain strain of Reagan/Bush conservative intellectuals of that era. David Frum’s 1994 book “Dead Right” talks about it briefly (he mostly lambasts it from the right). It should be mentioned this view fell into the memory hole of politics after Clinton’s victories in the 90s. For obvious reasons for being both wrong and politically toxic for supply-siders.

tengbretson 7y ago

> The state wields it's incredible power to shutdown nearly all free enterprise. > "Why would capitalism do this??"

weeksie 7y ago

Most of the surge in "deaths of despair" can be chalked up to opioids being far more powerful. Fentanyl and OxyContin are your bogeymen, the rest of the causal speculation is window dressing. Not that we shouldn't want a more equitable society, but closing the coal mine didn't kill those hillbillies, Purdue Pharma did.

aspenmayer 7y ago
Let’s not take it for granted that there are many external factors that cause people to use substances. It’s not ideal that people are hurt. If they still had their jobs maybe their insurance would have covered addiction treatment. It would be more ideal if healthcare were disincorporated from employment. We should do better and not accept these harms as inevitable. They are upsetting and we should be stirred to right action to change the system.
- weeksie 7y ago
  People used drugs before.
  - aspenmayer 7y ago
    Yeah, probably before society even existed. They likely always will and that’s okay too. What’s your point?
    - weeksie 7y ago
      My point is that pet social projects are fine, and I would absolutely agree that we need a more equitable society, but the root cause of these deaths is that the drugs people use right now are far, far more deadly than they were before the turn of the century. Change that, you change the surge in deaths. We deindustrialized in the 80s and 90s. The spike didn't start until 2000, just after OxyContin came out. That's your guy.
      - deleted 7y ago
        [deleted]

robomartin 7y ago

Interesting work. I’ll accept their conclusion without looking at the underlying data. That said, conclusions are only as good as the data and methods used to produce them. If we looked our physical world and universe and neglected to include the influence of gravity we would reach conclusions that could be valid in that context yet not so if gravity is considered. It is important to understand this for any study, not just this one. So, what’s the “gravity” missing from this study? The erosion (or disappearance really) of the industrial base in the US (and other parts of the world). The industrial base is where the people at the center of this study found employment, careers and the basis for a fulfilling family life. With that gone we have the reality rightly exposed by this study. Yet, the solution isn’t more college degrees. This virus has exposed a sad reality: That the industrial base in the west has been eroded down to the point where we can’t locally manufacture simple products like masks and gowns at scale. We can’t even manufacture the plastic vials, swabs, reagents and packaging for vital test kits at scale (just try to find somewhere where you can order a billion of these in the US or Europe). That, as the world know now, is a formula for disaster. And that is where the solution to the problem exposed by this paper lies. Put simply, the US and Europe need to invest heavily in taking back massive segments of the industrial base. This won’t be cheap, simple or fast, and yet I think everyone understands this must be done. We don’t need more degrees, we need to recover a portion of the economy that has evaporated over the last fifty years. The other missing elements in the study are: Europe and the rest of the world. Europe is an obvious place to ask: Does the same demographic have the same problems? The rest of the world is, in some way, the “placebo” for a study like this. The study says that non-US whites and other races in the US don’t seem to have this problem. The obvious question is: How do they do at their countries of origin? The answers to these basic questions would help frame the results and perhaps reveal some of the issues in the US. One of the questions I would ask is: What is the effect of the $15/hr minimum wage on this segment of society? I visited a friend’s factory in Los Angeles yesterday. Massive place. Imagine a Home Depot full of every type of manufacturing equipment you can imagine. We talked about why he can’t manufacture consumer goods in this factory. It came down to high minimum wage, high taxes and onerous regulatory burden. He could literally hire hundreds of people and make consumer goods at scale were it not for this framework that simple makes manufacturing of consumer goods at scale (include masks, gowns and test kits in that) in the US impossible. I am not n necessarily talking about simple products here. Phones, computers, graphics cards, displays, computer mice, tablets, watches, printers, tv’s, microwave ovens, refrigerators, clothes washers, grass mowers, etc. I could go on forever. Walk into a Home Depot or Best Buy. We can’t make anything sold in those stores (except for some of the construction materials at Home Depot). The problem isn’t the lack of college degrees. The problem isn’t even capitalism. The problem is a combination of failed international and domestic policies that allowed for the loss of a massive portion of the industrial base that employed tens of millions of people for decades. We can fix this.

Nasrudith 7y ago

I think there isn't enough emphasis on culture as a factor of deaths of despair. The fact it is restricted to being higher among whites as opposed to those even worse off. Not to victim blame but that the difference might be useful for uncovering the root cause. There likely dysfunctional elements enshrined that are individually found within - take anti-intellectualism which is not exclusive to them may arise more in fatal combinations. There are likely many in reality but a simple "fatal combination" may also suffice. Anti-intelletualism has always lead to bad outcomes really as a whole. There may even be toxic movements /within/ a given college culture but crucially there is always an element of self improvement there as a motivation. Even in the most degenerate stereotypical case of "learn nothing in four years to get the diploma for connections" they still have a goal even if they have latter regrets from doing things wrong. The crab-bucket mentality often found within looks down upon those who do anything to try to make more of themselves as it makes them feel bad to see others try when they do not. A third obvious ingredient is "lack of opportunity" which has synnergy with the first two - if they see opportunity but wind up in learned helplessness leaving it out of reach or fundamentally betraying who they are or degrading themselves. Combine the three and well it starts to become understandable how it becomes a fatal trap. But minority groups show it isn't so simple. Given the evidence has throughly shown people are people the difference is likely that they tend to more often have or develop some sort of support network because they feel the world or authorities are aligned against them. Even the long cast out from born family LGBT members who were (and sadly often still are) societally strongly encouraged to keep it secret. Sadly one outlier I am aware of are Native Americans who tend to have less than ideal situations with reservations to put it mildly. It might be a matter of magnitudes as well. Of course even if the hypothesis is correct there is still a matter of how to address each variable of the systems.

hhs 7y ago
> Anti-intelletualism has always lead to bad outcomes really as a whole There’s a book called “Anti-intellectualism in American Life” by Richard Hofstadter, which explores the history of this [0]. Useful talk on HN too [1]. [0]: https://en.wikipedia.org/wiki/Anti-intellectualism_in_American_Life https://en.wikipedia.org/wiki/Anti-intellectualism_in_Americ... [1]: https://news.ycombinator.com/item?id=20989342 https://news.ycombinator.com/item?id=20989342

pragmatic 7y ago

No mention of NAFTA and the elites of both parties selling out the working class? I was all for NAFTA at the time but then I saw the consequences. People forced to train their replacements for a chance at another month of pay. Plants going to Mexico, etc. The people of the Boomer, Xer generation were told to work hard and everything would work out. When you find your body wrecked from 12 hour shifts, your employment opportunities limited and as a cherry on top labelled "deplorable" in the popular media, is it hard to see why older white Americans with less education might be depressed? You don't need a PhD and a bowtie to figure this out.