In the year following the first Moon landing of 1969, the poet and musician Gill- Scott Heron illustrated the inequality that existed between millions of impoverished African-Americans struggling to afford basic necessities and the soaring ambition of white America which had just spent $25.4 billion ($180 billion in today’s money) sending a few white men further than the American Dream ever promised, when he wrote that:
“A rat done bit my sister Nell, with whitey on the moon, Her face and arms begin to swell, and whitey’s on the moon. I can’t pay no doctor bills, but whitey’s on the moon.”
If the Moon landings were the crowning glory of white America, it is also the starting point in Anne Case and Angus Deaton’s new book, Deaths of Despair and the Future of Capitalism, where the self-ascribed exceptionalism of this cohort starts to unravel.
In Deaths of Despair, Case and Deaton shine the light on a United States that is engulfed in a health crisis that fails to capture media attention or force cities into a lockdown. It is a pandemic of sorts, claiming roughly 190,000 lives each year but one that most definitely discriminates regarding the profile of the victim it claims.
The causes of death are mainly suicide, deaths that relate to alcohol and drug overdoses. These deaths disproportionately impact those on low income and without college degrees, but the central theme of this book is that no longer do these deaths of despair discriminate on racial grounds.
Jobs and dignity
Rather, it is the children of the boomer generation who are now feeling the cruel clench of unadulterated capitalism. White manual workers who once embodied the promise of American exceptionalism are dying. The casualties are found in the former American rust-belts, in rural heartlands and cities where once there existed strong unionised workforces. The sense of collective identity and frontiers spirit has been eroded away.
An increasingly globalised world has served to deliver an environment where working-class people are congested in where they live, but lonely in how they are now expected to exist. Automation has taken away jobs and dignity, with companies choosing to downsize or relocate to countries that provide cheaper labour, rendering whole towns and large swathes of the population surplus to requirements.
That people in society devoid of hope reach for bottles, needles and, ultimately, a desire to end their own lives is not a radical concept. The authors acknowledge that the central premise contained within Deaths of Despair is just developing upon the works of earlier socialists such as Émile Durkheim, who first acknowledged that “suicide happens when a society fails to provide some of its members with a framework within which they can life dignified lives”.
That the book is unoriginal isn’t necessarily a criticism. Whether society is willing to give a name to it or not, there has always been an acceptance that poverty kills and capitalism has its victims. The attempted shock factor of this book seems to be a slightly clumsy “But did you know it kills white people too?”
The authors have a central premise which they cling to a little too rigidly throughout the entirety of the book. It is that over the last century, life expectancy in America has risen from 49 to 77 ,but among white people without a college degree the death rate for those aged between 45 to 54 has risen by 25 per cent.
The curiosity is regularly mentioned that midlife deaths have not climbed comparatively in other western countries and nor have they increased to any degree among Hispanic or black Americans.
Harmful opiates
What is a criticism, however, is the absence of any form of critical analysis of the unconstrained system of capitalism in America today. The authors lay the blame at the feet of bad-faith actors in US private healthcare or pharmaceutical industries for the wide availability of harmful opiates or the inability to access mental health supports. However, they too easily dismiss the role a publicly funded national health service could play in alleviating the crisis.
As a contribution to the role societal inequality plays in poorer health outcomes of the population, Deaths of Despair is too limited in its scope to offer much to the discussion already built upon by works such as The Spirit Level. The authors are too devout advocates of the Pax Americana to substantially engage with the topic in any meaningful way.
Devoid of any real policy solutions, the authors resort to rudimentary explanations drenched in the apple-pie politics of capitalism past. Simplistic longings for the return of communal gatherings in churches and union halls and lamentations for the breakdown of the traditional nuclear family are offered instead of actual legislative policy changes, healthcare or education reform.
I was initially captured by the emotiveness and the importance of the subject, but very quickly you start to feel part of the authors’ own crisis of conscience as they regularly punctuate the world of deserted American factories and trauma to remind the reader that to “stop stealing, you don’t tax the thief’” as an argument against wealth distribution or meaningful policy intervention to the problems they themselves are articulating.
An interesting read if you too long for the good old days, less so if you’re minded toward some sort of structural change.
Gary Gannon is a Social Democrat TD for Dublin Central
