Deaths of Despair

In a series of papers beginning in 2015 and culminating in the 2020 book Deaths of Despair and the Future of Capitalism, Anne Case and Angus Deaton documented a pattern that reshaped public understanding of inequality in wealthy nations. Mortality among white, non-college-educated Americans was rising — driven primarily by suicide, drug overdose (particularly opioids), and alcoholic liver disease — at a time when mortality in every other demographic group was falling. The pattern could not be explained by poverty in the absolute sense; the affected populations were not materially poorer than previous generations in the same demographic. What had changed was the collapse of the institutional structures — stable employment, union membership, community organizations, the social identity that comes from productive work — that had given meaning and structure to working-class life.