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Book Review:
Epidemic of pain exposed 

Deaths of Despair

Anne Case and Angus Deaton, 2020

I just finished reading Anne Case and Angus Deaton's book, Deaths of Despair, which is excellent. The chapter on self-reported levels of pain among white males without a college degree is worth several times the price of the book.  It's pretty remarkable when 60-year-old males without B.A.'s report more pain than 80-year-olds! 


Case and Deacon assert that "... in America today, pain in mid-life has grown so rapidly that we have the unusual situation that the middle-aged are actually reporting more pain than the elderly."   Also, what to think about a country with a population of 330 million,100 million of whom report being in chronic pain, with 98 million people prescribed opioids in 2017? Those on the short end of the economic stick in the U.S., i.e., those without a college degree, are truly suffering, both emotionally and physically. 


Case and Deacon's chapter on the U.S. health care system is great; and they have a discerning, dispassionate analysis of the economic costs and benefits of immigration. Other policy analyzes and proposals in the book are forgettable, as in most books about income inequality. 


What's missing in this book is the intimate perspective of the people Case and Deacon are writing about. These authors understand that the crumbling of the economic foundation of well paid laboring jobs has led to unhappiness, shame, self loathing, depression, etc., among those who lost their jobs, but their analysis does not go deeper than that. All of this has happened in a culture in which many middle aged and older adults were raised to view themselves and others as successes or failures, a culture of individualism in which social context and social factors do not count in the psychic economy. What has occurred is not just the loss of manufacturing jobs that supported industrial cities and towns. In the absence of such jobs, there is no culturally endorsed good and worthy life for American adults without a college degree, except perhaps entering the military, and possibly fighting unnecessary and forgotten wars, a dispiriting experience.  Case and Deacon also offer a cultural analysis of White America that comes from Charles Murray's book, Coming Apart: The State of White America, 1960-2010.  All the trends that Murray discussed several years ago have accelerated, especially declining marriage rates and reduced church attendance among low income whites.                      

© Dee Wilson

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