death of despair 2

Death of Despair, 2



part head (3) life expectancy
role (2) hangout correspondent
pain distress pain killer
series explore provide (2)
air (2) sense (2) make sense
jet set share (4) prescription
set (2) senior set oppression
opiod drunk (2) heart attack
poison get off (2) hooked (2)
abuse specialize competitor
crisis inflation document (2)
involve obvious tremendous
predict disappear ivory tower
adjust self-worth inflation-adjusted
decline period (3) on the ground
left (3) stuff (2) all over again
suicide epidemic substance (2)
spiral close up downward spiral
income sheriff (2) supposed to
relieve dramatic hopelessness
pour stun (2) feeding tube
retire side effect weight gain
libido chronic availability
rate climb (2) buy/bought/bought (2)
impact hypothesis component
ravage worthless not so fast (2)
suffer alleviate equalization (2)
uptick struggle argument (2)
unease major (2) come apart (2)
devote inequality identity (2)
status serotonin to grade on the curve
replace premature wear down (2)
loser disphoria psychological
link well-being absolute terms
brain ahead (2) physiological
play (3) exposed acknowledge
flat (3) turn to (3) protracted
excuse labor force knock down (2)
hell relate (2) medication
crazy euphoria deterioration
despair fall apart American Dream
dispute dream (2) moral fiber
fund full time relative (2)
give up lie around explanation
do well drop out overwhelmed
focus countless pick up (4)
access believe (2) direction (2)
cure long term expectation
remedy so-called






The second of a two-part look at the declining life expectancy for some middle-aged White Americans.

Last week the economics correspondent Paul Salman looked at the role of prescription pain killers and alcohol may play in the trend.

Tonight he explores how the economy and job market may be involved.

It’s part of our weekly series, “Making Sense”, which airs Thursdays.

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The Hardy’s in Maysville, Kentucky, a popular hangout for the senior set.

Martin Sour used to work for the sheriff’s department, where he says he saw his share of Saturday night drunks — but nothing like the current opioid drug epidemic.

Martin Sour, Former Sheriff: “People get hooked on it, and can’t get off it, or don’t want to. It’s causing a lot of the younger generation to lose their lives.”

And by “younger generation”, Sour means his middle-aged neighbors, who as we reported last week, are experiencing a stunning rise in premature deaths due to alcoholism, suicide and drug abuse.

But why?

Angus Deaton, Princeton University: “The health crisis here is particularly among White working-class, or White people with a high school diploma and no more.

For those people, the economy’s been very hard for a very long time.”

Predictably, Angus Deaton and Anne Case, economists who have documented a dramatic decrease in life expectancy, say an obvious place to look for a cause is the economy.

Anne Case: “It used to be that with a high school degree, you could get a job that could actually provide for your family. And the disappearance of those may lead people to feel a lot more stressed.”

Indeed in the period covered by their study, 1999 to 2014, inflation-adjusted income for households headed by high school graduate, fell by nineteen percent.

Well away from the ivory tower, on the ground in Maysville, Wayne Pendleton has lived through the change.

Wayne Pendleton, Maysville Resident: “Maysville, when we moved here was a pretty well town here. We’ve lived here seventeen years, and you can name the stuff that is left here.”

You can’t take a job away from a guy who’s fifty-five years old, and expect him to start all over again.”

Sherman Saunders, Maysville Resident: “Even at my age, it’s depressing if you’re not trying to do something.”

Despite four heart attacks, Sherman Saunders still wants to work.

Marcy Conner, Nurse: “Most of the men aren’t working.”
Marcy Conner, a nurse specializing in substance abuse, has a close up view of the downward spiral.

Marcy Conner, Nurse: “And all of the sudden, you lose your job. So here’s a male with no identity. He’s not working. He’s supposed to be a provider for his family, he can’t even do that.

So that low self-worth, along with that feeling of hopelessness, we start seeing tremendous depression.

So how do you relieve depression?

You can relieve it with drug use, alcohol use or suicide.”

Conner’s own husband died of alcohol poisoning.

Marcy Conner, Nurse: “Poured alcohol down his feeding tube . . . until he died.”

The husband of best friend Becky Manning also killed himself.

Becky Manning, Maysville Resident: “He . . . blew his head off.”

Joseph Manning had been a truck driver for thirty years.

And then he retired at fifty-five — which then gave him nothing to do. Then he started getting depressed. And then we would go to different doctors.

Then they would just try different drugs. And those never worked, because they caused side effects, which made him feel worse about himself.”

Journalist: “Weight gain.”

Becky Manning, Maysville Resident: “Yes he gained weight.”

Journalist: “Libido.”

Becky Manning, Maysville Resident: “Absolutely; ‘you know I’m worthless. I can’t be here for my wife’.”

Journalist: “So when you hear about the end of work, jobs like truck driver jobs will be replaced by self-driving cars, you think . . .?”

Becky Manning, Maysville Resident: “What are these men going to do?”
Marcy Conner, Nurse: “And this next generation, I think you’re going to see the death rate continue to climb.”

Local doctor, Craig Denham buys into the economic hypothesis.

Dr. Craig Denham, Family Physician: “Economics is a major component. Job availability is a major component.”

So case closed, right? Economics explains the epidemic of suicides and overdose deaths ravaging America’s White working-class.

Not so fast, say Case and Deaton.

Anne Case, Princeton University: “Europeans have suffered too in this, jobs leaving the country; but we don’t see them killing themselves.”

Angus Deaton, Princeton University: “Yeah, Spain suffered from unemployment rates that went for five percent to twenty-five percent.

And health improved.”

And what about working-class Black Americans?

Anne Case, Princeton University: “African-American rate of deaths from suicide, drug overdose and alcohol have been flat; they have not risen.”

Darrick Hamilton, Economist, The New School: “It’s not as if stress is something new to the Black American population; we’ve been dealing with stress for quite a long time.

The impact of stress is not new, which is why you don’t see an uptick among Black Americans like you do with White Americans.

We’re used to struggling. Unfortunately.”

Angus Keaton, Princeton University: “And also there’s this argument on the other side that Whites have been ahead for so long that when they see their world coming apart, even though they’re still doing much better than Blacks, they may see equalization as oppression.”

Economist Bob Frank has devoted much of his career to the study of inequality.

Robert H. Frank, Economist, Cornell University: “Life is graded on the curve: it’s not how well you do in absolute terms; it’s how well you do relative to your competitors.”

Or relative to your own past.

Robert H. Frank, Economist, Cornell University: “And if you’re in a chronic loser position, I think that’s a position that wears people down eventually.”

Psychologically and physiologically, as low status is linked to decreased serotonin in the brain, which can cause disphoria, a state of unease and distress.

Robert H. Frank, Economist, Cornell University: “If you’re exposed to having low-status in a chronic way, and experiencing protracted feelings of disphoria, it’s not surprising that many people would turn to drink and drugs as a way to alleviate such feelings.”

In fact, according to a recent study by economist Allan Kruger, middle-aged men who’ve dropped out of the labor force report low levels of emotional well-being, and more than half take pain medication every day.

Angus Keaton, Economist, Princeton University: “And so if you suffer enough, and your kids are not doing well, and your world’s going to hell in a hand basket, then suicide either directly or indirectly through pain-killers or alcohol, might not seem like a completely crazy thing to do.”

There is we should acknowledge, another take on the rise of the so-called “deaths of despair”.

Anthony Flannery: “I don’t buy into the ‘everything fell apart, so now I can’t do nothing’.

I still believe in the American Dream.”

Anthony Flannery, who works long hours in health care, and on funding his dream of making music full-time, doesn’t dispute the data; he just doesn’t think they provide an excuse or even much of an explanation.

Anthony Flannery: “So people that just lie around and give up, I don’t relate to it. Okay, I can understand getting knocked down, but then say, ‘I don’t know what to do; I’m overwhelmed.

I know that. I’ve been there countless times.

But you need to get focused, pick yourself up, find a direction, and make it happen, in your life. And for your family!

But if the problem is a decline in moral fiber, what would explain that?

Too easy access to remedies that seem to cure all problems, until they become the problem themselves?

Or longer term, the deterioration of the economics of White, working age America, relative to any and all expectations?


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1. There is a health crisis in some parts of the United States. True or false? Is this due to cancer, heart disease and stroke?

2. Does it affect everyone equally, or does it tend to affect certain groups in particular?

3. Have there been changes in the economy in Maysville, Kentucky? Describe the changes. How has the economy changed?

4. Describe the downward spiral of some of the victims. What led them to early deaths? What are the contributing factors?

5. A poor economy is the only reason for the plight of all communities. Is this correct or incorrect?

6. What are the psychological and sociological explanations for the so-called deaths of despair?

7. Everyone agrees with the explanations given by economists, health professionals and psychologists. Is this right or wrong?


A. Are there similar problems in your community?

B. Describe the lives of poor or working class people.

C. Do you agree with the economists, doctors and psychologists; or Anthony Flannery?

D. Why might White American working class communities be devastated, but not in other countries, for example, Spain?

E. What might happen in the future?

F. What is the solution to this situation? What should people, the government do?

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