The decline in life expectancy and health among less-educated white Americans is often attributed to “deaths of despair”—those from conditions like substance abuse and suicide. (Suicides, the CDC reported last week, are up nearly 30 percent since 1999.) The cause is often attributed to “cumulative distress,” as Princeton’s Anne Case and Angus Deaton have speculated.
“The failure of life to turn out as expected [is] consistent with people compensating through other risky behaviors such as abuse of alcohol and drug use,” they wrote recently.
A new study has confirmed that low-income Americans are, in fact, despairing. The authors of this paper, published this week in the Proceedings of the National Academy of Sciences, relied on a survey called MIDUS—Midlife in the United States—that interviewed American adults about their mental health in 1995–1996 and again in 2011–2014. They found that for the poorest whites in the sample, mental health consistently declined between those two times, suggesting low-income white Americans became less happy over the years. Meanwhile, higher incomes were “consistently associated with less distress and greater well-being,” the authors, Noreen Goldman of Princeton and Dana Glei and Maxine Weinstein of Georgetown University, write.
What’s more, the poorest white adults saw decreases in positive feelings, well-being, and life satisfaction between the two time periods, along with substantial increases in negative moods. Meanwhile, the richest saw little change in negative moods and some improvement in well-being since the ’90s.
And though it’s middle-aged white Americans who have suffered the greatest increases in premature death in recent years, the mental-health changes in this study were evident in all the age groups in the survey, not just people in their 50s or 60s.
“Our results paint a picture of substantial social stratification in psychological health among American adults,” the authors write. In other words, the rich are getting happier and the poor are getting sadder.
The study is purely correlational, so the authors can only speculate as to why this is happening. They posit that it could include “increasing income inequality and wage stagnation for the working class; long-term deterioration in employment opportunities that have led to intergenerational decline in economic security; reduction in stable marriages ... increasing work-family strain; and weakening interactions within communities and associated social isolation.” In other words, it could be the very kind of cumulative distress Case and Deaton referred to last year.
Together, these forces can be enough to make someone want to reach for opioids or alcohol to numb their psychic pain. And ultimately, if declining life expectancy is any indication, some do.
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