To conservatives, the white midlife mortality reversal in the United States may initially seem to confirm Murray’s argument about moral decay caused by the welfare state. But that interpretation runs into an obvious objection: Similar trends are not evident in the European countries that have even more generous systems of social protection than the United States does.
Although Case and Deaton are cautious about interpreting the data, they single out two possible causes of the mortality reversal. The first relates specifically to the timing of increased drug-related deaths: the introduction and ready availability of opioid prescription painkillers (such as Oxycontin) beginning in the late 1990s, followed by a shift to heroin, both directly linked to rising death rates among whites over the 1999-2013 period. But it is not clear, Case and Deaton point out, whether rising drug use is a response to an “epidemic of pain,” or whether the introduction and distribution of new prescription painkillers played an independent, causal role. One way or the other, however, Case and Deaton’s study puts in bold relief the sheer magnitude of the consequences of today’s drug plague.
A second potential cause highlighted by Case and Deaton (and possibly related to the first) is stress from economic change resulting from slower economic growth and rising inequality. “Many of the baby-boom generation,” they note, “are the first to find, in midlife, that they will not be better off than were their parents. Growth in real median earnings has been slow for this group, especially those with only a high school education.” But they also observe that some other rich countries have seen “even slower growth in median earnings than the United States, yet none have had the same mortality experience.”It seems so very clear that the American experience with prescription painkillers and addiction has been a real disaster, yet it still seems one that attracts inadequate attention.
The magazine thinks this says a lot about the American welfare system:
Here is where the stronger systems of social protection in other countries may play a role in both reducing inequality and cushioning people from the adverse social psychological consequences of wage stagnation. One key difference potentially affecting people in midlife, as Case and Deaton point out, is that the other rich countries have maintained defined-benefit pensions, while employers in the United States have shifted increasingly to defined-contribution pensions (such as 401(k) plans) that do not provide the same degree of security. As a result, many Americans with only a high-school education not only lack the skills in midlife to find good jobs or even to stay employed but also face the likelihood of destitution in old age.
These trends put new light on current debates about disability insurance and retirement policy. Contrary to those like Murray who attribute the growth in Social Security Disability Insurance to a decline in the work ethic, Case and Deaton’s data suggest that the increased number of beneficiaries reflects a real deterioration of health in middle age. Raising the Social Security retirement age may seem to be no problem for the educated and affluent who are in good health and do little physical labor, but delaying retirement poses a much bigger problem for workers who are experiencing increased burdens of pain and disability in midlife.
We'll be reading a lot more about this study, I bet...
And by the way: I reckon it indicates nothing good for the practical consequences of more libertarian views on social and economic issues.