two americas

What the economic statistics obscure in the averages is that there is not one but two Americas — and a clear line demarcating the division is educational attainment. Americans with four-year college degrees are flourishing economically, while those without are struggling.

Worse still, as we discovered in new research, the America of those without college degrees has been scarred by death and staggeringly shorter life spans.

The divergence of life expectancies on either side of the college divide — one going up, one going down — is both shocking and rare. We have found reference to only one other case in modern history, in the former Communist countries of Eastern Europe after the collapse of the Soviet Union. Like those countries, the United States is failing its less-educated people, an awful condemnation of where the country is today.

What can be done? We could learn from those European countries that have various educational qualifications that fit different kinds of jobs and lack the sharp binary distinction between those with and without college degrees that is so corrosive in the United States.

We are encouraged by the efforts of both public and private employers to remedy this; it is a low-cost policy that could have large benefits. For example, Gov. Josh Shapiro of Pennsylvania signed an executive order removing the B.A. requirement for 92 percent of state jobs; similar policies are in place in Utah, Maryland, Colorado, Georgia, South Carolina, Virginia, New Jersey and Alaska.

Anything that reduces health care costs would help, as would eliminating employer-funded health insurance, replacing it with vouchers paid for by general taxation. Fighting NIMBYism (residents’ “not in my backyard” opposition to local development) and expanding affordable housing in successful cities would increase mobility. Job creation under the Inflation Reduction Act is a move in the right direction. Working people would do better with stronger unions and fewer hostile measures such as right-to-work laws.

The suffering of less-educated America is not something that must happen, nor is it a necessary price to be paid for progress for the rest of us. Indeed, we find it hard to imagine that an educated elite can prosper indefinitely without a better future for everyone else.

https://www.nytimes.com/2023/10/03/o...smid=url-share

interesting thoughts from Anne Case and Angus Deaton

We can also start by firing the “student loan forgiveness” idea into the sun

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Originally Posted by acesfull86

We can also start by firing the “student loan forgiveness” idea into the sun

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i don't think it would help address the problems discussed in the article

or as one of my old professors once wrote in my bluebook "brilliant answer wrong question"

Quote:

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Originally Posted by nsacpi

i don't think it would help address the problems discussed in the article

or as one of my old professors once wrote in my bluebook "brilliant answer wrong question"

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It wouldn’t address the problems directly, but my point is there’s only so much time in the day and so much political capital to be spent. If we believe the author’s thesis, it’s pretty despicable how much oxygen that terrible loan forgiveness idea continues to get amongst leaders of a certain party, considering the benefits would flow almost entirely to the ”haves” portion of our two Americas.

i agree on the need to prioritize bandwith

https://www.vox.com/future-perfect/2...-heart-disease

For the past decade or so, Princeton economists Angus Deaton and Anne Case have been promoting a particular story about death in America. Less-educated Americans, particularly those without college degrees, have seen their life expectancy outcomes diverge from those of more-educated Americans. Much of this divide can be explained through a category that Deaton and Case call “deaths of despair”: deaths from suicide, opioid overdoses, and liver cirrhosis and other alcohol-related causes. The deaths are concentrated in non-Hispanic whites. This phenomenon indicates something is deeply wrong with the way American society treats its most marginalized citizens, including lower-class whites.

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So what’s going on here? Is there an American underclass that’s falling behind and dying earlier than the rest of the country? Is the divide between college graduates and non-graduates increasingly central in determining life outcomes for Americans, down to the very number of years we get on this planet?

These are two different questions, and the answers seem to be, respectively, “yes” and “no.” Case and Deaton are highlighting a real problem, confirmed by other researchers: Americans with different levels of education die at different rates, and the least-educated Americans have seen their death rates surge in a way that more-educated Americans have not.

But the relevant divide does not seem to be between people who earned a bachelor’s degree — who remain a minority among American adults — and people who didn’t. Other research suggests that the problem is concentrated in specific areas of the US, and between the very least-educated Americans (particularly high school dropouts) and the rest of the country, rather than between college grads and non-grads.

Moreover, the cause of the divergence between high school dropouts and the rest of the country does not seem to be caused by “deaths of despair.” There is no doubt that the opioid epidemic in particular has wrought spectacular damage in the US. But some researchers are finding that stagnating progress against cardiovascular disease is an even bigger contributor to US life expectancy stalling out, and to mortality divides between the most- and least-educated Americans.

That implies we might want to think more specifically about heart disease, and about the American underclass, and less about the bachelor’s/non-bachelor’s divide that Case and Deaton highlight. That might enable us to produce a more useful policy agenda for tackling the problem.

Among both Black and white middle-aged Americans, death rates were falling among the most-educated groups pre-Covid. For those in the middle of the education spectrum, death rates have been falling for Black Americans and stagnant for whites; Black death rates still exceed those for whites but the gap is narrowing. For the least-educated, which roughly means high school dropouts, death rates have been rising starkly for white men and women, and rising slightly for Black women, while staying roughly constant for Black men. (Novosad, Rafkin, and Asher also look at death rates in other age ranges, but note that death is rare enough before you get to your 50s that it doesn’t affect life expectancies in the US as much.)

Case and Deaton in their latest piece describe this as confirmation that the “qualitative” takeaway from their research is correct. I’m not sure I’d be that generous. “White high school dropouts are dying at higher and higher rates” implies that a small but significant share of the population is experiencing a mortality crisis. “Americans without a college degree are dying at higher and higher rates” implies that the majority of Americans are experiencing a crisis, since a majority of Americans don’t possess a college degree even today. That might be a better narrative for convincing people to care about the most vulnerable, but it doesn’t give us as much information about where the problem is.

Areas with smaller mortality gaps tend to be places, the researchers find, with lower rates of smoking and higher rates of exercise, which makes sense when you consider that the variation in death rates between cities is driven not by factors like car crashes or suicide but conditions like heart disease and cancer, which are themselves driven in part by lifestyle conditions. Local unemployment rates and other indicators of the health of the local labor market did not seem to be associated with longevity, nor did income inequality. These aren’t firmly causal findings, to be clear, but they might be suggestive of potential causes to investigate.

But the overall life expectancy problem in the US also has far more to do than we often recognize with stagnating progress against cardiovascular disease, which is still the leading cause of death in the US. Researchers Neil Mehta, Leah Abrams, and Mikko Myrskylä argued in a 2020 paper that the dominant reason life expectancy has stalled in the US is not that drug deaths have grown but that a previously large, robust decline in deaths from cardiovascular disease has stalled out. The death rate fell by half between 1970 and 2002, but given that it’s still common enough to cause 695,000 deaths in 2021, a stalled decline could be a very big deal.

Though explanations for this stagnation are still unclear, the authors present a couple of options: rising levels of obesity (especially at younger ages, compounding negative health effects over more time), or, counterintuitively, the US’s early success at discouraging smoking (which could explain why its cardiovascular death rates aren’t falling as fast as those in Europe, which gave up smoking later on). They find that the stagnation from cardiovascular disease is broad-based geographically in the US, unlike the rising death rates among low-income Americans studied by Chetty et al.

Economists Novosad, Rafkin, and Asher make similar points in their paper on the fate of the least-educated Americans over time. As of their data endpoint in 2018, “deaths of despair” — that is, from drug overdoses, suicides, and alcoholism — “account for a large share of mortality increases for young whites, but a very small share of rising mortality among older whites and very little of the divergent mortality rates of black,” they note. “Further, deaths of despair have increased more uniformly across the education distribution than deaths from other causes.” In other words, while the overall rise in mortality is concentrated among the least-educated, the opioid, suicide, and alcohol-related rise is not.

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All this points to a very specific challenge that policymakers must confront: How to reduce deaths from cardiovascular disease (and also cancer) among the poorest, least-educated Americans. Case and Deaton like to prescribe various economic measures as ways to combat rising death rates, like eliminating the link between employers and health insurance, expanding affordable housing, strengthening unions, and removing needless requirements that certain workers have bachelor’s degrees.

I happen to think all those policies are good ideas. But I’m somewhat skeptical they would move the needle on heart disease among high school dropouts, especially compared to more targeted approaches like expanding cholesterol screening or ensuring Medicaid covers medicines like semaglutide that reduce the risk of heart disease.

This breakdown between HS and no HS is very helpful. It sharpens the picture quite a bit.

Although it is worth noting that the gap in life expectancy between college vs HS (no college) is also widening. Though not as sharply as with those who did not finish HS.