The powerful and yet subtle ways in which work influences lives is writ large in the new look some economists are taking at the dip in U.S. life expectancy.
University of California, Berkeley researchers opened this can of worms in the summer when they published a study showing improvements in public health linked to policies to increase wages among the working poor.
“A way out from rock bottom: Economic policies can reduce deaths of despair,” published at the CEPR Policy Portal in July, argued there is evidence to support a conclusion that “the minimum wage and the earned income tax credit – the two most important policy levers for raising incomes for low-wage workers…significantly reduce non-drug suicides among adults without a college degree, and that the effect is stronger among women. The findings point to the role of economic policies as important determinants of health.”
These findings coupled with others – notably the increase in suicides among white men in economically struggling, blue-collar parts of Appalachia, the Ohio River valley and the Deep South, and substance abuse in many areas – is leading some to take a new look not only at income but at what might simply be classified as hope.
In a mea culpa in the Twin Cities Pioneer Press last month, Minnesota economist Edward Lotterman confessed to being “particularly chagrined about these data because when similar trends were observed in Russia, I took a cavalier attitude in discussing it with students. The decline in life expectancy there in the 1990s came from very similar factors, suicide and alcohol abuse by low-education males. But now our nation faces a similar phenomenon even though our economy is performing well by broad indicators of both output and employment. Not so much for a declining Russia back then.”
Nor for much of rural Alaska then or now, either. The rural parts of the 49th state have for decades struggled with suicide and alcohol abuse among low-education males in a land where the majority of people live lives of comfort.
“…We must ask ourselves: Why so much despair, suicide and engulfment into addiction?” Lotterman wrote.
“And these questions, and the apple-to-oranges comparison with Russia exposes the deepest conundrum of modern economics: What determines happiness or satisfaction in life? And how do these trends relate to monetary measures of income and consumption that economists use to determine human well-being?”
Lotterman continued on for paragraphs in an effort to answer those questions, but they can all be answered with that one word “hope.”
When he finally got around to this important and hard to define human emotion near the end of his column, he observed that “the feeling of hopelessness among white men in the Appalachian coalfields or the industrial Rust Belt of the Ohio River Valley, stems in part from feelings that the economic deck is stacked against them. We bailed out AIG and the big banks through the Troubled Asset Relief Program, but regulators turned a blind eye to mortgage lenders that robo-processed millions of foreclosures with scorn for any legal niceties. Greater international trade may benefit consumers, but those who pay the adjustment costs is concentrated on narrow groups like low-education white males.”
Or, in Alaska’s case, low-education Native males.
The white males these days happen to be the demographic that most supports President Donald Trump. Polls have shown 60- to 70-percent of them in the Trump camp. Some in the media and politics, including Democrat presidential candidate Elizabeth Warren, have tried to dismiss all of this as simply a vestige of the lingering evil of white supremacy.
There are no doubt white supremacists who back Trump, but there is more to it than that as Lodderman indicated.
“A fundamental failing of conventional economics is ignoring transaction costs,” he wrote. “Models that show how greater trade makes both societies better off assume that labor is mobile. Are appliance factory workers laid off in Ohio on Friday supposed to go to work writing apps on Monday morning in Silicon Valley?”
Trump’s efforts to strike back at China – the cheap-labor capital of the world – resonate with factory workers left jobless by the global economy and U.S. corporate leaders with an eye on nothing but the financial bottom line.
Though former President Bill Clinton, a Democrat, has called the Make America Great Again (MAGA) slogan of the Republican Trump a racist dog whistle, MAGA could also be viewed as a call to return manufacturing and associated jobs to the U.S. and with them the stability employment provides in people’s lives, especially in rural areas.
Researchers from The Ohio State University in September fingered “lower levels of education, employment, and household income” as key factors in the rising suicide rate across rural America. The pattern there now mimics what rural Alaska has been dealing with for a long, long time.
“Long-term and persistent poverty appears to be more entrenched and economic opportunities more constrained in rural areas,” the researchers wrote in the study published in the Journal of the American Medical Association.
The study tied a general, national uptick in suicides in part to “the presence of gun shops and a higher percentage of uninsured individuals” in urban areas, but conceded “increases in the presence of gun shops had less association with suicide rates in rural counties” where suicide is at its worst.
“Greater social isolation, challenges related to transportation and interpersonal communication, and associated difficulties accessing health and mental health services likely contribute to the disproportionate association of deprivation with suicide in rural counties,” the study said. “National and global trends associated with improvements in the economic outlook of larger cities and towns, such as advances in automation, information technology, and alternative energy, may bypass rural communities, particularly those focused on farming and extractive industries, such as coal mining. Rural counties may lack the flexibility and human capital necessary to adapt to meaningful changes in the broader economy, leading to greater susceptibility to deprivation than more urban or suburban communities.”
The perils of poverty and isolation now being recognized across the country have haunted rural Alaska since the 1970s arrival of television to inform people they were poor and isolated. The Anchorage Daily News (ADN) won a Pulitzer Prize in 1980 for highlighting these problems in a series titled “A People in Peril” although it glossed over the links between poverty, isolation and despair.
The Pulitzers awarded its prize for Public Service “for reporting about the high incidence of alcoholism and suicide among native Alaskans in a series that focused attention on their despair and resulted in various reforms.”
The reforms largely involved increased state efforts to banish alcohol from rural areas. That task proved even harder than the new, national task of trying to reduce opioid abuse in America in general.
The ADN and New York-based ProPublica have now joined in a new effort to link continuing problems in the state’s rural areas to a lack of law enforcement. U.S. Attorney General William Barr has responded with $10 million in grants for law enforcement and victim services in rural areas.
Whether adding police will work any better than trying to banish alcohol only time will tell, but the national indications are that the true problems of the region are rooted in deeper issues that in some ways parallel those of the country’s inner cities.
“An overwhelming number of inner-city households are severely distressed by unemployment, lack of education, family dissolution, overcrowded housing, drug abuse and crime,” researchers studying New Orleans noted at the start of the decade. “In the inner city of the nation’s 100 largest cities in 1990, there were only six working adults for every ten unemployed adults.”
The lack of jobs, the study published in the Journal of Ethnicity in Substance Abuse concluded, led to all sorts of dysfunction, and most notably a turn to dealing drugs “as a viable way to obtain much-needed resources like money and social capital.”
Similar forces have for decades driven rural Alaska bootlegging and the problems that follow.
“The economics of the illegal sales of alcohol is staggering. For example, a bootlegger can
purchase a 750-milliliter bottle of alcohol legally for $10 or less in an urban liquor store.
The same bottle of alcohol in Bethel, Kotzebue or Barrow may sell for $50. In the more
remote communities, alcohol can easily sell for $150 to over $300 per bottle depending on the supply and demand. The initial purchase for the bootlegger involves a minimal cash investment, a maximum cash return with little threat of being caught or criminally charged.”
Just as the economics of drugs drive drug dealing in inner cities, the economics of alcohol power bootlegging in rural Alaska, but the real issue centers not just on the economics of supply but on the psychology of demand, a subject that has attracted more attention as opioid abuse has spread across the country.
A 2015 study of 79 people being treating for opioid addiction found “94.9 percent of individuals sampled reporting self-medication behaviors. In adjusted analyses, individuals engaging in more frequent opioid use tended to self-medicate negative emotions with opioids more often.”
The study is in line with others that have linked drug and alcohol abuse to chronic stress. And though many people think of their jobs as being stressful, research from around the world has found joblessness to be more so.
Researchers at University College London reported the stress among the unemployed was so great they could find it in people’s blood.
“Using data on 23,025 participants from the Health Survey for England and Scottish Health Survey, the researchers found that unemployed men and women had higher levels of inflammatory markers than employed counterparts (even) after taking into account a wide range of demographic and lifestyle factors: occupational social class from last job, housing tenure, smoking, alcohol consumption, body mass index, long-term health conditions, and depressive/anxiety symptoms,” Science Direct reported.
“It is well known that unemployed people are at greater risk of mortality and physical ill-health compared to employed counterparts, but it is still unclear exactly how unemployment damages health.”
One way might be in leading people to self medicate their despair, which often triggers a cascade of other problems.
People in peril
“The consequences of alcohol misuse extend beyond its potential to cause self-harm,” the Alaska Section of Epidemiology noted last year. “The growing interest in the broader societal concerns associated with alcohol consumption has evolved to characterize alcohol misuse as an agent of social harm.
“Examples of such harm include the breakdown of families, child neglect, domestic violence, material welfare of families, and mental health problems in family members and close friends (including suicide).”
The problems caused by people abusing alcohol are well documented. Less so the factors that lead to alcohol abuse, but Florida researchers in 2013 took a look at labor market statistics and alcohol-abuse statistics.
“We employ various fixed-effects models to address potential bias from unobserved and time-invariant individual heterogeneity. All results show a positive and significant effect of unemployment on drinking behaviors and the findings are robust to numerous sensitivity tests,” they later reported in Industrial Relations: A Journal of Economy and Society. “Perhaps macroeconomic policy decisions intended to stimulate the economy during economic downturns should also consider the avoided personal costs and externalities associated with alcohol misuse.”
This unemployment-related connection is not unique to the U.S. or to Alaska.
As researchers in Australia noted, “low socio-economic status communities (which would define many Alaska villages) are often characterized by high unemployment, drug use and drug availability, crime etc, which provide a cultural environment that is conducive to problem drug use.”
They made some of Australia’s problems sound a lot like some of Alaska’s problems:
“The health, well-being and drug-use patterns of Aboriginal and Torres Strait Islander
peoples are significantly worse than for the rest of the Australian population. A multitude of reasons have been found or hypothesized to explain this situation. While the experiences of Aboriginal and Torres Strait Islander communities are not the same, many experienced brutality and trauma from the European usurpation of their lands.
“This was followed by successive policies of ‘protection’ and ‘assimilation’, one objective of which was to reshape Aboriginal and Torres Strait Islander peoples societies in the image of the dominant society, with all the undermining of Aboriginal and Torres Strait Islander peoples cultural practices, languages and so on that this entailed.
“These experiences weakened communities, the authority of elders, and family strength, as well as contributing to stress and trauma, loss of culture and loss of parenting skills. Policies that deprived Aboriginal and Torres Strait Islander peoples of status, power or self-determination contributed to feelings of inferiority, powerlessness and hopelessness.”
A sense of hopelessness makes life difficult for any humans, and in Australia is reported have “resulted in:
- “poorer educational attainment
- “unemployment, which contributes to welfare dependency, apathy, boredom, loss of
self-esteem and economic disadvantage
- “physical and mental health problems, including self-harm and suicide
- “alcohol and other drug use, crime rates and violence,” the National Drug and Alcohol Research Centre at the University of New South Wales reported.
“All of the above contribute to many Aboriginal and Torres Strait Islander peoples feeling
hopeless, angry, traumatized and ashamed, and being stigmatized (victim blaming) and
marginalized (socially excluded). These outcomes further contribute to their alcohol and
other drug problems.”
The situation is much the same in parts of rural Alaska. The problem is complex and compounded by joblessness on various levels.
Law enforcement might help protect the innocent when things spin out of control, but it really does nothing to solve the larger economic issue that in Alaska, at least, has gone underreported and largely undiscussed for decades while its symptoms – alcohol abuse, drug abuse, sexual assault, domestic violence, hopeless and despair – attract all the attention.