Our Brother's Keeper

The release of a new and shocking report concerning the impact of economic change on vulnerable citizens could not have come at a better time. It comes in the wake of the papal visit and before an election year, when both the American people and leaders of the church are examining their economic and moral priorities. Pope Francis has challenged both the church and Congress to direct their energies toward serving the weak and the poor. 

A team of economists—Anne Case, a professor of economics at Princeton University, and Angus Deaton, her husband, also a Princeton economist and a Nobel Prize-winner—have published “Rising Morbidity and Mortality in Midlife Among White Non-Hispanic Americans in the 21st Century” about white Americans, ages 45 to 54, who died between 1999 and 2013. To the researchers’ astonishment, the death rate among these men and women rose dramatically, while the rate for other demographic groups in the United States and their European counterparts remained the same. 


This increase has been attributed to drug and alcohol poisoning, suicide and chronic liver diseases. Although these maladies struck others as well, members of this group are marked by a lack of education; they either dropped out of high school or did not pursue a college degree. These findings are disturbing because, in recent years, job-related illnesses followed by inadequate medical response have ravaged this age group. Many of their contemporaries have thrived, but since the 1990s physical and mental health issues and the struggle for daily survival among this battered-by-life minority have taken their toll. As Mr. Deaton told The Washington Post, “Half a million people are dead who should not be dead.” These figures are “about 40 times the Ebola stats. You’re getting up there with H.I.V./AIDS.” He describes these victims as white Americans who have “lost the narrative of their lives.”

Other countries, particularly in Europe, survived economic changes because of strong social safety nets. In contrast, jobs in manufacturing and construction in the United States have all but vanished; the less-educated unemployed lack the resources that would allow them to have the lives they imagined. 

Paul Krugman, another Nobel Prize-winning economist, writing in The New York Times on Nov. 9, sees that “despair appears to be spreading across Middle America” with troubling consequences for society as the wounded cannot deal with the failure for them of the American dream. Universal health care, higher minimum wages and aid to education could do a lot to help, but it would not cure existential despair. Another Times contributor, Richard A. Friedman, blames doctors who enable addiction: “An opioid overdose epidemic is at the heart of this rise in white middle age mortality” (Nov. 8). These drugs were intended for cancer pain; but now primary care physicians who lack appropriate training and are egged on by aggressive marketers use them for purposes other than those intended. 

The website nakedcaptalism.com, which offers “fearless commentary on finance, economics, politics and power,” has accumulated several hundred letters that expose the pain afflicting this  population. One writes, “But in the end, it sucks to be discarded by society like a piece of trash.” Another, flooded by alcohol and pain, clutches the gun that “makes suicide much simpler.” Another describes himself as a “good person who got crushed by this so-called ‘society’ and saw no other way out.” They rarely mention religion. One ex-banker, devastated by his “failure,” nurtures a collection of painkillers to do their job as his “shove off” date approaches.

In the Book of Genesis, Adam asks Cain where his brother, Abel, is. Cain replies, “Am I my brother’s keeper?”  But until society acknowledges these stories—until we help people recover the “narratives of their lives”—we are not even in a position to ask Cain’s question. The presidential candidates’ debates have mostly shied away from the inequality issue, apart from promising to cut taxes for the wealthy.

Other advanced countries, which provide a much better safety net for people in economic hardship, have not seen an increasing mortality. We should learn from them. Drugs that can be abused must be prudently prescribed. Colleges and universities could reconsider their recruitment strategies and reach out to non-elite populations.

Media agencies that can sponsor investigative reporting have a special responsibility to shine light on those dark corners where the poor and sick huddle. Perhaps we need another Michael Harrington, whose The Other America (1962) introduced John F. Kennedy and then Lyndon B. Johnson to the “invisible poor.” Finally, church leaders could redirect their influence and resources—in synods, diocesan publications, church-owned television networks and parishes—to rescuing our dying brothers and sisters. That is our obligation as “keepers.”

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William Rydberg
3 years 5 months ago
I still remember Pope Francis recounting the day of his election, and the words "Remember the Poor..", Blessed be the Holy Trinity, who gave us such a son of St Ignatius, a true Jesuit Father in Christ,
Chuck Kotlarz
3 years 5 months ago
Eight of the ten states with the lowest suicide rates are liberal dominant states. The suicide rate of the ten lowest states is half that of the ten highest states. In dominant party states overall, at least 75% of Congressional members and Governors come from the dominant party. The dominant party also has a majority in at least 75% of both state legislatures.
Joseph J Dunn
3 years 5 months ago
The data point to a serious life or death problem, but can we offer solutions, when the problem itself is still not understood, per Deaton and Case? Here is a link to the full paper by Deaton and Case—not too long and plain English. http://www.pnas.org/content/early/2015/10/29/1518393112.full.pdf. Note that the economists present a list of possible factors contributing to the cessation of the decline in midlife mortality rate for U.S. white non-Hispanics age 45-54, and the concurrent rise in morbidity, especially neck, joint and sciatic pain, and serious psychological disease. While the availability of oxycodone in the late 1990s and the increase in heroin use are cited as possible contributors, even the generosity of Social Security Disability payments gets their attention.Nowhere do the economists point to "other advanced countries, which provide a much better safety net for people in economic hardship" as exemplars for solving what is clearly an important problem. While "the presidential candidates’ debates have mostly shied away from the inequality issue, apart from promising to cut taxes for the wealthy," let's remember that Bernie Sanders consistently campaigns for higher taxes on upper incomes and corporations. As it happens, Deaton's book, "The Great Escape: Health, Wealth, and the Origins of inequality", is well worth reading, as it gives an impressive discussion of inequalities both globally, and within the U.S. Fortunately, these two economists have seen the data and pointed to a problem not seen earlier. And they provide some important insight. We owe our brothers "the invisible poor" a thoughtful and effective response that gets to their real needs now, and that addresses why in our society so many (even many who finish high school) are left without a useful education, and why there is such a dearth of manufacturing jobs or other challenging, good-paying work. As many popes have proclaimed, meaningful work and the ability to earn one's bread can bring meaning to life. The Deaton-Case paper, and Deaton's book, deserve as much interest and attention to detail as Harrington's book received fifty-three years ago.
Richard Booth
3 years 4 months ago
Contrary to the perspective of the author, I do not see the study results as either "new" or "shocking." Anyone who lives in the modern world can see what is, and has been, going on. Drs. Case and Deaton formalized some of the economic factors, which increases people's scientific awareness of the problem in an organized, objective way, as is a primary goal of scientific inquiry. Without diminishing the doctors' contribution in the least, I would appreciate seeing what sociologists, psychologists, and other academic thinkers have to say in their research. I remember reading Harrington when his book was published, as well as many others dealing with the same kinds of issues. Senator Moynihan often talked about these things. It is unfortunate that presidents had to find out about the "culture of poverty" from Harrington's book. There was a lot published before that time. Finally, I am not sure we want to refer to the people to whom many awful things have happened as "battered by life" because, on one level, everyone is jostled by life in some way. Moreover, this notion implies victimhood rather than resilience. It is true, however, that we inadequately care about and for those who seem to have lost meaning in their lives.


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