Long may you run
No pictures today and not much coherent content, but you get what you pay for, and less.
There was a time many years back when I had the opportunity to work down the hall from my wife, Kate. We were both pipe smoking, know-it-all college professors at a state college in a little town that had a benefit of great early season snow up in the hills. I had one of those mini sized refrigerators in my office and I often had cans of diet root beer from Tops and we could take a break in our day and slouch in mismatched chairs, there amongst the clutter, just enjoying our bag lunches and making big plans. Working with Kate was always such a treat. I have to assume Dr. Anne Case and her spouse, Sir Angus Deaton have some sort of cluttered office with that Nobel prize in Economics nailed to the wall, and hopefully a mini fridge with some cold pops for when things get slow around Princeton. I bet it's a treat for them when they run into each other on campus. The two of them wrote a book recently, based on their research into the decline in American longevity. The fact that America has a decreasing lifespan, while other developed peer nations are increasing, has been in the news a bit lately. I feel like it hasn't been in the news nearly enough, but nobody from the news asked me.
When we talk about large statistical data, things seem tidy, but taking a look up under the hood, not so much. Understanding where numbers come from, how they are aggregated, and what mistakes are baked into the numbers is part of the challenge. Who gets to be in the denominator, or who gets tossed aside? Can we really count all of something? Do people lie or make things up? Data from years or decades ago just get ever worse. Of late, we have been trying to track down some old birth certificates from the city and found that much of this municipal data was actually collected on paper by the churches that ran the hospitals and kept here and there, “there” generally being some basement. Years of my father’s service records were lost, probably in the July 12, 1973 fire in St. Louis that burned through hundreds of years of records.
There is a beautiful song in Hamilton, “who lives, who dies, who tells your story?” In this case, Dr. Case and Deaton were interested in the story of the American lifespan and the education level of various groups of people, as related to longevity. But as noted in the excellent paragraph above, it’s just not so simple. People give birth all over the place, but mostly it’s in a hospital which creates a somewhat consistent record. Over the course of a lifetime, people are counted through the federal census, which lives in a separate data bucket, and is not associated with individuals counted at birth. All of the activities of life, driving a car, earning wages, even providing a phone number to the pizza place, these all creates data pools about people, but they are not well indexed to fit together well, and people have the maddening habit of choosing their own names for their offspring, rather than having a species with a number assigned at birth. The gall. Death certificates are another standardized, paper-based record system that is stored electronically at the federal level and indexed by social security number. Data on things like educational attainment are provided by funeral directors who generally complete the form, with information gleaned from the stressed and bereaved family members who sometimes get the details wrong. The format for this data doesn't quite match the CDC population survey or longitudinal mortality survey, because there are different ways we can measure educational attainment, either total years or degrees earned. Adding another mattress atop the fire is the fact that education was not included as a question on the death certificate until the late 20th. century, so all those old records cannot help tell the larger story of the sweep of time across America. And standardization across countries? Let's not go there.
So, the Princeton scholars had a tangled data mess, similar to what faced Hercules at the stables, but easier on the back at least. They went back to the US Certificate of Death from 1989 forward when the form was revised to include education. In looking at cross tabulations by degree attainment, they found that for the 40-ish percent of the US population with a bachelor's degree or higher, lives were growing longer in a way similar to peer nations. For the rest? As the years since the 90’s have flowed by, an alarming increase in deaths by drug and alcohol overdose or abuse, and suicide have increased with each successive generation. In their new book, they lumped these three causes into a “deaths of despair” category. In many ways, we have made great strides in making America a safer and somewhat healthier place, but we have been continually losing ground with a whole swath of the population. People with some resources are able to move to places with greater opportunities, so the distribution of those lifespans become clustered, with those born in Mississippi living to age 71 and Hawaii to over 80. Attainment of a bachelor's degree in Alabama is less than a quarter, while Massachusetts is nearly half.
Back in college, I read Wealth of Nations by Adam Smith in some economics class. I had a summer where I learned about our accounting and monetary systems, along with macro economics. I read the Wall Street journal and Economist on paper and learned about how the invisible hand of the free market economy allowed us all to be rational economic actors and fulfill our needs with efficiency. There were luxury goods, substitutes, inferior goods like Little Debbie bars, and the markets were all policed by good men and women who served as our neutral referees. Audited financial statements, home appraisals, bond ratings by agencies, all of these cornerstones of our market were just a given, beyond reproach. As Willie Nelson noted, it’s funny how time slips away.
As we live our lives as a social species, part of how we define our meaning is protecting the people we love. When the war in Ukraine started, the pictures of women at the border with children holding a stuffed toy, dirty from the long trip, with a father left behind to fight left me haunted. There go I. The authors make the point that for many Americans, providing for the basic needs of a family in terms of access to health care, consistent housing, and healthy food is increasingly out of reach. By connecting access to health insurance with employment and making employment decisions based on maximizing shareholder value, the decision to privatize a whole swath of the workforce has left many Americans pushed outside of the circle. We have cheaper socks, and someone can bring us a snack in 15 minutes, but that whole layer of the economy relies on workers who are not really providing for a family. The pride of working, the loyalty toward the great American corporations, has been replaced by the Uber and the drive up window service. And maybe it goes back to my summer of economics study in that stuffy attic apartment in Columbus. Maybe the lines have crossed and we have maximized the marginal utility of units of labor input and created a system that provides people with the most things and experiences to stuff into a life for the lowest cost.
When I step back, I do wonder at the cost of this great feast. We are an increasingly lonely nation, we have fewer close fiends, less social connection, social media that uses algorithms to drive anger and discord. We have a media system that serves to distract us with non-issues of gas stoves and beer advertisements all wrapped up with fake outrage. At the same time, whole swaths of America are left behind and the bond of caring for each other dissolves. We have more, but we are sicker, and more alone, and more likely to feel the elemental shame of not providing for another when it really mattered. And in the rage of a nation divided, people ask a good question. Why do your kids start school with new shoes? Why does your wife get to live because of the cancer drug and mine dies? Why do you get to work remote during the pandemic and I drive the bus? And the good questions bring out the worst sort of carnival barkers, with the worst answers. It’s the Jews, the gays, the people who get free phones. But maybe it’s just the thing we built, doing what we built it for. Perhaps David Bowie was wondering the same thing back in 1971 when he wrote about the changes of a nation.
But still the days seem the same
And these children that you spit on
As they try to change their worlds
Are immune to your consultations
They're quite aware of what they're goin' through