"We don't know why it came to this."
April 11, 2016 9:58 AM Subscribe

White women between 25 and 55 have been dying at accelerating rates over the past decade, a spike in mortality not seen since the AIDS epidemic in the early 1980s. Why?
posted by Shepherd (139 comments total) 33 users marked this as a favorite

The root causes are important to discuss, but the proximate causes for the increase in mortality are perhaps less mysterious than is suggested:

According to recent studies of death certificates, the trend is worse for women in the center of the United States, worse still in rural areas, and worst of all for those in the lower middle class. Drug and alcohol overdose rates for working-age white women have quadrupled. Suicides are up by as much as 50 percent...What killed Jones was cirrhosis of the liver brought on by heavy drinking...There were plots nearby marked for Jones’s friends and relatives who had died in the past decade at ages 46, 52 and 37. Jones had buried her fiance at 55. She had eulogized her best friend, dead at 50 from alcohol-induced cirrhosis.

People in vast geographical swathes of the country are sad, lonely, and hopeless, in large part because they have a real lack of economic mobility, moribund labor markets, and cuts to social services that make life and social advancement much harder for the non-rich in almost every respect. It's sad, and it's probably amenable to at least some improvement if we can turn the tide against the sociopathic policies of the GOP and the establishment Democrats, but it's not hard to understand as long as you're not in denial about the reality of life in contemporary America.
posted by clockzero at 10:13 AM on April 11, 2016 [139 favorites]

“It’s a loss of hope, a loss of expectations of progress from one generation to the next,” said Angus Deaton, a Nobel Prize-winning economist who had studied the data.

“What we’re seeing is the strain of inequality on the middle class,” President Obama said.

“Erosion of the safety net,” Hillary Clinton said. “Depression caused by the state of our country,” Donald Trump said.

Alcohol is a terrifyingly dangerous drug for multiple reasons. I wish we gave people to access to safer recreational options.
posted by Drinky Die at 10:16 AM on April 11, 2016 [28 favorites]

It's not just "white women", it's poor, white, rural and rust-belt women. White women from Central Park West are not dying at increased rates.

Their world has been utterly devastated by thirty years of neoliberalism. Their (usually ex) husbands have no jobs. They have no skills that the market is willing to pay for. Their churches (dominated by male preachers) preach against homosexuality, socialism and female emancipation but not against offshoring jobs.

So they drink. They do drugs. They vote for Trump. And they die.

Vast swathes of our nation are literally dying of capitalism.
posted by Tyrant King Porn Dragon at 10:18 AM on April 11, 2016 [122 favorites]

“Depression caused by the state of our country,” Donald Trump said.

There's something perfect about that.

I hope we save a few pitchforks for the people getting rich off the discount retailing model that strings minimum wage workers along on a constantly shifting, 30 hour work week.
posted by bonobothegreat at 10:26 AM on April 11, 2016 [17 favorites]

Atlantic

Guardian (previously)

Broader demographics observed, similar conclusions.
posted by wildblueyonder at 10:28 AM on April 11, 2016 [3 favorites]

It's not just unemployment, it's soul-sucking underemployment, and shit jobs with shit wages and shit benefits. Everyone knows someone who drowns their sorrows, and how often is that coupled with either un/under employment or a shitty workplace that grinds you down and gives you less than a living wage?
posted by cell divide at 10:28 AM on April 11, 2016 [36 favorites]

No, it's because there are not enough good jobs.

It sure would be nice if we, as a country and a society, could allow people to meet their basic survival needs and pursue fulfilling existences without subjugating themselves to the whims of profit-driven employers.
posted by Faint of Butt at 10:29 AM on April 11, 2016 [56 favorites]

I would want to compare this situation with what was discussed in the myth of the family farm thread. In a sense, we are seeing a regression to what was the norm for rural life before the 20th century, and specifically before the New Deal and the massive increase in living standards during the postwar years. This is what the return of patrimonial capitalism looks like at the ground level.
posted by Cash4Lead at 10:31 AM on April 11, 2016 [41 favorites]

I'm curious if the confluence of social media presenting every success story with the embarrassing parts, failures & dysfunctions hidden along with the post-feminist message that women can achieve anything no matter how non-meritocratic our institutions are has any part in this.

I don't think the Instagram-perfection pressure is strong among rural poor women. There's no money or time for it. This isn't about upper-middle class anxieties but about how thoroughly America fucks over the poor. There's no work, there's no social services, there's no help for reproductive health or abortions, there's no social mobility. Is it any wonder people despair?

Also, at least in my community: heroin. (Though like heavy drinking, perhaps more a symptom than a cause. But it sure doesn't help.)
posted by sonmi at 10:33 AM on April 11, 2016 [14 favorites]

Wasn't there a post recently about a similar spike in mortality for similarly-situated males?
posted by Sangermaine at 10:36 AM on April 11, 2016 [6 favorites]

The accompanying statistical analysis has a fairly stark pair of infographics detailing the parts of the U.S. where the mortality rates for middle-aged white women have risen and fallen since 1990.

Speaking purely from a California resident's perspective, it is not at all surprising to me to note that the areas with rising death rates are among the more economically and environmentally challenged, while the areas with falling death rates have much more robust economies. The advantage that money confers on life expectancy is remarkably stark.
posted by sobell at 10:37 AM on April 11, 2016 [3 favorites]

It would be nice if they included base rate data and the comparison groups in these stories. It's a disturbing trend for a population sub-group but perhaps they should mention that mortality for black women, while decreasing, still remains higher than the group this article is about.

You know, this is the kind of well-intentioned sentiment that makes poor White people feel like absolutely nobody is on their side. We can't even talk about an alarming and drastic increase in excess mortality among poor White women without a reflexive need to downplay the significance in relative terms and shift the focus to a different ethnic group?

I mean, you're not empirically wrong about Black women having a mortality rate much higher than it should be, but this isn't a conversation about who has it the worst.
posted by clockzero at 10:38 AM on April 11, 2016 [53 favorites]

Yeah, my county is specifically mentioned in the article, and I'm going with opioid abuse. There's also definitely a lot of drinking, but I'm not sure that's new.

I also really, really don't recognize my county from the way people talk about this stuff on Metafilter. For what it's worth.

Wasn't there a post recently about a similar spike in mortality for similarly-situated males?

Yup, but apparently the increase is worse for women. I think this is confusing to people, because it's about rate of change, not raw numbers. White men are still more likely to die young than white women are. It's just that the mortality rate for middle-aged white women is rising faster than the mortality rate for middle-aged white men is. And while black men and women are still more likely to die young than white women are, their mortality rate is declining.
posted by ArbitraryAndCapricious at 10:40 AM on April 11, 2016 [10 favorites]

What this reminds me of is Russia after the USSR collapsed and everybody started hitting the vodka and heroin.

I feel like if this story were about people of color, they would be accorded less dignity, though.

~~~
Perhaps in another ten or fifteen years, when it's apparent to everybody except the most hardened racists that the elites care no more for poor whites than they do for poor people of color, we can all get together and have some meaningful social change. It's gotten so that not only is there no more money to buy off white working class people, but it's not even necessary for social stability, so naturally white working class people are suffering just like everyone else has.
posted by Frowner at 10:42 AM on April 11, 2016 [21 favorites]

I mean, you're not empirically wrong about Black women having a mortality rate much higher than it should be, but this isn't a conversation about who has it the worst.

It's nonetheless weird to have an article of this length about TERRIBLE CRISIS BEFALLING WHITE WOMEN without even a cursory acknowledgement that black women (and Native Americans, don't know about Hispanics) are therefore living somewhere beyond crisis.
posted by praemunire at 10:43 AM on April 11, 2016 [27 favorites]

We can't even talk about an alarming and drastic increase in excess mortality
how do we know if its "alarming and drastic" without at least a passing glance at the raw data? isn't that all the previous message was asking about? I don't think there is any intention to de-humanize this sad story but when we talk about mortality of a group or a trend it would help to have the data.
posted by H. Roark at 10:43 AM on April 11, 2016 [3 favorites]

(Sorry, my prior post was not intended to downplay the seriousness of the problem, just to say that it must be considered in context.)
posted by praemunire at 10:45 AM on April 11, 2016 [1 favorite]

You know, this is the kind of well-intentioned sentiment that makes poor White people feel like absolutely nobody is on their side

Er yeah but the thing is, only now that it's affecting white women is anyone with power paying even the most cursory of attention. So there's kind of a really, really important point being made here that "oh the poor white people, nobody's on their side" is dismissing.
posted by feckless fecal fear mongering at 10:46 AM on April 11, 2016 [10 favorites]

I mean the flipside of "it is never poor white people's turn" is the constant message to black women that it is NEVER our turn. The depradations of poverty only seem to matter when it happens to white people and never mind your ongoing crisis that is so common as to be unremarkable.

I lay that directly at the formation of this. Poverty and lack of hope is a problem no matter what color you are, so maybe we can just talk about it across races and talk about lifting everyone up instead of making it about only white people and reifying the divide. That would be pretty chill.
posted by dame at 10:48 AM on April 11, 2016 [41 favorites]

We are pretty much doomed as a people, as this thread demonstrated in a myriad of ways.
posted by entropicamericana at 10:49 AM on April 11, 2016 [11 favorites]

I mean, let's keep playing into the one-percent's hands by sniping and fighting among ourselves.
posted by entropicamericana at 10:50 AM on April 11, 2016 [38 favorites]

Er yeah but the thing is, only now that it's affecting white women is anyone with power paying even the most cursory of attention.

It's a drop in life expectancy. There has not been a similar drop for other demographic groups:

The steepest declines were for white women without a high school diploma, who lost five years of life between 1990 and 2008, said S. Jay Olshansky, a public health professor at the University of Illinois at Chicago and the lead investigator on the study, published last month in Health Affairs. By 2008, life expectancy for black women without a high school diploma had surpassed that of white women of the same education level, the study found.

posted by Etrigan at 10:52 AM on April 11, 2016 [19 favorites]

But the point is that the rates of mortality are increasing at an alarming rate among this group of white women, not about poverty in general. The rate is actually decreasing among black women.

I feel like people in this thread are really getting tripped up on this, that it's about a large trend of change not total numbers.
posted by Sangermaine at 10:52 AM on April 11, 2016 [8 favorites]

I think we can have this conversation without either ignoring the differences between whites and non-whites or pretending like rural lower middle class white women are somehow a demographic about which people in power care.
posted by Bulgaroktonos at 10:52 AM on April 11, 2016 [28 favorites]

I suspect this discussion is going to piss me off.

Look: this is a weird thing. It is really, really unusual for mortality rates to increase except when there's some kind of really clear cause, like a war or an epidemic or some kind of major social disruption. You don't have to value white people more than other people to think this is something that requires explanation.

This article is part 1 of a two-part series. Part 2 is more about the big picture.
posted by ArbitraryAndCapricious at 10:53 AM on April 11, 2016 [46 favorites]

The point that is made in the statistical article about insults to the liver is telling. The three factors that lead to liver disease, and morbidity, are obesity, alcohol, and opiates. Each of these problems is hard to deal with. Having all of them means that you are likely doomed to be part of the early-death statistic.
posted by Midnight Skulker at 10:56 AM on April 11, 2016 [3 favorites]

New York City has one of the narrowest gaps in life expectancy between rich and poor nationwide.
posted by 1970s Antihero at 10:58 AM on April 11, 2016 [7 favorites]

I'm sorry but there is this "oh no now white people are living like minorities and it is a TRAGEDY and we should DO SOMETHING." And we should do something, but asking to acknowledge that a lot of lower middle class white rage is about being treated they way they have treated blacks for hundreds of years is not an unreasonable thing to ask.

It is not divisive to point that out. And then be sure that whatever approaches are taken work for everyone and actually lift every boat. But if you can't see the insult of acting like an increasing rate is more important that a tragedy you have just ignored till it affected people who look like you (who are still not even as badly off!), then I don't see how you will get to the best solution of pursuing the widest help and justice.
posted by dame at 10:58 AM on April 11, 2016 [21 favorites]

See, I see these numbers and I think of a woman I know, who couldn't get her hepatitis squared away, and was not able to find work that did anything other than barely feed and house her, and so drank to whatever it is people being beat down drink to, and then had a mild stroke, and then was gone.

46 years old. A picture on her casket that looked like a cheerleader mom, young and healthy, before all the things that stacked up finally crushed her. By the end I don't think she cared what happened to her, and the only contact she consistently had was from collectors trying to chisel her medical debt out of her bones. All the medical facilities said she had to attempt to address the debt before treatment.

She thought no one cared about her, and the evidence indicated that she wasn't wrong.

She'd been buried for a week the first time I even heard she was gone.

A sad arc, to what point I do not know. Wish it hadn't been like that.
posted by dglynn at 11:06 AM on April 11, 2016 [70 favorites]

I have been waiting on this story for a few decades now, because looking around me at the struggling white people I know, I've been wondering "how in the hell are they still alive?" Up close, it's sort of been a horrifying tribute to the tenacity of human bodies, because I know at least three addicts who, by all logic, should have been dead years ago. One is my relation, and we all live in constant expectation of the phone call that she's been found somewhere. And we only know a tiny bit of what her life has really been like, but that tiny bit is nightmare fuel.

The one who has died did so by his own hand after one more DUI made it impossible for him to work anymore because he couldn't legally drive. Which also meant he couldn't get to counseling or AA meetings or anything else.

And the thing is, once you've been through that and had your mind and body damaged, even if you do get off the stuff, what's waiting for you? What good life are you going to go to?
posted by emjaybee at 11:06 AM on April 11, 2016 [22 favorites]

If we really care about why, it might not be a good idea to look at it as a gendered issue, because white men seem to be affected by whatever this is, too.
posted by saulgoodman at 11:08 AM on April 11, 2016 [3 favorites]

I think one reason that these conversations go the way they do is that there's very little possibility of doing anything. It's not even like we as a society can get anything done to help anybody.

Honestly, I think this is on white people. Working class white people - and I am basically a working class white person, even though I have a college degree, since I'm a secretary and unlikely to be anything else ever - need to hitch our wagons to racial justice, because everything that we need is part of a racial justice agenda. We could have welfare, but we don't, because racism was used to justify ending it. We could have real national health care, but we don't, because we haver and haver about Mexican immigrants getting it. The whole anxiety about "deserving" poor people that is biting us in the ass now because we are no longer seen as "deserving" - that is a racist thing. There's one real tide that will lift all boats, and it's racial justice.

"White women's lives are starting to look more like Black women's lives, and that tells us that racism is a snare and a delusion", that's what folks need to be saying.
posted by Frowner at 11:08 AM on April 11, 2016 [142 favorites]

It's nonetheless weird to have an article of this length about TERRIBLE CRISIS BEFALLING WHITE WOMEN without even a cursory acknowledgement that black women (and Native Americans, don't know about Hispanics) are therefore living somewhere beyond crisis.

It's not really weird at all to report on big changes in trends such as mortality rates. Again, yes, there are very real and important racial health disparities that are also important to discuss and address, but this article isn't about what mortality rates for everyone look like. Surely the article doesn't need to talk about mortality rates for all demographic groups in order to talk about any of them?

how do we know if its "alarming and drastic" without at least a passing glance at the raw data?

I mean, they give a description of the trends in quantitative terms:

White women between 25 and 55 have been dying at accelerating rates over the past decade, a spike in mortality not seen since the AIDS epidemic in the early 1980s. According to recent studies of death certificates, the trend is worse for women in the center of the United States, worse still in rural areas, and worst of all for those in the lower middle class. Drug and alcohol overdose rates for working-age white women have quadrupled. Suicides are up by as much as 50 percent.

Journalists pretty much never include "raw" data in their reportage anyway, so this seems like a strange critique.

Er yeah but the thing is, only now that it's affecting white women is anyone with power paying even the most cursory of attention. So there's kind of a really, really important point being made here that "oh the poor white people, nobody's on their side" is dismissing.

I'm not sure what you mean by "it" in this case, because there are multiple causal factors here and the drivers of excess mortality in one group aren't identical to those of every other group. In any case, though, I think it's kind of cruel to trivialize concern for the subjects of the article as "oh the poor white people, nobody's on their side." They are actually also still human beings who are miserable and dying, and one of the important implications of this article is that nobody in power is on their side, despite the fact that they're White.
posted by clockzero at 11:11 AM on April 11, 2016 [14 favorites]

The one who has died did so by his own hand after one more DUI made it impossible for him to work anymore because he couldn't legally drive. Which also meant he couldn't get to counseling or AA meetings or anything else.

This can't be overstated. We have a criminal lack of transportation options in the United States for people who can't drive or can't afford their own vehicles. DUI's are just one of the many reasons people have for not being able to transport themselves independently. Like the daughter in the article, who always had to beg rides because she couldn't come up with the money for a car. People in Europe or other countries where public transport infrastructure is a given have a tough time understanding this about the US.
posted by The Underpants Monster at 11:13 AM on April 11, 2016 [24 favorites]

Sullivan told me that in poor, rural regions doctors are using opioids to treat a “complex mixture of physical and emotional distress.” He said, “It’s much more convenient for both patient and physician to speak in the language of physical pain, which is less stigmatized than psychological pain.” Some of these patients could be said to be suffering from what his colleague calls “terribly-sad-life syndrome.” “These patients are at a dead end, life has stymied them, they are hurting,” he said. “They want to be numb.” He believes that doctors are inappropriately adopting a “palliative-care mentality” to “relieve the suffering of people who have had very tough lives.”

- Prescription for Disaster
posted by griphus at 11:13 AM on April 11, 2016 [33 favorites]

I also feel like there might be some ways to look at whether or not there's white-people-specific angles on this. Are white people more likely to have weak community ties, for instance? Are white people more unwilling to use such social services as exist? Do racialized patterns of land ownership and settlement mean that immiserated whites are more likely to live in places where it is difficult to get around and there's none of the casual/graymarket labor that you find in cities? Those are really concrete questions, though, not so much with the "OMG white women are dying" - they're policy questions, like, "how do we deliver services best based on community characteristics?"

I feel, too, like this could chime with the First Nations post from today. Some of the problems - not all - seem to have overlap, and I bet that some of the solutions would be similar.
posted by Frowner at 11:15 AM on April 11, 2016 [28 favorites]

Honestly, I think this is on white people.

Absolutely agree with your comment, frowner.

But a lot of more privileged liberal, white, politically-engaged people I've encountered seem to view this as some well-deserved comeuppance for those awful, bigoted white working class people (because I guess they're so blind to race they don't even see their own or something).
posted by saulgoodman at 11:16 AM on April 11, 2016 [12 favorites]

Bulgaroktonos >

I think we can have this conversation without either ignoring the differences between whites and non-whites or pretending like rural lower middle class white women are somehow a demographic about which people in power care.

I guess that raises the question, what is "this" conversation, really?
posted by clockzero at 11:19 AM on April 11, 2016

Frowner >

"White women's lives are starting to look more like Black women's lives, and that tells us that racism is a snare and a delusion", that's what folks need to be saying.

I am not convinced that that's what's happening here, though. Just because the mortality rate for White women (especially those in rural areas in the central US) might be approaching that of Black women, it doesn't follow that they're dying of the same things or that society-at-large or public institutions are failing them in the same ways. I ardently concur that racism is a snare and a delusion, in many ways, but the empirical situation with respect to different populations and geographical areas seems complicated, and if we misunderstand that complication we're more likely to go astray in responding to it.
posted by clockzero at 11:25 AM on April 11, 2016 [4 favorites]

I think the conversation can be: why is this happening now, to white women, what common factors unite the groups of white women whose death rates are increasing (because it looks to me like a problem with significant location and class elements), how does that resemble or differ from the causes of health problems in other communities, including African Americans and Native Americans, and what kind of approaches would solve as many of these problems as possible. I think that's a productive conversation that doesn't require pitting racial groups against each other or contrasting the relative power of groups that are largely powerless and all suffering.
posted by Bulgaroktonos at 11:28 AM on April 11, 2016 [9 favorites]

I guess that raises the question, what is "this" conversation, really?

As others have pointed out, it's mostly us making noise about things we cannot change, because our society is not structured in a way to allow the people affected by this to have any control over the issues that cause it, no matter the color of their skin.

Short of full-scale revolution (which usually ends badly for everyone anyway) and the end of Nations and the birth of something new (please not Corporate-States, please not Corporate-States), these same things will continue, and we will continue to talk about it, and things will continue to not change.
posted by deadaluspark at 11:28 AM on April 11, 2016 [2 favorites]

Where were rich liberals when welfare was dismantled in the nineties?

Busy taking the public school system apart and sipping champagne on their Uber bar hopping jags?
posted by saulgoodman at 11:35 AM on April 11, 2016 [8 favorites]

Where were rich liberals when welfare was dismantled in the nineties?

Worried about presidential oral sex, what "is" is, and all moving to the north-west and north-east coasts where the money was (computers and biopharma, respectively). No one had their eyes on growing wealth disparity and the hollowing out of the "middle class". Jobs were supposed to follow prosperity, or so that nice Mr. Greenspan promised everyone.
posted by bonehead at 11:49 AM on April 11, 2016 [3 favorites]

Busy taking the public school system apart and sipping champagne on their Uber bar hopping jags?

That's now. The implicit answer for then was "churning out New Republic articles in support of welfare reform," obvs.
posted by atoxyl at 11:53 AM on April 11, 2016 [6 favorites]

"If we really care about why, it might not be a good idea to look at it as a gendered issue, because white men seem to be affected by whatever this is, too."

I think the most revealing thing in this is that when this stuff was first reported, it was reported about middle-aged white men, not the cohorts somewhat older and not the cohorts somewhat younger, and not the white women in these age ranges, all for whom this trend is also evident. No, it was all about middle-aged white men and the discussion around the web, including here, was often centered around causes that are specific to middle-aged white men. It was all about the men. Now it's all about the white women.

Which is to say that the attention this is getting and the tenor of the discussion is all about identity and not driven nearly so much by genuine concern over the probable socioeconomics behind it. I distrust all this discussion.
posted by Ivan Fyodorovich at 11:55 AM on April 11, 2016 [15 favorites]

I also feel like there might be some ways to look at whether or not there's white-people-specific angles on this.

Like I said, I think a lot of it is access to prescription pain killers. You know how doctors under-treat people of color's pain? In a perverse way, that may have protected their communities from the opioid epidemic.
posted by ArbitraryAndCapricious at 11:56 AM on April 11, 2016 [8 favorites]

I also feel like there might be some ways to look at whether or not there's white-people-specific angles on this. Are white people more likely to have weak community ties, for instance? Are white people more unwilling to use such social services as exist? Do racialized patterns of land ownership and settlement mean that immiserated whites are more likely to live in places where it is difficult to get around and there's none of the casual/graymarket labor that you find in cities? Those are really concrete questions, though, not so much with the "OMG white women are dying" - they're policy questions, like, "how do we deliver services best based on community characteristics?"

These are such valuable and thoughtfully-articulated questions. This is why we need robust public support for good social science, among other things.
posted by clockzero at 11:57 AM on April 11, 2016 [15 favorites]

Which is to say that the attention this is getting and the tenor of the discussion is all about identity and not driven nearly so much by genuine concern over the probable socioeconomics behind it. I distrust all this discussion.

I think you're missing the point. The identity of white, middle aged women is getting a lot of play because it's unexpected. People who we think retain a certain amount of privilege, it turns out, often don't due to the socioeconomic factors that many face.
posted by roomthreeseventeen at 12:00 PM on April 11, 2016 [6 favorites]

"'I think we are undergoing a change that’s comparable to the Industrial Revolution,' Aron said. 'Those of us who are lucky enough to have jobs are sort of clinging to them for dear life.'"

QFT

and not "sort of"
posted by blucevalo at 12:18 PM on April 11, 2016 [12 favorites]

Where were rich liberals when welfare was dismantled in the nineties?

It's worth noting that Sanders, among others, opposed the 1996 welfare reform bill.

It is difficult for some of us who are lifelong leftists and lost all those fights over the years not to want people who consistently supported the dismantling of the social safety net because it was for those other people to at least have to acknowledge what they did rather than act shocked that it turns out that they need some help, too (even though they're white!). Instead, the demographic's choice so far seems to have been to double down on the racism. I struggle with managing this frustration, because I know it can't be allowed to inform policy. Nobody deserves to suffer and die like the subject of the article did, nobody. Our country cannot thrive unless people like her are assured basic human dignity. But, you know, maybe admit it wasn't the best idea to be the enthusiastic henchmen to a bunch of looters, as if you couldn't guess how that story would end?
posted by praemunire at 12:19 PM on April 11, 2016 [20 favorites]

Are white people more unwilling to use such social services as exist?

In some states, trying to access social services is such a runaround now and demands so much time and attention, it comes with huge opportunity costs just trying to qualify. There's a lot of social pressure on whites dealing with hardship to suck it up and focus on finding work as a first priority or be viewed as parasites looking for handouts by their peers. Some industries tacitly force workers to resign so they won't be able to claim unemployment benefits, and if you don't play ball, it can harm your professional reputation and get you tangled up in time consuming and costly HR administrative and arbitration processes. More lost opportunity.

People also have a tendency to assume all whites enjoy so much privilege as white people, if they're struggling or failing it must be due to their own exceptionally bad character. Whites give this treatment to other whites, too--sometimes I think even more viciously, because acknowledging that the system can fail even fellow whites challenges their own ideas about having fought for and earned their own positions of economic privilege. Rich and/or culturally upper class whites hate struggling and/or culturally lower class whites almost more virulently than other ethnic groups. They'll gladly torture a white homeless person and feel righteous for doing it as a way of denying the legitimacy of their struggles and victim-blaming, to distance themselves from the challenge to their own unexamined sense of racial superiority. That's my take on the phenomenon.
posted by saulgoodman at 12:22 PM on April 11, 2016 [17 favorites]

Just spitballing here, but I think Frowner's really on to something.

Are white people more likely to have weak community ties, for instance? Are white people more unwilling to use such social services as exist? Do racialized patterns of land ownership and settlement mean that immiserated whites are more likely to live in places where it is difficult to get around and there's none of the casual/graymarket labor that you find in cities?"

I see this as tied to politics, the wildly successful bullshit story that Republicans have sold to many working class whites: minorities are bad and unwilling to work (except Latinos but they're "illegal" and stealing your jobs), minimum wage is bad because it kills [low-paying deadend] jobs, good moral Christian PATRIOTS live in the heartland and work hard and party hard and drive expensive Ford F-150 pickups and KICK ASS. Not like minorities or those whiny godless "elite" liberals who get educations and move to liberal cities with more minorities and thriving economies and ride bikes and shit.

It's a dangerous and powerful story mixing racism, religion, political ideology and moral superiority, but then the mill shuts down because the old growth is all gone, and you're a 32-year old high school graduate in the middle of nowhere with two DUIIs, a huge truck loan, 3 kids you can't afford and no job except a $7/hr part time job at Walmart.
posted by msalt at 12:28 PM on April 11, 2016 [10 favorites]

A lot of the points raised in this thread are directly addressed in part 2 of the story, which ArbitraryAndCapricious helpfully linked to above. In particular, the race gap is discussed at length; for example:

Others have questioned the sudden focus on whites, pointing out that African Americans continue to have shorter life spans and face severe health challenges exacerbated by racial segregation and discrimination. Why, they ask, give so much attention to a group that remains statistically advantaged?

“The truth is that white death rates are still much, much lower than they are for African Americans,” said Bridget Catlin, senior scientist at the University of Wisconsin. “My concern is that people will think, ‘Oh, it’s whites that need to be helped.’ ”

It's worth reading to get at the numbers beneath the compelling narrative of the OP. Several more general causes for the disparity are floated, including the easy availability of opioids, smoking, the disappearance of blue-collar work, and the generational squeeze that means women of this age are more likely to have to balance both full-time work and family/childrearing responsibilities.

Personally, I find these stories agonizing and too-familiar. My mother died in her early 60's and while her story is not quite the same as the ones told here, there are some stark similarities.
posted by informavore at 12:30 PM on April 11, 2016 [10 favorites]

What we're seeing here is an interesting moment of ideological transition: the immiseration of the American working class has moved from open secret to universally acknowledged truth, then shrugged off as "inevitable" by the very people who made it so.

The "invisible hand" and "market forces" rhetoric of the US elite has always been designed to equate economics with the weather - impersonal, inevitable, and beyond the influence of policy. Their dismissing of the slow-motion extermination of the working poor feels entirely in keeping with decades of this kind of propaganda.
posted by ryanshepard at 12:46 PM on April 11, 2016 [16 favorites]

I mean, let's keep playing into the one-percent's hands by sniping and fighting among ourselves.

There are an awful lot more of us than there are of them, and history has shown again and again, that one day, when we decide we can't take it any more, we will turn the pitchforks away from one another & towards them. That day can't come soon enough at this point.
posted by Devils Rancher at 12:52 PM on April 11, 2016 [5 favorites]

Some interesting snapshots from the several more detailed demographic articles posted in comments here:

“In seven southern states—West Virginia, Mississippi, Oklahoma, Tennessee, Kentucky, Alabama, and Arkansas—the gap between actual and expected mortality in 2014 exceeded 200 deaths per 100,000 people. In West Virginia, mortality rates were higher than at any time since 1980. ... four of the seven worst-off states the researchers highlighted have opted not to expand Medicaid as part of Obamacare."

"...not only are middle-aged white people drinking more, using more opioids, and killing themselves at higher rates, more of them are getting sick with the diseases that usually kill older people. And when they do get sick, they don’t get better."

"[Among middle aged whites] Only for those with a bachelor’s degree or higher did overall death rates continue to decline."

"When men began quitting cigarettes in large numbers in the 1960s and 1970s, the smoking gap between men and women nearly vanished. Lung cancer now kills far more women than breast cancer."

"African Americans die an average of four years younger than white Americans do, for example. However, the mortality rate for African Americans is declining, and that of white Americans is increasing—a historically anomalous trend."

[This study found] "a growing divide between urban and rural health .... whites are a large majority in most rural areas."

Without data, one article also notes that now-middle aged white women are the first generation to work en masse, and that what's happening could also be described as the erosion of the higher life expectancy white women had compared to men and minority women.
posted by msalt at 12:54 PM on April 11, 2016 [4 favorites]

I haven't figured out how to link directly to my search results, but you can find out a lot by playing with the CDC's WONDER Search.

What I found, in order to put actual numbers on the urban/rural white/black mortality rates (crude death rates per 100,000):

White women, 25-54, 2013/2014:

Large Central Metro: 135.3
Large Fringe Metro: 152.2
Medium Metro: 184.7
Small Metro: 201.7
Micropolitan (non-metro): 228.7
NonCore (non-metro): 257.3
Total: 171.6

Black women, 25-54, 2013/2014:

Large Central Metro: 243.7
Large Fringe Metro: 191.0
Medium Metro: 255.1
Small Metro: 277.3
Micropolitan (non-metro): 312.2
NonCore (non-metro): 360.9
Total: 241.7

So middle-aged black women are still well behind middle-aged white women in all categories, though the best-off black women ("Large Fringe Metro") are doing better than rural white women.

Query criteria I used:

2013 Urbanization: All
Age Group: 25-34 years, 35-44 years, 45-54 years
Gender: Female
Hispanic Origin: All
ICD-10 Codes: All
Race: All
States: All
Year: 2014
Group By: 2013 Urbanization, Race
Show Totals: True
Show Zero Values: False
Show Suppressed: False
Calculate Rates Per: 100,000

The worst-off middle-aged women of all are, unsurprisingly, "American Indian or Alaska Native" living in "NonCore (non-metro)", with a raw mortality rate of 369 per 100,000 in 2014.
posted by clawsoon at 12:56 PM on April 11, 2016 [3 favorites]

Devils Rancher: There are an awful lot more of us than there are of them, and history has shown again and again, that one day, when we decide we can't take it any more, we will turn the pitchforks away from one another & towards them. That day can't come soon enough at this point.

History has also shown that the elites almost always win, at least in the short term, because of their better organization. When Adam delved and Eve spanned...
posted by clawsoon at 12:59 PM on April 11, 2016 [5 favorites]

Frowner: What this reminds me of is Russia after the USSR collapsed and everybody started hitting the vodka and heroin.

The part 2 article mentioned that, too:

In modern times, rising death rates are extremely rare and typically involve countries in upheaval, such as Russia immediately after the collapse of the Soviet Union.

Funny, isn't it, that this started happening in both superpowers after history ended and the neoliberal consensus won?
posted by clawsoon at 1:01 PM on April 11, 2016 [14 favorites]

Are white people more unwilling to use such social services as exist?

So, I went on food stamps, once, briefly. And I pass for white, anyway, and my whole Hispanic family is all in Texas, not Ohio. I knew a lot of people who were poor, but always just above the line that was "too poor to buy food". So when I went and sat in that waiting room, it was the most alone I can remember feeling. There was nobody who I could talk to who'd been through this experience.

Mostly, I felt... off-balance. Every insult felt worse because I didn't know it was coming, I guess? And there were a lot of them. I was treated like an idiot and a child at every turn, and I was white-passing and they knew I had a college degree. You could tell that their script had not been written for the "temporarily embarrassed millionaires". Or for the temporarily-disadvantaged poor and working class white community. Or for educated millennials in unstable situations who couldn't always rely on family for help.

It is, to me, not really a "whiteness" problem but a problem with having these programs and then not giving them the funding to do outreach, which leaves poor communities to try to do it themselves. Having previously had cancer probably means you'll have experience at navigating the health care system, yeah? Imagine if we expected the seriously ill to manage their care the way we expect the poor to manage their benefits. Communities with a lot of serious illness would probably be better at it, not because they're better off, but because they've got connections to people who can help. Because you sure as hell weren't getting help from ODJFS, when I was there. They existed entirely to be a barrier between you and benefits. If these government offices started actually helping people instead of serving as gatekeepers, then everybody would be better off. If that was the goal.

I'm pretty sure America's racism against the black and Hispanic community has grown to the point where it's also seriously hurting poor whites, but people seem to prefer keeping people of color away from benefits to ensuring that poor whites get them.
posted by Sequence at 1:01 PM on April 11, 2016 [33 favorites]

Rich and/or culturally upper class whites hate struggling and/or culturally lower class whites almost more virulently than other ethnic groups.

This looks to me like the exact same phenomenon of straight cis men virulently attacking less-'masculine' men. It's about 'traitors.'

clawsoon's numbers support my thesis above: this is getting airtime because it's white women being affected (at approximately 71% the rate) of black women, for whom these numbers are normal.
posted by feckless fecal fear mongering at 1:02 PM on April 11, 2016 [3 favorites]

Re social services; they don't exist, for the most part, for anyone, and the pittance available is short term assistance. Ill give you an example, my best friend is a single mom, after her husband left her for an younger woman. His parents are wealthy, but all of his assets "evaporated" before he left. Because he doesn't work, the state can't collect child support, but because she is supposed to get child support, she doesn't qualify for any assistance, not the low cost insurance, not WIC, not food stamps, not after school care for the kids, nothing. She dropped out of college when she got pregnant, so she has a high school education. She works for $8_10 an hour as a dog groomer, which is insanely hard physical labor. She can't take days off if she's sick, if she's injured, if her kids have a field trip, or need to see the doctor. She works her ass off, and is barely keeping her head above water. And she has to put up with a handsy as whole manager who keeps trying to trap her alone, and is punishing her for not being compliant about his advances. She can't complain, because she works for a chain, and it's the only place that offers insurance for employees like her. One excess electric bill, or a medical emergency, and she is well and truly fucked.

So, it's not that white folks won't apply for assistance, it's that there is no assistance for which to apply. This isn't a race issue, it's a social issue. In Texas, if you have more than $5,000 in assets, including your car, you don't qualify for food stamps. Welfare cutoff is $2,000 in assets including car, house, savings, etc. These programs are designed to never pay out. Poverty is seen as a moral failing in this country, irrespective of creed, color, or gender, and the rich folks sure do wish the rest of us would die and quit cluttering up the place.
posted by SecretAgentSockpuppet at 1:05 PM on April 11, 2016 [54 favorites]

Imagine if we expected the seriously ill to manage their care the way we expect the poor to manage their benefits.

I don't have any experience navigating whatever poverty safety net we have, but my experience with our insurance system suggests that we're not at all shy about dumping the burden of navigating a labyrinth of bureaucracy onto the seriously ill.
posted by wildblueyonder at 1:08 PM on April 11, 2016 [12 favorites]

Which is to say that the attention this is getting and the tenor of the discussion is all about identity and not driven nearly so much by genuine concern over the probable socioeconomics behind it. I distrust all this discussion.

Why so quick to move from a discussion of the topic to a discussion of the discussion?
posted by clockzero at 1:14 PM on April 11, 2016

Frowner: I think one reason that these conversations go the way they do is that there's very little possibility of doing anything. It's not even like we as a society can get anything done to help anybody. .... Honestly, I think this is on white people. Working class white people - and I am basically a working class white person, even though I have a college degree, since I'm a secretary and unlikely to be anything else ever - need to hitch our wagons to racial justice, because everything that we need is part of a racial justice agenda. We could have welfare, but we don't, because racism was used to justify ending it. We could have real national health care, but we don't, because we haver and haver about Mexican immigrants getting it.

And yet there's reason for hope in the numbers: Middle-aged black women have seen a drop in mortality over the past decade-and-a-half, from 300 per 100,000 in 1999 to 240 in 2014.

That's 20% better. So, clearly, something can be done, despite the horrors of welfare reform and racism. I'd be fascinated to know what's driving the positive changes for black women.

(My first guess: Black women disproportionately live in cities compared to white women, and cities are getting better at preventing death while rural areas are getting worse. I'd be curious to know if the same rural/urban health divide is happening in, say, Denmark.)
posted by clawsoon at 1:25 PM on April 11, 2016 [5 favorites]

But a lot of more privileged liberal, white, politically-engaged people I've encountered seem to view this as some well-deserved comeuppance for those awful, bigoted white working class people (because I guess they're so blind to race they don't even see their own or something).

Rich and/or culturally upper class whites hate struggling and/or culturally lower class whites almost more virulently than other ethnic groups.

As long as we’re sharing anecdotal experiences about people’s philosophies, I am a rich, coastal, liberal, white lady (well I pass for white anyway) who runs almost exclusively in circles of rich, coastal, liberal, white people. This is not even remotely a sentiment I have ever heard. Having social and financial privilege does not reflexively drain people of empathy for people who don’t.

I mean, sorry to #notallrichliberalwhitepeople here, but this is the kind of left turning on itself that drives me crazy. It’s just bananas counterproductive to make an enemy of an ally and ignore the actual enemies here, you know: The Right.

I also don’t see how “capitalism” is killing people here, since the Scandinavian “Nordic Model" is in fact capitalist and doesn’t seem to have these problems, and it’s not like everyone’s health and longevity were great in Communist Russia or Socialist China.

I absolutely agree that we need better social safety nets, and that we’d have them if it weren’t for racism and the Right. I mean, yes, Bill Clinton’s ’96 Welfare Reform Bill did much to dismantled the advances of Johnson's War on Poverty.

But apparently nobody remembers what it stood in opposition to — Speaker of the House Newt Gingrich’s “Personal Responsibility Act” which would “discourage illegitimacy and teen pregnancy by prohibiting welfare to minor mothers and denying increased AFDC for additional children while on welfare, cut spending for welfare programs, and enact a tough two-years-and-out provision with work requirements to promote individual responsibility.”

Gingrich proposed this in 1994, the year Republicans swept to victory, gained control of Congress and won gubernatorial and state legislative races nationwide.

Can we do better now? I certainly hope so. But sniping at each other from within isn’t going to get us there.
posted by pocketfullofrye at 1:27 PM on April 11, 2016 [23 favorites]

It can be about the intersection of identity issues (at the grass roots, how people behave level) and the probable socioeconomic issues. The prefix socio- implies that social identity is already a part of whatever more genuine discussion there might be to have.

I doubt seriously anyone here would argue things are worse now for poor whites than for poor blacks. That would be absurd. Blacks had to survive generations of far worse before the more recent economic trends that affect all of us, and started with tremendous disadvantages. But I almost never pick up on any contempt for poor whites (at least, the ones who aren't also very publicly and virulently racist because they've succumbed to the kinds of self-defeating racism and identity politics Mark Twain wrote about) from black people genuinely engaged in the struggle. It's middle and upper class whites who have the most contempt for poor whites

Having social and financial privilege does not reflexively drain people of empathy for people who don’t.

I'm mostly reflecting on experiences in the South here, and no generalization is ever completely true, but I stand by the claim in general.
posted by saulgoodman at 1:33 PM on April 11, 2016 [2 favorites]

I absolutely agree that we need better social safety nets, and that we’d have them if it weren’t for racism and the Right. I mean, yes, Bill Clinton’s ’96 Welfare Reform Bill did much to dismantled the advances of Johnson's War on Poverty.

It's counterfactual to blame it all on the right. Clinton sure seemed pretty proud of destroying welfare in 2006, holding it out as an example of the benefits of bipartisanship. Primary sources from the time also contradict the idea that he was forced into it - he literally ran in 1992 on a promise to "end welfare as we know it."
posted by dialetheia at 1:39 PM on April 11, 2016 [19 favorites]

Having social and financial privilege does not reflexively drain people of empathy for people who don’t.
Science seems to be on my side here.
posted by saulgoodman at 1:44 PM on April 11, 2016 [6 favorites]

It's counterfactual to blame it all on the right.

There is, for now, no political left with power in the US - you have a center right as exemplified by the Clintons, and various shades of a far right, ranging from relatively mainstream to wingnut fringe. So I think it's correct to blame it all on the right.
posted by ryanshepard at 1:44 PM on April 11, 2016 [14 favorites]

cities are getting better at preventing death while rural areas are getting worse

To put hard numbers on this, I did more CDC Wonder searches:

For middle-aged women of all races, the suburbs were the best place to live in 1999 (death rate 142 per 100,000). Every place else was worse, but pretty similar among themselves; death rates were in the relatively narrow range of 169-196. Urban cores were at 174.

By 2014, that had changed dramatically. Urban cores were now as good as suburbs for middle-aged women (death rates 147 and 149, respectively). Every place else is either worse (10% worse in medium metro) or much worse (37% worse in rural areas).

I'm going to go out on a limb here and suggest that what's happening has less to do with welfare reform and more to do with the massive shift of wealth from rural to urban that's been going on over the past couple of decades across many parts of the Western world. Because white women were disproportionately rural, they were on the wrong end of that shift. Black women, though they still haven't caught up with white women, are going in the right direction because they were more likely to be living in what has become the right place at this time, i.e. big cities.
posted by clawsoon at 1:45 PM on April 11, 2016 [7 favorites]

From the column linked to above under "Clinton seemed pretty proud of destroying welfare in 2006"

"The Republicans wanted to require able-bodied people to work, but were opposed to continuing the federal guarantees of food and medical care to their children and to spending enough on education, training, transportation and child care to enable people to go to work in lower-wage jobs without hurting their children.

Through the Welfare to Work Partnership, which my administration started to speed the transition to employment, more than 20,000 businesses hired 1.1 million former welfare recipients.

The success of welfare reform was bolstered by other anti-poverty initiatives, including:

the doubling of the earned-income tax credit in 1993 for lower-income workers

the 1997 Balanced Budget Act, which included $3 billion to move long-term welfare recipients and low-income, noncustodial fathers into jobs

the Access to Jobs initiative, which helped communities create innovative transportation services to enable former welfare recipients and other low-income workers to get to their new jobs

and the welfare-to-work tax credit, which provided tax incentives to encourage businesses to hire long-term welfare recipients.

I also signed into law the toughest child-support enforcement in history, doubling collections;

an increase in the minimum wage in 1997

a doubling of federal financing for child care, helping parents look after 1.5 million children in 1998;

and a near doubling of financing for Head Start programs.

The results: child poverty dropped to 16.2 percent in 2000, the lowest rate since 1979

Overall, 100 times as many people moved out of poverty and into the middle class during our eight years as in the previous 12. "
posted by pocketfullofrye at 1:50 PM on April 11, 2016

You know, I remember the dismantling of welfare. It's one of the first things I really remember as an adult, where I feel like I had some understanding of the issues. What I remember was white liberal cheerleading. There was worry on the left, sure, but far more of the "welfare is broken, this will help people" - very much the same kind of thing as liberal support for military intervention in Iraq. The same mustering of examples of how terrible the system was, coupled with a complete dearth of concrete suggestions for improving the actual lives of the people affected. It was part of the same wave of social policy initiatives that knocked down the projects while promising new, better affordable housing that mysteriously never got built.

Such liberalism as we have in this country was absolutely behind the dismantling of welfare, just as it was behind all the idiocy of the Clinton years. I cannot tell you how weird it feels to realize that a period which feels so incredibly recent to me has been smoothed and reshaped by the passage of time until now it's the right who was to blame. I guess I know how my dad feels when he talks about the Carter administration.
posted by Frowner at 1:52 PM on April 11, 2016 [22 favorites]

"Maybe it's actually just Facebook and feminism"

My intent was to blame the backlash against feminism, so to the extent I failed in my word choices I apologize.
posted by BrotherCaine at 1:56 PM on April 11, 2016 [1 favorite]

Economic Policy Institute on Welfare-To-Work in 2002.

And that's the weak sauce, respectable version. The end of welfare as we know it was an awful crime against ordinary people and it made life shittier and more precarious for many, many people.

What's worse is that this was all predictable. It was known at the time that there weren't the kind of good jobs needed for everyone to be able to attain a decent standard of living, and it was known that many many things (ill health, needing to care for sick relatives or small children, transportation issues, housing issues) would prevent people from working full time in well-paying jobs even if those jobs were available. This was all known. It was pretty standard Z Magazine/Guardian/Progressive magazine fare, which is where I read about it.

I remember very clearly that when public housing was demolished here in Minneapolis in the late nineties, we already had many national examples of how such housing was demolished and the promises to replace it had turned out to be lies. But of course it was going to be different here. Spoiler alert - it wasn't different.
posted by Frowner at 2:01 PM on April 11, 2016 [14 favorites]

Overall, 100 times as many people moved out of poverty and into the middle class during our eight years as in the previous 12. "

Sure, as a natural result of normal business cycles. It was very quickly reversed when that bubble burst in the early 2000s, and led to a doubling of extreme poverty. Related: Nothing Bill Clinton said to defend his welfare reform is true.

Further, Democrats adopting right-wing framing about "dependence" "dignity" and "deadbeats" around these issues was (and arguably remains) extremely damaging to economic justice efforts. This piece is centered around Hillary Clinton but I'm sure you could find a million other examples from the time. This kind of thing in particular really burns me up: “One day, Rhonda Costa’s daughter came home from school and announced, ‘Mommy, I’m tired of seeing you sitting around the house doing nothing.’ That’s the day Rhonda decided to get off welfare. Today, Rhonda is an administrative assistant at Salomon Smith Barney, a New York financial services firm. After a year and a half on the job, she earns $29,000 a year with full benefits and stock options.” Wonder what happened to Rhonda after the bubble burst.
posted by dialetheia at 2:05 PM on April 11, 2016 [20 favorites]

Overall, 100 times as many people moved out of poverty and into the middle class during our eight years as in the previous 12. "

Sure, as a natural result of normal business cycles. It was very quickly reversed when that bubble burst in the early 2000s, and led to a doubling of extreme poverty. Related: Nothing Bill Clinton said to defend his welfare reform is true.

There's no doubt that a strong economy was partly responsible for the unprecedented move of people out of poverty under Bill Clinton.

And yet, if that's all it took, why isn't it happening under our current strong economy? You can quibble with how much of it was a direct result of the policies. But the piece that claims that nothing Bill Clinton said was true does not actually dispute that he did these things:

raised the minimum wage
increased funding for child care
doubled funding for head start
increased tax credits for poor people
funded programs for education and transpiration to jobs
posted by pocketfullofrye at 2:15 PM on April 11, 2016

That’s the day Rhonda decided to get off welfare. Today, Rhonda is an administrative assistant at Salomon Smith Barney, a New York financial services firm. After a year and a half on the job, she earns $29,000 a year with full benefits and stock options.” Wonder what happened to Rhonda after the bubble burst.

Let's grant your insinuation that she lost her job in the recession. Even so, do you think it's bad that she want from welfare to a good job? Would it have been better just to stay on welfare and not get her hopes up?
posted by msalt at 2:20 PM on April 11, 2016 [1 favorite]

our current strong economy

Why, after 50 years of unabated progress in life expectancy for every conceivable group of Americans – men, women, young, old, rich, poor, high-school dropouts, college graduates, rural, urban, white, black, Hispanic or Asian — had one demographic group in the last decade experienced a significant increase in premature deaths? Why were so many white women reporting precipitous drops in health, mental health, comfort and mobility during their working-age prime? Why, over the last eight years alone, had more than 300,000 of those women essentially chosen to poison themselves?

“It’s a loss of hope, a loss of expectations of progress from one generation to the next,” said Angus Deaton, a Nobel Prize-winning economist who had studied the data.

posted by Rustic Etruscan at 2:22 PM on April 11, 2016 [7 favorites]

Writing in Vox, Julia Belluz covers another study of life expectancy: Income inequality is chipping away at Americans' life expectancy.

... the strongest pattern they uncovered was that low-income individuals lived the longest (and had more healthy behaviors) in places with well educated, high-income populations, as well as generous government spending.

So, contrary to theories that extreme inequality can lower life expectancy, especially for the poor, the researchers found that cities with a lot of rich people — like New York and San Francisco — actually had poor people who lived longer.

The researchers aren't entirely sure why, and called for more research. They do, however, suspect that it has to do with health-promoting public policies and better-funded public services in rich cities.

Reminds me of Orwell's comment:

However unjustly society is organised, certain technical advances are bound to benefit the whole community, because certain kinds of goods are necessarily held in common. A millionaire cannot, for example, light the streets for himself while darkening them for other people.

So maybe poor people are healthier in urban areas because the rich people who also live there have a direct incentive to support funding for public services.
posted by russilwvong at 2:22 PM on April 11, 2016 [12 favorites]

as a white woman in arkansas who was raised in poverty (and am only considered middle class here), this has been a very rough thread to read. maybe just remember that some of us are here and can hear you.

as for the welfare discussion - when i was straight up homeless and jobless i couldn't get food stamps for...reasons...that were never fully explained to me. my paperwork kept getting "lost" and i ran out of people who would drive me the 20 minutes to go stand in line for another 5 hours to work it out.
posted by nadawi at 2:23 PM on April 11, 2016 [37 favorites]

our current strong economy

Our what again?
posted by RogerB at 2:24 PM on April 11, 2016 [13 favorites]

Even so, do you think it's bad that she want from welfare to a good job? Would it have been better just to stay on welfare and not get her hopes up?

That's a false choice - it's not like that job was created via welfare reform. I think it's bad that welfare reform was premised on there being enough jobs for everyone, which turned out to be catastrophic for poor families as soon as that turned out not to be the case. In any event, no, I would not trade a few years at a middling job for the wholesale dismantling of the welfare social safety net. Lillie Harden's story might be instructive: "AlterNet sought to interview Harden to see if her condition had improved, and learned that she died in March of last year, at the age of 59. She was living in North Little Rock, Arkansas at the time, a community where a fifth of the population lives below the poverty line. Eliminating the safety net for Lillie Harden did not transform her family the way Clinton boasted. The pride she had in getting a job gave way to the harsh socioeconomic realities of her life."
posted by dialetheia at 2:30 PM on April 11, 2016 [17 favorites]

Oh, yes, let's do another go-around of the "strong economy" whose rising tide lifts all fucking boats, unless you don't own a business or lots of stock.

Automation, free trade and credentialism are destroying the opportunities of the middle-class, especially the older middle-class. If you are a 45 year old woman without a college degree who's had the same job working at the same factory or small business for the last 20 years and you get fired or the business goes down, well, you're just fucked. You're absolutely fucked. You can't get another job because no one will look at your resume without a degree. You can't move for work because you own an underwater mortgage and nobody's buying. You have no safety net because you and your husband/boyfriend split and you've never made enough for a safety cushion. Your kids can't support you because they're just as bad off, but maybe they have student loans as well as being not able to find a job.

How are you supposed to walk back from that? Lack of a social safety net (welfare, food stamps, section 8) - lack of these things will sink you in that situation for sure. No question about it. But even if you're lucky enough to get them, what happens to your self-esteem? If you're the type of person that felt some pride in self-reliance, what then? What do you have to keep you going, and to give your life meaning and value?

I'd drink and shoot up too. I don't blame them at all.

I saw an article the other day from Larry Summers of all people, talking about how stupid Americans and Europeans are for not supporting free trade deals. He said, yeah, you might lose your job at the factory and that's bad for you, but just think how much cheaper your toys and cell phones will be. What's the use of that if you don't have a job?
posted by permiechickie at 2:33 PM on April 11, 2016 [14 favorites]

nadawi: when i was straight up homeless and jobless i couldn't get food stamps for...reasons...that were never fully explained to me. my paperwork kept getting "lost"

Growing up in a rural area, I remember that most of the government jobs were held by well-educated liberals from outside of the area. As much as urban liberals in this thread have protested that they fully support All The Good Things for poor rural people, it might be that the liberals who were on the ground running government programs in rural areas looked down on the backward rednecks they were serving, and that this played some part in the death-by-a-thousand-paper-cuts that nadawi describes.

Just a thought.
posted by clawsoon at 2:33 PM on April 11, 2016 [5 favorites]

Frowner: I think one reason that these conversations go the way they do is that there's very little possibility of doing anything. It's not even like we as a society can get anything done to help anybody.

Honestly, I'm not so sure that's true. I would argue that the weakening of the social safety net is likely a major factor. US politics may be deadlocked at the federal level, but perhaps if people focused on organizing at the state and local levels, it'd be possible to change the social-safety-net policy at those levels.
posted by russilwvong at 2:35 PM on April 11, 2016 [2 favorites]

well, what can i say? - this thread is depressing as hell, as it doesn't seem like the left is any more effective or concerned than the right is - (pro tip - if you're really concerned, you'll be effective)

no wonder people are voting for trump and his big lies

wait until they find out the system won't allow him in - or that he's lying through his teeth, anyway

you might actually see poor and working class whites arm themselves

oh, wait - they already have haven't they?

this country needs to find a solution soon before all hell breaks loose
posted by pyramid termite at 2:35 PM on April 11, 2016 [1 favorite]

Oh, yes, let's do another go-around of the "strong economy" whose rising tide lifts all fucking boats, unless you don't own a business or lots of stock.

Uh... nobody in this thread is actually arguing that our current economy is lifting all boats. I'm the person who used that phrase a few comments up, specifically to contrast the strong economy under Bill Clinton under which people did move out of poverty, and the current economy which is, by most economic measures, stronger than it has been since the recession, but is clearly not benefitting everybody equally.
posted by pocketfullofrye at 2:41 PM on April 11, 2016 [1 favorite]

The classism/regionalism of liberals (and bits of the left) discussion reminds me of when people talk about Northern vs. Southern racism, characterizing Northern racists as people who would be aghast to be called racists but are still practice racism. I'm not talking about anyone here, but boy howdy is that phenomenon a thing with classism, IME.
posted by The Gaffer at 2:42 PM on April 11, 2016 [10 favorites]

The rising tide lifts all boats, but rich people really enjoy shooting holes in everyone else's boats, so everyone spends most of their time frantically bailing.
posted by emjaybee at 2:52 PM on April 11, 2016 [3 favorites]

Orwell's comment... A millionaire cannot, for example, light the streets for himself while darkening them for other people.

Technologically, I think that is no longer true.
posted by oneswellfoop at 3:01 PM on April 11, 2016 [4 favorites]

What started happening in 2004 that would've helped urban black middle-aged women?

That's when their mortality improvements started a yearly march in the right direction that has continued every single year since then, right through the recession. There's something really interesting going on there, and I'm very curious to know what it might be.
posted by clawsoon at 3:03 PM on April 11, 2016 [5 favorites]

All I know is that this is happening to someone I love, and it is so painful to go to the Rust Belt, which is where she is from, and to see countless women toiling, day in and day out, working to keep it together, drinking and doing drugs to numb the pain, and then dying young and worn out and yellow from cirrhosis. And when they are on their way to death, no one picks up the slack, unless there are other women around. And you're damned if there aren't--she certainly is, my friend, and her extended family that is local is actually angry at her because she isn't able to do what she used to do (making meals for people, watching their kids, lending out money)--but then they're damned if they are there, the other women. It's hard not to imagine the same fate befalling Tiffany from this story.

.
posted by sockermom at 3:04 PM on April 11, 2016 [15 favorites]

I will try to be as diplomatic as possible. Let's all agree that a Democratic super majority would be much preferable to what we have now, but even with the changing demographics from immigration, there is no hope for a Democratic super majority without reeling in the White working class. To get those White working class voters to consider bailing on the Republican Party and voting Democrat, you have to acknowledge their problems without rubbing their face in the fact that other groups have it worse.
posted by Beholder at 3:07 PM on April 11, 2016 [9 favorites]

So they drink. They do drugs. They vote for Trump. And they die.

Vast swathes of our nation are literally dying of capitalism.

I am calling attention to this piece of rhetoric because, as good and as natural as it sounds to say, it distracts from the underlying point. The same white women in Central Park West with up-to-date skills are not dying. They may not be prospering as much as they should, but they are not the ones suffering.

Cell growth is good; uncontrolled cell growth is cancer. The problem isn't capitalism, it's an unregulated market and a lack of education.

Strictly speaking, when people who are unskilled or underskilled start to die off, this is an example of a "self-correcing problem." Fortunately, as human beings who care about more than simply the bottom line GDP, we would prefer that the unskilled or underskilled be given skills and opportunities. To blame market economies as a whole is a very tempting and easy target, but it belies the fact that unskilled or underskilled people would have just as much of a problem in a centrally planned economy.

These women are dying because there is no social safety net, because education has been eroded to a shadow of itself over generations, because robber barons are squeezing every last bit of productivity and wealth out of the middle class, because infrastructure is stretched beyond its operating limit, because overall prosperity is going down, and because public discourse has been turned into a Guelphs versus Ghibbelines mob fight to distract the population from the fact that the exceedingly rich have decided that they no longer need us.

This is a much more ugly and complicated knot to untie, but we need to understand that no matter what mechanism the body politic wants to use, whether for the creation and enforcement of public policy or for the conduct of an economy, when the people running the machine decide they don't want you and that you are worthless, you have nowhere else to go. Whether that machine follows 17th century mercantilism, Stalinist planned economies or whatever clusterfuck of smoke and mirrors we have now, the fact is that the haves has decided the have-nots are too costly to keep as chattel.

Replacing one system with another isn't going to solve the problem; fixing the machine is unlikely; but finding a way of reaching out and helping each other is going to be a start.
posted by baconaut at 3:15 PM on April 11, 2016 [13 favorites]

Let's grant your insinuation that she lost her job in the recession. Even so, do you think it's bad that she want from welfare to a good job? Would it have been better just to stay on welfare and not get her hopes up?

I think you completely missed the point of that whole comment, and you're responding with a non-sequitur.
posted by clockzero at 3:25 PM on April 11, 2016 [2 favorites]

To get those White working class voters to consider bailing on the Republican Party and voting Democrat, you have to acknowledge their problems ~~without rubbing their face in~~ while getting them to realize the fact that other groups have it worse and they were part of the reason other groups DO have it worse. A level of understanding most Americans are incapable of.

The problem isn't capitalism, it's an unregulated market and a lack of education.
An unregulated market and a lack of education are the perfected form of Capitalism (and indistinguishable from Feudalism).

Stalinist planned economies
And let me re-re-repeat my contention that Stalinism and other variations of Communism were never really Socialism, they were/are always Fascism wearing a Socialist mask. But then, all of Economics isn't a "dismal science", it's a Pseudoscience, the equivalent of Astrology and Homeopathy in the Social Sciences, and the best Economic system ultimately has to be one that emerges after we kill all the Economists.
posted by oneswellfoop at 3:31 PM on April 11, 2016 [8 favorites]

A millionaire cannot, for example, light the streets for himself while darkening them for other people.

I'm entirely confident that the internet of things and tech bro-aided financialization will find a way to prove Orwell wrong. It seems like their primary aim to turn the commonweal into a nasty, niggling series of cash transactions.
posted by ryanshepard at 3:33 PM on April 11, 2016 [4 favorites]

all of this talk about voting trump, voting republican, etc - all our states are purple, from sea to shining sea. the flyovers keep turning red because of gerrymandering and voter suppression which should be straight up illegal. i have always voted democrat. many of the people i know have only voted democrat. we're the ones actually down here fighting this shit for our very lives. the idea that we have to start looking out for our own self interests, as if we're not in a better spot to recognize that than people who live a thousand+ miles away, is pretty insulting even if its not meant in that light. i mean that double for people who grew up here and got out and feel a certain kind of way about the friends and family and towns they left behind.
posted by nadawi at 3:35 PM on April 11, 2016 [24 favorites]

Such liberalism as we have in this country was absolutely behind the dismantling of welfare, just as it was behind all the idiocy of the Clinton years. I cannot tell you how weird it feels to realize that a period which feels so incredibly recent to me has been smoothed and reshaped by the passage of time until now it's the right who was to blame.

I mean, it was well and truly both - yes Reagan got the whole ball rolling, yes Bill Clinton promised welfare reform in his first campaign, yes the Gingrich Republicans promised to do even worse, and yes that certain brand of "center left" pundit was all about it. It's the grand bipartisan accomplishment of the era!
posted by atoxyl at 3:43 PM on April 11, 2016 [1 favorite]

I've picked on The New Republic enough in this thread but - lol j/k not nearly enough.
posted by atoxyl at 3:48 PM on April 11, 2016 [3 favorites]

ryanshepard: I'm entirely confident that the internet of things and tech bro-aided financialization will find a way to prove Orwell wrong.

From up here in Canada, even the wealthy support public health insurance and public pensions (i.e. insurance against out-living your savings). You get tremendous efficiency gains from risk-pooling across the entire population, avoiding the problem of adverse selection. Joseph Heath explains. This seems like a perfect example of Orwell's argument.

Personally, I think the hostility of Republican elites to the social safety net is primarily driven by ideology (a sample), not their actual self-interest. They're so committed to their ideology (mandatory taxation is wrong!!) that they want to sacrifice the huge gains you get from cooperation. As Hobbes noted, life in the state of nature is poor as well as short.
posted by russilwvong at 4:24 PM on April 11, 2016 [6 favorites]

If calling attention to the fact that our lack of a safety net is affecting white people in large numbers and maybe we should finally start thinking about what a rational and compassionate society does for its citizens, then I'm all for it. Things are in such crisis right now, I'm not going to waste any of my time arguing about people's motivations while I go use that money implementing change. As someone who's been spending vast amounts of government money on the medical consequences of untreated mental health and chemical dependency -- for people who really only needed affordable housing, a living wage, a decent public education, and a little mental health care -- I'm fine with people waking the hell up because inequality is starting to affect people who look like them. Us whiteys put up with black people getting screwed for hundreds of years; I doubt very much people are on the cusp of realizing maybe we'd all do better if we *all* did better unless they see other "good Christian white folk" beaten down by the system. If this causes us to pass a real minimum wage, vocational rehab, mental health parity, and humane unemployment laws, then fine. We can still call out the institutional racism while pointing out that shit's bad, getting worse, and your white privilege isn't protecting you anymore.

I was on call at the hospital last week and literally spent hundreds of thousands of dollars on people who just needed real chemical dependency treatment and a safe roof over their heads. For the cost of "saving" one of these people in the ICU (for whom it's too late anyway, who will leave the hospital to face the same shitty options) we could provide real options for hundreds of people who might actually have a chance. But, you know, that's just a handout for people who choose to be lazy...
posted by Slarty Bartfast at 4:36 PM on April 11, 2016 [25 favorites]

As long as we’re sharing anecdotal experiences about people’s philosophies, I am a rich, coastal, liberal, white lady (well I pass for white anyway) who runs almost exclusively in circles of rich, coastal, liberal, white people. This is not even remotely a sentiment I have ever heard. Having social and financial privilege does not reflexively drain people of empathy for people who don’t.

You've never, ever heard the pejorative use of dismissive phrases like "white trash" or "redneck"? Really? Really?!

I mean, sorry to #notallrichliberalwhitepeople here, but this is the kind of left turning on itself that drives me crazy. It’s just bananas counterproductive to make an enemy of an ally and ignore the actual enemies here, you know: The Right.

I also don’t see how “capitalism” is killing people here, since the Scandinavian “Nordic Model" is in fact capitalist and doesn’t seem to have these problems, and it’s not like everyone’s health and longevity were great in Communist Russia or Socialist China.

There are some truly dismaying and uninformed comments in this thread but this would have to rank up there with the worst.

From the direct equation of Norway's social democratic economic sytem with the ever increasing laissez faire capitalism advocated for and practised within the United States, to the suggestion that Russia and China ever had anything other than quasi state-administered capitalism, it is truly remarkable the contortions neoliberals will go through to justify the perpetuation of an unjust system where poverty is a personal choice and one's value and morality is tied directly to materialist success.
posted by smithsmith at 4:46 PM on April 11, 2016 [17 favorites]

I did more digging in the CDC Wonder database to find out what's going on with urban black women aged 25-54. It looks like reduction in HIV and heart disease deaths each account for about 23% of the drop in mortality, and reduction in cancer deaths accounts for another 19%.

So a full 65% of the improvement is the result of better medical care for diseases which require intense and expensive intervention. This improvement has not happened for rural black women.

My guess is that the hospitals which serve urban black women have gotten much better, or that urban black women have gotten much better access to already excellent urban hospitals.
posted by clawsoon at 4:49 PM on April 11, 2016 [10 favorites]

I dunno. My sense is that preventing HIV deaths doesn't really take state-of-the-art care. It takes sustained, competent care. We could provide that kind of care in rural communities, even when there's not a fancy hospital nearby, but we don't, because reasons. (Did anyone else watch Wilehmina's War, the Frontline documentary about how hard it is for black women in rural South Carolina to get competent care for HIV? It's one of the most enraging things I've seen in a long time.)

I wouldn't be surprised if some of the reduction in cancer and heart disease deaths were due to prevention: things like fewer women smoking or more women getting pap smears. I'd be interested to know if there were a rural/ urban divide in smoking rates.
posted by ArbitraryAndCapricious at 5:02 PM on April 11, 2016 [3 favorites]

This is purely anecdotal. My wife died suddenly at 53 of a pulmonary embolism. She was in poor health, but I didn't realize how bad until it was too late. From my perspective her decline went hand in hand with her use of prescribed drugs, a witches brew of pain medication and antidepressants.

Her history in a nutshell was this: In her 20s she developed a severe, stabbing back pain, which coincided with a bad case of the flu (and flu shot). May or may not be related. Never was conclusively diagnosed for the back pain. She got shoved into the fibromyalgia wilderness. By her early 40s, after countless attempts at physical therapy, acupuncture, biofeedback, and medications, she was hooked on opiates, that rollercoaster ride ending when she checked herself into rehab and got put on suboxone to kick the opiates. In addition to that, she was constantly prescribed one antidepressant or another. Thye antidepressants may have taken the edge off the pain, but they also took away her willpower to take proper care of herself - smoking, overeating. She became a different person. The suboxone made her want to isolate herself and led to more depression. The doctor's answer to that was an off label use of a drug called Abilify, and that's the stuff I think killed her.

So anyway, I think the increase in medical "care" for women in this demographic is probably to blame for the rise in early deaths.

Sorry if I'm repeating stuff from upthread. I confess not reading everything. It's just my hot button issue, so I had to just start typing.
posted by Robotilt at 5:16 PM on April 11, 2016 [5 favorites]

Wow, what a mischaracterization of my comment.

You've never, ever heard the pejorative use of dismissive phrases like "white trash" or "redneck"? Really? Really?!

I never said those phrases dont exist, I said the people I know who are privileged liberals don't use them, or at least they don't around me, in exactly the same way they don't use racial epithets.

From the direct equation of Norway's social democratic economic sytem with the ever increasing laissez faire capitalism advocated for and practised within the United States, to the suggestion that Russia and China ever had anything other than quasi state-administered capitalism

Good lord, I'm certainly not equating the Nordic Model with what we have now in the US. I did say it is accurate to call them both capitalism, which it is. What China has now is capitalism, it wasn't always. None of that means I'm in favor of what we have now, it simply means that there are models of capitalism in which people suffer less than they do under our current system, and there are non-capitalist models under which people still suffer.

it is truly remarkable the contortions neoliberals will go through to justify the perpetuation of an unjust system where poverty is a personal choice and one's value and morality is tied directly to materialist success.

There is literally nothing in my comment to indicate that I'm a neoliberal. Nowhere do I advocate shifting the responsibilities of the state to the private sector. Instead, I call for the exact opposite -- a strengthening of the safety net.
posted by pocketfullofrye at 5:24 PM on April 11, 2016 [3 favorites]

This probably restates a lot of things that people have talked about already but, as someone who has extensively studied health outcomes in rural areas, I have to throw some thoughts out there.

There are few important trends to consider that have had a major impact on the health of people in rural areas. One is that those who could get out and move to urban areas with more opportunity, better resources, and better educational options, have done so. This has been going on for a while, but well-off people have left small towns in droves. That means that those who are left behind in those communities are the ones who could not get out, and the resources (education, jobs, social services) have gotten worse due to lack of funding or terrible policy or some combination. The resources for those who were left behind have not kept up with the need. Health care and education have moved further and further out of reach for these individuals. Schools and social services have been consolidated in more urban areas, which could just mean a slightly larger town up the road but these things are suddenly farther away. Rural hospitals are closing fast because they cannot keep up with necessary changes in technology, they are being converted into emergency clinics or simply shut down. In particular, reproductive and prenatal health, diagnostic, and surgical services are severely limited or do not exist in many rural areas. Huge investments are needed to prepare these hospitals for EMRs and to update equipment and when all the patients are Medicaid, Medicare, CHIP, or Tricare I don't think the money is there, even with DISH payments. Additionally, technology does not reach them. Cell phone service is still terrible in many rural areas. Internet access is a struggle, which limits access to job applications, online classes, and valuable information. Information does not reach them as quickly, therefore health habits like a better diet, exercise, or quitting smoking are not really taking off. And where would they exercise, anyways? There may be no sidewalks, no parks, and no gyms. And better diets are challenging when getting groceries requires driving some distance and then freezing most things. The peak incidence of heart disease in rural areas was some 20 years after the peak incidence for urban areas. Smoking is still quite high in most rural areas, though it has decreased a lot in urban areas. Social and cultural norms are still behind urban areas, as well.

As others have pointed out, the lack of transportation is critical. So is the lack of good healthcare. Differences in cancer mortality between rural and urban areas are largely due to differences in diagnosis, rural areas have more late-stage diagnoses while urban areas which results in higher mortality.
posted by arachnidette at 5:24 PM on April 11, 2016 [29 favorites]

baconaut >

Cell growth is good; uncontrolled cell growth is cancer. The problem isn't capitalism, it's an unregulated market and a lack of education.

This rhetoric would be more convincing if it weren't so easy to suppose that capitalism itself is a pathological state. Capitalism isn't the only way we can have growth. But let's grant for the sake of argument that capitalism itself is not "the" problem.

Strictly speaking, when people who are unskilled or underskilled start to die off, this is an example of a "self-correcing problem."

No offense, but you're sounding pretty heartless right off the bat as the defender of capitalism. Referring to the deaths of people who aren't ideal workers as a "self-correcting problem" is fucking dark.

To blame market economies as a whole is a very tempting and easy target, but it belies the fact that unskilled or underskilled people would have just as much of a problem in a centrally planned economy.

That doesn't really seem like a proven fact. It seems like another aguendo-type supposition. It's not at all convincing.

This is a much more ugly and complicated knot to untie, but we need to understand that no matter what mechanism the body politic wants to use, whether for the creation and enforcement of public policy or for the conduct of an economy, when the people running the machine decide they don't want you and that you are worthless, you have nowhere else to go.

That's not how economies work. That's not how societies work.

Whether that machine follows 17th century mercantilism, Stalinist planned economies or whatever clusterfuck of smoke and mirrors we have now, the fact is that the haves has decided the have-nots are too costly to keep as chattel.

So you're saying that the haves (I assume you mean elites in business and government and not just rich people) have just up and decided that the have-nots, who are in this conception their personal property (that is what chattel means), are "too costly" to "keep"? What in the world does this mean? It sounds like a formulation of the oft-observed tendency of laissez-faire market economies to produce enormous inequalities through the manipulation of labor markets and the privileging of capital over labor, but you inexplicably assert without any evidence that this is not due to unique dynamics associated with capitalism, but rather is just human nature. I mean, this sounds like tendentious nonsense, frankly.

Replacing one system with another isn't going to solve the problem;

But this is a tautology, because you already said that the presence of economically useless (from the perspectives of elites) poor people has nothing to do with the system of political economy that exists. And if various systems of political economy have no differences worth mentioning in this respect, why are you defending capitalism?

fixing the machine is unlikely; but finding a way of reaching out and helping each other is going to be a start.

Reaching out and helping each other is one of the finest things we can do. Surely pushing and fighting and striving for more egalitarian systems of law and political economy falls squarely within that category?
posted by clockzero at 5:44 PM on April 11, 2016 [8 favorites]

arachnidette: This probably restates a lot of things that people have talked about already ... those who could get out and move to urban areas with more opportunity, better resources, and better educational options, have done so. ... those who are left behind in those communities are the ones who could not get out...

I haven't seen it mentioned in the discussion so far, and it's a great point.
posted by clawsoon at 5:46 PM on April 11, 2016 [1 favorite]

I work in healthcare in a semi-rural part of Ontario, and while there are of course differences (Universal Health Care, different forms of social support/subsidized housing/the Disability, etc.) it can be shocking from a city boy's point of view - when things get bad, they get extremely bad.

There is a lot of poverty, and it's the type of crushing generational poverty that is the hardest to escape. If there's no jobs, no transport, no real social support - you either get out of the area, or you're there for life, eking out a living doing odd jobs. Maybe you can join the military, for a while you could take your luck with the oil sands.

There are some supports that we've been trying to introduce, things like a counselor, nutritional/diabetes education, addiction services - but a huge lack of things like basic adult literacy classes, mental health clinics, access to food, homecare.

One of the real secrets, I always thought, was rural homelessness. It's just not something I thought of before working up there - of course people have a place to go, or they'd freeze. There are a lot of folk who don't have a place to go, and live rough until someone shoos them away from their property, or sleep in their cars, or most commonly couchsurf with a friend/sexual partner/dealer until that other person gets tired of the extra person, and the cycle begins again.

Ontario's been toying around with the idea of a Universal Basic Income and to be honest I think there's nothing that would help these folk more. Access to banks is obviously a problem with this but the provincial govt has been thinking about converting Canada Post locations to also have a mail bank type system.

I know throwing money at a problem isn't much of a plan, but in these areas, and there's a lot of these areas, there's nothing. Having a decent, stable source of income might be enough to allow someone to save up for a few months and be able to move, or get a beater car that will at least get them to a job, it's something.
posted by the uncomplicated soups of my childhood at 5:52 PM on April 11, 2016 [16 favorites]

Good lord, I'm certainly not equating the Nordic Model with what we have now in the US. I did say it is accurate to call them both capitalism.

Sorry. I'm just confused. You're not equating the Nordic Model with the US economic system but it's still accurate to call them the same thing nonetheless?
posted by smithsmith at 5:57 PM on April 11, 2016 [1 favorite]

Sorry. I'm just confused. You're not equating the Nordic Model with the US economic system but it's still accurate to call them the same thing nonetheless?

Yes, they are both forms of capitalism, just as humans and gorillas are both forms of primate.
posted by pocketfullofrye at 6:02 PM on April 11, 2016 [2 favorites]

The Nordic countries are rather more Socialist than they are capitalist.
posted by feckless fecal fear mongering at 6:06 PM on April 11, 2016

I think people underestimate how rural the United states can be. I met a white woman from south dakota who had never seen anyone of a different race in person until her mid 30s.

Rural low also comes with challenges in terms of access to things like clean water. Many Apalachicola communities come from miners of coal.

These areas lead to a frustrating degree of isolation, abs resources are isolated. In southern Illinois, some department of rehabilitation offices serve 5 or 6 counties. For a person with disabilities that just compounds problems.
posted by AlexiaSky at 6:08 PM on April 11, 2016 [10 favorites]

to the suggestion that Russia and China ever had anything other than quasi state-administered capitalism

Yes they were failed socialist economies and no China is not in any real sense communist anymore but come on now with the "no true socialist" rhetoric here.

The Nordic countries are rather more Socialist than they are capitalist.

The term is "social democracy" and it's pretty indisputably a combination of both.
posted by atoxyl at 6:30 PM on April 11, 2016 [5 favorites]

Yes, they are both forms of capitalism, just as humans and gorillas are both forms of primate.

Which I guess brings us back to your original point - apparently capitalism isn't the problem just as being a primate shouldn't prevent gorillas from going to the moon.

I just cannot understand how someone could witness the growing injustice outlined in the OP under an increasingly pure form of laissez-faire capitalism and then compare it to an economic model heavily tempered by a heaping teaspoon of socialism and conclude that it's not actually capitalism that's the problem here because the place where there's less capitalistic behaviour isn't facing these issues.

Don't you think it's kinda interesting that the further we move away from unchecked free market principles the more just the socioeconomic outcomes tend to be?
posted by smithsmith at 6:34 PM on April 11, 2016 [2 favorites]

Yes they were failed socialist economies and no China is not in any real sense communist anymore but come on now with the "no true socialist" rhetoric here.

I don't know why you're conflating socialist and communist as though they are interchangeable terms but one of the fundamental socioeconomic principles of communism is that the means of production is structured under common ownership of the people. If you're suggesting that's actually what occured in China and Russia in the 20th century then you're having a laugh.
posted by smithsmith at 6:40 PM on April 11, 2016 [5 favorites]

I just cannot understand how someone could witness the growing injustice outlined in the OP under an increasingly pure form of laissez-faire capitalism and then compare it to an economic model heavily tempered by a heaping teaspoon of socialism and conclude that it's not actually capitalism that's the problem here because the place where there's less capitalistic behaviour isn't facing these issues.

Or you could conclude, as most of these Nordic states we keep talking about have, that the advantages and disadvantages of each are best balanced in an intermediate model? This is all getting a little off the direct topic though - I don't think you're going to get much disagreement that unchecked capitalism isn't the problem here.
posted by atoxyl at 6:40 PM on April 11, 2016 [4 favorites]

Half-baked theory related to the topic of the thread: Socialism, in practise, may mostly be about the transfer of wealth from rich urbanites to the rural poor. This was made most concrete by Mao, who forced educated urbanites to go to the countryside. Theoretically, this was so that the urbanites could learn from the peasants. In practise, it resulted in the creation of lots of rural human capital, as the educated urbanites taught peasants to read and write. It was a transfer of wealth, in a most human form, from urban to rural.

Don't you think it's kinda interesting that the further we move away from unchecked free market principles the more just the socioeconomic outcomes tend to be?

Free markets are supposed to do two things: a) Maximize utility by giving everyone as much of what they want/need as possible, which works best when wealth and income are equal, and b) motivate producers and sellers to make the stuff that everybody needs/wants, which doesn't work without making wealth and income unequal. You can't have just one or the other, or the market stops working; you gotta have both. Hence the fact that all developed economies are mixed systems.
posted by clawsoon at 6:46 PM on April 11, 2016 [2 favorites]

Which I guess brings us back to your original point - apparently capitalism isn't the problem just as being a primate shouldn't prevent gorillas from going to the moon

Well in this metaphor, apparently the gorillas have gone to the moon, because these Nordic countries are doing a decent job of taking care of their citizens, despite being capitalist.

I don't think you're going to get much disagreement that unchecked capitalism isn't the problem here.

Aoxyl is exactly right, nobody here is arguing for unchecked capitalism, god knows I'm not in favor of it. If I could wave my wand and make the US the socialist paradise Marxists envisioned, I certainly would.

Short of that, we can make things much better for people than they are now, even under capitalism, and we're going to make a lot more progress on that front by trying to change the form of capitalism we have to be more like the Nordic Model than we will by holding out for some form of socialism that has literally never existed on earth.

With which I risk starting yet another loop of stupid lefty infighting over idealism versus pragmatisim, which will take us even further off-topic, so I am now bowing out of this thread.
posted by pocketfullofrye at 6:59 PM on April 11, 2016 [4 favorites]

Folks, maybe at this point let's let the definitions-of-socialism sidebar rest, and steer things back around toward the immediate subject of the article?
posted by LobsterMitten (staff) at 7:03 PM on April 11, 2016 [6 favorites]

The intersection of transportation and health in the urban/rural divide got me thinking about the improvements in heart attack treatment over the past decade.

Disparities that used to exist, with African-Americans, Hispanics and older people facing the slowest treatment times, have disappeared, Dr. Harlan Krumholz, a cardiologist at Yale, and his colleagues said in a paper in Archives of Internal Medicine....

Lack of Speed Kills

...Now, nearly all hospitals treat at least half their patients in 61 minutes or less, according to the most recent data from the American College of Cardiology.

Getting a heart attack treated in under 61 minutes in a rural area where hospitals are few and far between (and getting fewer and further between) seems like a tall order, especially when rural EMS units have trouble affording things like ambulances and defibrillators.
posted by clawsoon at 7:18 PM on April 11, 2016 [3 favorites]

I think people underestimate how rural the United States can be.

It is so mind-boggling to realize that approximately 19% of the U.S. population (as classified by the World Bank as "rural") is scattered across a vast percentage of U.S. lands. The USDA offers another set of stats: 15% of U.S. residents live across 72% of the nation's land.

There's a book that looks at the slow-motion crisis in rural America, Hollowing Out the Middle, but the proscriptive measures the authors suggest to help rural America -- including "encourage immigration," upgrading digital technology infrastructure in rural areas, radically retooling the educational systems in rural America, adopt an emphasis on environmental awareness and organic agriculture as a new market -- seem to be very wishful thinking.
posted by sobell at 7:32 PM on April 11, 2016 [4 favorites]

For The Poor, Geography Is Life And Death
posted by the man of twists and turns at 8:38 PM on April 11, 2016 [2 favorites]

The Association Between Income and Life Expectancy in the United States, 2001-2014
posted by the man of twists and turns at 8:46 PM on April 11, 2016 [2 favorites]

Man, this story is the dystopian alternate world reality of what my life could have looked like.

Just yesterday, my dad was showing me pictures from a trip he took to Stratford Oklahoma, my paternal great-grandparents' hometown. Although that web site is from 2001, my dad's more recent pictures are equally desolate. "And the sad part is," he said, "that's about the best-looking town of all the ones I passed through."

My dad's one of the lucky ones. He made it out of Oklahoma and made a life where he could raise my brother and me in incredible privilege and comfort. But the steps he took to get to that point are damn near unattainable today.

Step 1: My grandparents moved to Oklahoma City, and my grandfather, with no college degree, got a union job in a meat packing plant. My grandmother stayed at home and raised six children on those wages. Not as many meat packing jobs these days, and to the extent that they do exist they sure as hell aren't unionized and don't pay enough to support a large family.

Step 2: Dad got a navy ROTC scholarship to the University of Oklahoma. He wouldn't have been able to afford college otherwise. Although OU still has an ROTC program, these programs are losing funding at many schools.

But why not just enlist, do your service first, and then go to school on the GI bill, you ask? Turns out that's not a safe bet these days either.

2A) Somehow, amazingly, he did not end up going to Vietnam.

Step 3: After his service, my dad went back to OU for a masters. Some kind professor told him during that time that he really had the skills to go for a PhD, somewhere other than Oklahoma even. He ended applied, ended up at Dartmouth, met my mom (through an old friend from Oklahoma who had also come east), landed with her in New Jersey, and never went back. What if that professor hadn't taken the extra step of advocacy?

"These people will vote for Trump and then they'll die" types of comments bother me because there's a very fine line separating my queer anarchist city-dwelling self from Anna Marrie Jones. I read stories like this, and I think of my cousin out in Oklahoma who's been in and out of jail in drug charges for years, who I never expect to see again in my life. The chain of events that got me to my cushy apartment while my my cousin is in a cell somewhere is so precarious, so rooted in economic opportunities that don't exist anymore. Pull out any one of those links and I could've had a life of minimum wage work and early death from cirrhosis too.
posted by ActionPopulated at 10:08 PM on April 11, 2016 [34 favorites]

baconaut: Cell growth is good; uncontrolled cell growth is cancer. The problem isn't capitalism, it's an unregulated market and a lack of education.

Education can never fix the economy for everyone, because having an education is mostly a competitive advantage. Getting everyone an advanced education will not magically make tons of new openings for educated professionals. Society will continue with the same jobs, only now they'll all require unnecessary degrees, because you will have to have one to compete.
posted by Mitrovarr at 10:19 PM on April 11, 2016 [15 favorites]

clockzero: Reaching out and helping each other is one of the finest things we can do. Surely pushing and fighting and striving for more egalitarian systems of law and political economy falls squarely within that category?

You say you want a revolution? Well, you know, we'd all love to see the plan.

My dad's one of the lucky ones. He made it out of Oklahoma and made a life where he could raise my brother and me in incredible privilege and comfort. But the steps he took to get to that point are damn near unattainable today.

I had an interesting talk with an old guy (80s now) who said he got stuck in Utah, making so little money that he literally could not afford to leave town. He said he had to join the army to get out ofthere. (Circa 1950s) Feels like we're going back to that time.
posted by msalt at 11:14 PM on April 11, 2016 [2 favorites]

We can't even talk about an alarming and drastic increase in excess mortality among poor White women without a reflexive need to downplay the significance in relative terms and shift the focus to a different ethnic group?

Not easily. We already did "white men are dying more than they used to!" last year, and despite a few cries for context, breaking the story up by demographic makes for more stories and more charged stories, which makes for more clickbait.

I think the focus will stay on white people, though. "Blacks are dying more than Whites, but less than they used to" requires a distinction between values and derivatives, which is too confusing for a news story. "Hispanics are dying less than non-Hispanic Whites, by an even wider margin than they used to" would make a good news story (it sounds like it would be news to many people in this thread, at least), except that newspapers can't just report facts outside the context of an enthralling narrative full of personal stories.
posted by roystgnr at 7:03 AM on April 12, 2016 [3 favorites]

It would've been lovely if they had just used the actual death rates for their graphs in the statistical analysis piece, instead of making it look like everybody had exactly the same death rates in 1990 and graphing from there.

Using an arbitrary common starting point is legitimate when there's no absolute measure of value, e.g. picking 1913 or 1980 in comparisons of currency values. In this case, though, there's a perfect absolute measurement: The number of people who died out of every 100,000 people in that group.

They do use absolute values in a couple of graphs, the most interesting probably being the sidebar about Alabama women.
posted by clawsoon at 9:09 AM on April 12, 2016 [1 favorite]

I had an interesting talk with an old guy (80s now) who said he got stuck in Utah, making so little money that he literally could not afford to leave town. He said he had to join the army to get out of there. (Circa 1950s) Feels like we're going back to that time.

Um, yeah. I met someone in this situation literally just yesterday. Turns out if you get mugged while waiting for a Megabus transfer, it's almost impossible to get money wired to you since you don't have ID....
posted by tivalasvegas at 5:07 AM on April 13, 2016 [1 favorite]

The squeeze on income and assistance has exactly this result. The most vulnerable people don't do well. Maybe those are the people with fewer skills, less resilience, worse luck. Their suffering is a direct result of Inequality.
posted by theora55 at 7:32 AM on April 15, 2016

Just in case anyone is ever in that circumstance, reads tivaslasvegas's, and gets discouraged, Wal-Mart doesn't (universally, policies vary by state and store) require ID to receive less than $50. Also, Western Union will allow the sender to specify a secret phrase that can be used to pick up money in lieu of an ID. The limits are fairly low not because of fraud risk (Western Union and Moneygram gave never given a shit about it..they say it's your problem if your money gets lost), but because of anti-money laundering laws and regulations. Thankfully, it is still possible for those that are stuck in that situation.

Apparently terrorists are transferring money around $100 at a time or something.
posted by wierdo at 5:10 PM on April 15, 2016 [3 favorites]

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