White Working Class Pathology and the Trump Vote

Yesterday the Washington Post published an article summarizing a fascinating study by two Princeton University economists, Anne Case and Angus Deaton, analyzing the startling increase of “deaths of despair” (suicide, drugs, and alcohol) since 2000–particularly among whites with a high school education or less. It occurred to me that this trend coincides with the increased tendency of working class whites to vote Republican, seemingly against their own economic interests, which was especially notable in the last election. Could these two trends be related?

The Case/Deaton study (link to the full paper available here) builds on their study published two years ago, which revealed a surprising rise in mortality among American non-Hispanic whites, especially those who are middle-aged and with no more than a high school education. This holds true for both men and women, and most of this increase is due to deaths from drug overdose, suicide, and alcohol-related disease.

This finding is particularly striking, since mortality rates in other developed countries have generally been trending downwards or fairly stable. It also goes against the trend among American blacks and Hispanics, whose mortality rates also have continued to decline.

There is also a striking rural/urban divide in the mortality rates with rural areas in the South and Midwest particularly showing a much greater increase.  By contrast, the death rates in major metropolitan areas are much lower and more stable, as a Washington Post analysis published last year showed.

From Case and Deaton, “Mortality and Morbidity in the 21st Century”

Why is this happening?  The authors note that it cannot be explained simply from falling or stagnant incomes, partly because that has affected American blacks and Hispanics to an equal if not greater degree, but there has been no spike in their mortality rates. Rather, they suggest that there is a complicated and still poorly understood social pathology deriving from a loss of optimistic expectations and a sense of declining status among whites without college educations. They tentatively propose “a preliminary but plausible story in which cumulative disadvantage over life, in the labor market, in marriage and child outcomes, and in health, is triggered by progressively worsening labor market opportunities at the time of entry for whites with low levels of education.” This is reflected in increased drug use (especially the huge increase of both prescription and illegal opioids), more alcoholism, and suicide.

This particularly affects people in their late 40s and 5os who are still in the labor force rather than those 65 and older who are protected by programs like Social Security and Medicare. The major divide is between people who have a college education and those who don’t.

So how might all this relate to voting trends? There has been an increasing polarity in American politics and voting that divides along the same axes: urban vs. rural, and college vs. non-college education.  Almost all US major cities and their more immediate suburbs vote heavily Democrat, while rural counties have gone increasingly Republican. (Take a look at this analysis by the Washington Post last November.) At the same time, there has been a similar split along education lines among white voters, with those with a college education more likely to vote Democrat while those with only high school or less much more likely to vote Republican.

The Democratic Party has long had a problem with keeping white voters and increasingly depends on black and Hispanic voters to win elections. In particular, Democratic presidential candidates have been losing white blue collar (non-college graduate) voters since the late 90s, and the trend is especially pronounced among males. (Take a look at the graphic above, taken from a study by the Pew Research Center.)  These voters used to be their base. Do they really believe that the Republican party will defend their economic interests, or is something else going on here?

Here’s my hypothesis: The Democrats’ loss of white blue collar voters is another symptom of the sense of malaise among non-college-educated and rural Americans that is fueling the increased mortality rates from diseases of despair. So many workers have seen well-paying skilled manufacturing jobs that used to afford a decent, comfortable life disappear, and they see nothing but minimum wage jobs to replace them. Rural communities have been hollowed out and see their economic bases drying up. The sense of optimism about the future has evaporated. The middle-aged realize that they don’t have the skills to prosper in an information-based economy and feel stuck and helpless. The unions that once defended their interests have been decimated. Their sense of status is slipping away, fueling resentment against elites and other ethnicities who they believe are getting undeserved advantages. People are angry and want someone to blame, while looking back to an idealized time when they felt secure and everything was good.

All of this makes people vulnerable to someone like Donald Trump, who provides them with the scapegoats they want and makes empty promises to restore the world they think they remember. He lets them know that those racist feelings that everyone has are justified and it’s now okay to say it out loud. The Republicans tell them that government is the problem, and if only those “job-killing” regulations were eliminated, prosperity would come pouring back. Stressed communities are desperate to entice corporations that promise to bring in jobs and are willing to give them anything they want. It’s just another drug to make you feel better and hold out a shred of hope.