This lecture builds on and extends the findings in Case and Deaton (2015, 2017) on increases in mortality and morbidity among white non-Hispanic Americans in midlife since the turn of the century. Increases in all-cause mortality continued to 2016, led by increases in drug overdose, suicide, and alcohol-related liver mortality, most notably among those with less than a bachelor degree. Not only are educational differences in mortality among whites increasing, but from 1998 to 2015 mortality rose for those without, and fell for those with, a college degree. Mortality rates in comparable rich countries have continued their pre-millennial fall at the rates that used to characterize the US. Why has the US left the herd? We propose a story of cumulative disadvantage from one birth cohort to the next, in the labor market, in marriage arrangements, and in health, that has been triggered by progressively worsening labor market opportunities at the time of entry for whites with less education. We examine mechanisms at work in the US that have made for an increasingly hostile labor market for working class workers, and policy levers that, if pulled, may help strengthen the market for less well educated Americans.
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