John Buell

Neoliberalism and Deaths of Despair

It is often said that winners write history, but in the case of the 2016 election a major effort to write the history is being orchestrated by that cadre of elites and opinion leaders who lost the election. The Washington Post and the New York Times, both staunch Clinton backers, are sure they know why Clinton lost. The Post cites economic anxiety and the Times speaks of the collapse of American identity. “[R]ecent survey data provides troubling evidence that a shared sense of national identity is unraveling, with two mutually exclusive narratives emerging along party lines,” Robert P. Jones wrote in the Times May 2. “At the heart of this divide are opposing reactions to changing demographics and culture. The shock waves from these transformations — harnessed effectively by Donald Trump’s campaign — are reorienting the political parties from the more familiar liberal-versus-conservative alignment to new poles of cultural pluralism and monism.”

Years after the election and re-election of an African American president that seems to be a difficult call. And long before the 2016 election developments in working-class America should have given pause to anyone who spent much time and energy assessing their needs and concerns. That these trends were hardly noticed or addressed says a lot about reasons for their failure. I would like to present an alternative explanation of our situation, one that differs not only in substance but also in the assumptions made about just how we study such social phenomena.

Racial attitudes are too often treated as static and conceptually discrete. Many whites voted for Obama in ’08 and ’12, then jumped to Trump in 2016. Some suggest that this proves they were not racist. Mehdi Hasan argues that, to the contrary, race factored more in 2016 than in 2008 and 2012 elections because McCain and Romney were unable or unwilling to make an explicit racist appeal.

But what if eight years of a disappointing Obama Presidency reshaped these voters. One candidate told a working-class audience that had seen its pensions eroded or stolen, its jobs becoming ever more precarious that America was already great. Her opponent highlighted these working class troubles, thereby stoking their anger at being neglected. He then singled out new and traditional enemies as causes of their plight, emphasized their laziness and criminality in contrast to his supporter’s hard work. In the process allowing the anger to feed on itself and grow. Then he turned that anger at a media that has long neglected working-class concerns. Race is surely part of this story, but both the tendency to resort to it, its emphasis on work versus welfare, and its intensity were heavily dependent on economic injustice.

That mainstream Democrats were oblivious to both the issues and the intensity surrounding them is even more indefensible when we look at some of the key events leading up to the election. Some disturbing data well known before the election nonetheless elicited little political response. The media and political class reaction to or lack thereof is itself a symptom of the disdain for the white working class even well before the unfortunate insult of the deplorables.

In 2015 Princeton’s Ann Case and Angus Deaton “documented a 21st century rise in the proportion of white non-Hispanic Americans dying in middle age. While midlife increases in suicides and drug poisonings had been previously noted – they argue – the fact that these upward trends were persistent and large enough to drive up all-cause midlife mortality was overlooked. Case and Deaton argue that concurrent declines in self-reported health, mental health, and ability to work, increased reports of pain, and deteriorating measures of liver function all pointed to increasing midlife distress … the turnaround in mortality for white non-Hispanics was driven primarily by increasing death rates for those with a high school degree or less.

These trends were consistently downward and were almost unique among major modern democracies. The two cases that show a similar disturbing trend should also acted a a clue that something other than cultural monism was involved, Greece and Russia, both in their own way victims of neoliberal shock therapy.

Subsequent work suggests the political significance of the Case/Deaton findings. Shannon Monnat at Penn State University finds that Trump over-performed the most in counties with the highest drug, alcohol and suicide mortality rates, and that much of this relationship is accounted for by economic distress and the proportion of working-class residents. Many of the counties with high mortality rates where Trump did the best have also experienced significant employment losses in manufacturing over the past several decades.

The story of working-class addiction involves more than macro facts of unemployment and deindustrialization. The supply side role of big pharma is also crucial, along with the cultural faith in the possibility of wonder drugs.

Purdue Pharma took out ads for OxyContin in medical journals across the nation in 2000. Seven years later, the company and three of its executives would be charged with misbranding its drug and downplaying the possibility of addiction. Three executives pleaded guilty, and the company settled with the US government for $635 million.

The rewards of bb pharma are part of a larger story of growing socioeconomic inequality that the Times almost completely neglects in its suggestion that modern politics is a battle between cultural pluralism and racism and xenophobia. We have a distressed working class injured by deindustrialization, disabled in part by injuries and morbidity and mortality of despair and major corporate employers benefiting from monopoly patents and making outsized profits and the Times asks us to talk of pluralism versus monism. A better conversation would continue to advocate expanding rights for excluded minorities while also recognizing the harm that globalization and neoliberalism have inflicted on both these minorities and the white working class.

John Buell lives in Southwest Harbor, Maine, and writes regularly on labor and environmental issues. Email

From The Progressive Populist, July 1-15, 2017

Blog | Current Issue | Back Issues | Essays | Links

About the Progressive Populist | How to Subscribe | How to Contact Us

Copyright © 2017 The Progressive Populist

PO Box 819, Manchaca TX 78652