Don’t Check Your Privilege — Some Thoughts on “White Despair”

by Lillie Sauer

On my way to the recycling bin the other day, newspaper in hand, I spotted the headline of the front page ― “Whites in Ozarks dying at higher rates.” (1)  Reading further and seeing phrases such as “despair epidemic” and “excess deaths” I couldn’t help but scoff. It’s not that I don’t think the news of particular groups of people dying in larger proportions than others of a similar demographic is newsworthy. It is always a concern when particular causes of death are disproportionately spread among people of certain demographics. The headlining piece gave some statistics of the despaired dead, citing a 585% increase in drug overdoses, 763% increase in binge drinking deaths, and 30% increase in suicides over a 20-year span Still, upon further reading of this article and others like it, I only found myself questioning even more what the purpose of this piece of news was. (2) There has been little to no discussion of despair in terms of mental health, so apparently, we have reverted to talking about psychological problems in ambiguous and ignorant terms.

My issue with the language of these articles is threefold. First, they reduce the causes of these substance abuse- and suicide-related deaths to a vague notion of despair. To be fair, some of the articles go a bit further than this and talk about factors such as the possibility of correlation with the collapsing labor market for the uneducated or the weakening “traditional structures of social and economic support.” (These explanations bring up problems of their own, which I will discuss later.) (3) Second, the language involved suggests that while a disproportionate number of white people dying equals a “despair epidemic,” the same with respect to any other ethnic group is simply the way things are. This is not merely uncharitable interpretation on my part. The articles in question express such things quite explicitly: “Populations of color have experienced greater and more longstanding economic stresses but haven’t seen death rates go up” and “It’s as if poorly educated whites have now taken over from blacks as the lowest rung of society in terms of mortality rates.”  Third and finally, white people are not dying at higher rates than other ethnic groups and ― it really should go without saying ― they are not the only ethnicity experiencing “despair.” Pointing out the rising rates of white people dying doesn’t help us get any closer to the causes of increase in deaths, unless a simple lack of melanin is to blame.

One point of concern is the study itself, which initially was conducted in 2015 by Anne Case and Angus Deaton of Princeton University and reanalyzed in 2017. Upon their second analysis of the data, they discovered that those aged 25-64, without college degrees, were seeing the greatest increase in deaths of this nature.  By way of explanation, they point to the “widespread erosion of institutions that provided stability in American life for much of the 20th century: the manufacturing industry, the church, unions and stable marriage.”  Having had merely anecdotal experience with all but 7 years of the last century, I cannot personally attest to the validity of this theory. From the little that I know of certain parts of the country at a few specific times in the past 50 years, though, it’s by no means a bad theory. The fact that we see this especially in the uneducated populations of the Midwest makes sense, as they tend to rely on traditional customs and structures, rather than social and academic progress; much more than do those living on the east and west coasts. This is likely a matter of resource distribution and the personal values that play a significant role in determining what resources a person thinks he or she needs. Case and Deaton offer plenty of reasons why people might be in this situation, and they predict that it will continue to worsen for these populations, but offer no suggestions as to how we might change things for the better.

Perhaps Case and Deaton should not be expected to provide us with such suggestions, but I don’t see the point in conducting a study like this without the intention of sparking a dialogue of progress, especially when it gets off on the wrong foot by asking for sympathy for white people living in Missouri, Oklahoma, and the like, and then proceeds to stick that foot directly into its mouth by comparing their despair to that experienced by any other race in this country that finds itself subjected to racist behavior and institutions. In the real world, a disproportionate number of black men are being killed by police officers and in a majority of states, deaths of people of color outnumber those of white people, despite their far smaller share of the general population. (4)  So even with these soaring numbers of white deaths from “despair,” privilege, in many ways, still belongs to white Americans.

Why is “despair” the central focus in in our discussions of this problem anyway? My initial inclination to scoff was mostly in response to the flippant usage of the word. Not only does it explain nothing about what is happening to these people in their daily lives that causes them to turn to drugs or suicide for relief, but it makes the problem sound much simpler than it is. Upon further reading of their findings – combined with  a little bit of common sense and a background in psychology – it seems quite obvious to me that the discussion of this data sidesteps the issue in the worst possible way. Here, plainly in front of us, are several crazy-high numbers associated with deaths from substance abuse and suicide. But rather than have a discussion about the atrocious state of mental health care in America, we have made this a politically-charged discussion of unstable social structures and ― let’s not stop there ― race. The problem I see with using the word “despair” is not that it is inaccurate, but that it is crude and obfuscating and thus, unhelpful. From my perspective, this whole issue is obviously first and foremost a case of our failing mental health care and educational systems, and for these failings, we have largely our failing government to blame.

Finally, in reading numerous articles discussing this study, I have found no reason why this issue should be discussed with regard only to white people. The possible factors that the authors suggest might be contributing to the increase in white deaths, are in no way unique to white people. If anything, they are a greater burden upon other ethnic groups in America than whites in almost every case. The only difference, as I mentioned earlier, is that white people are now dying at rates closer to those of other races. Still, if we look at these rates proportional to the race of the population in question, which a lot of these studies aren’t doing when talking about these numbers, there is still a huge disparity in overall quality of life between whites and other ethnic groups. As I see it, not only is the invocation of race here arbitrary, it is ignorant, insensitive, feckless, and regressive.

Notes

  1. https://www.news-leader.com/story/news/politics/2018/01/24/epidemic-despair-whites-ozarks-dying-greater-rates/1051913001/
  2. https://www.npr.org/sections/health-shots/2017/03/23/521083335/the-forces-driving-middle-aged-white-peoples-deaths-of-despair

https://www.theatlantic.com/magazine/archive/2016/09/the-original-underclass/492731/

  1. http://www.latimes.com/nation/la-na-white-health-20170323-story.html
  2. https://www.washingtonpost.com/news/post-nation/wp/2016/07/11/arent-more-white-people-than-black-people-killed-by-police-yes-but-no/?utm_term=.a821fa23fb07

https://www.kff.org/other/state-indicator/death-rate-by-raceethnicity/?currentTimeframe=0&sortModel=%7B%22colId%22:%22Location%22,%22sort%22:%22asc%22%7D

22 Comments »

  1. The author treats despair as necessarily a mental health problem. It is a sign of depression if everything is going well in one’s life and one despairs anyway, but in this case the author points out that there is a collapsing labor market and traditional social structures are not longer there. It seems to me that most people would despair if such a situation occurs and that there is nothing pathological about that. Now it would be great if we were all Stoic sages and able to face such situations without getting upset or despairing, but few of us are Stoic sages.

    Rather than to treat victims of economic decline as if they were mentally ill, wouldn’t it be better to retrain them for new jobs, encourage companies to open new plants in the area and to raise the minimum wage? It would be necessary to treat people for substance abuse of course, but I don’t see anything mentally ill about the people described above. For many people, to receive the label of “mental illness” somehow suggests that there are not full autonomous adult agents and that is insulting, although I am sure that the mental illness lobby will argue that there is nothing insulting about that.

    To sum up, we have a social and economic problem here, not a problem of mental illness, and one that should be addressed as a social and economic problem. In a country as rich as the U.S. you can educate the labor force and
    provide well-paying jobs for almost everyone. The reeducation of the labor force should apply of course to people of all races, not just to white victims of economic decline.

    Liked by 1 person

  2. “deaths of people of color outnumber those of white people, despite their far smaller share of the general population”

    The link at footnote 4 looks at deaths per capita and therefore cannot be used to support the author’s assertion.

    I don’t know that a simple count of deaths would help much anyway, as it does not account for differences in age distribution and other factors. (More old people = more deaths from natural causes.)

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  3. As I see it, not only is the invocation of race here arbitrary, it is ignorant, insensitive, feckless, and regressive.

    You are quite happy to invoke race here:
    there is still a huge disparity in overall quality of life between whites and other ethnic groups.
    but then condemn its invocation in the very next sentence.

    When a group exhibits marked changes in behaviour and experiences it is a pointer to something interesting or important going on, making it worthy of study. What is unworthy is to label concern about it “ignorant, insensitive, feckless, and regressive“. Why express yourself in such an immoderate way?

    These are after all most remarkable changes:
    drug overdose rates among young and middle-aged whites rose by 585 percent over two decades and increased by 439 percent among older teens.
    Deaths caused by binge drinking jumped by 763 percent over that time period, and the suicide rate rose by 30 percent.

    Does this not deserve deep concern and close study? Why scoff at it?
    I couldn’t help but scoff.
    My initial inclination to scoff was mostly in response to the flippant usage of the word.

    I saw nothing flippant about the use of the word ‘despair’ in the article.

    Some experience a level of despair that causes them to take their own lives. And the report noted that not only are suicides increasing, but the rate of suicide by hanging, strangulation or suffocation increased by more than 150 percent over the two-decade study period.

    These are particularly violent forms of suicide and indicate especially deep despair, which is why the report drew attention to this form of suicide. Despair is not a difficult concept to understand but despair is something very difficult to withstand. The victims of despair deserve our deepest concern and every effort should be made to understand its causes and epidemiology. Even if that means studying that despised group, poor whites.

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  4. What I find missing from your article is system thinking.

    A problem has
    1) a symptomatic cause.
    2) a functional cause.
    3) an institutional cause.
    4) a root cause.

    A measured response requires us to address all four causes, beginning with treating the symptomatic cause and ending with removing the root cause, which represents the order of difficulty. Improving mental health care, as you recommend, while certainly very desirable, only addresses the matter symptomatically. It fails to address the more important matters of functional, institutional and root causes.

    This kind of symptomatic thinking is very common because it is the easiest approach. The symptoms are the most obvious aspect of the problem and the lend themselves to ‘quick fixes’. So we do the easiest first and quickly move on. But the functional, institutional and root causes remain, meaning the problem will recur, absorbing increasing effort as we apply even more quick fixes.

    You are not alone in this. I spent most of my working life in an automotive manufacturer and found, to my ‘despair’, that symptomatic thinking was the order of the day. It was extraordinarily difficult to get the company to change its mindset towards a policy of removing the root causes of defects. I was directly involved in the effort to change this mindset and ‘despaired’ of ever getting there.

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  5. s.wallerstein, thanks for your comment. I think we’re mostly on the same page, but it seems we disagree about what mental health entails. By arguing that this is ultimately a failing of certain individual-focused systems, such as mental health care, I mean to imply a lack of education as well as access. It may be that economic crises led one to a state of despair, but insufficient ability or knowledge of how to cope leads one towards substance abuse or suicide. Obviously there are other options when one is “despaired”, which I why I find problems with the authors’ discussion of the issue.

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    • lilliesauer,

      Here’s an analogy which illustrates my main point.

      Let’s say I’m thrown in jail for a crime I didn’t commit and I see that no one cares. I begin to despair. Am I mentally ill?

      Should I learn to cope with my situation? Well, maybe it would be smart to accept my situation or maybe I should
      rebel with all my might even though it will not get me out of jail. I’m not Nelson Mandela, so I’ll probably learn to cope.

      Now we have a group of working class people who previously had fairly well-paying jobs in steel mails, etc., protected by unions. Those jobs no longer exist and they begin to despair. Are they mentally ill?

      Should the unemployed working class learn to cope with their situation? Maybe it would be smart or maybe they should rebel against how they’ve been treated.

      In both cases the people involved are victims of a social system, in the first case, of an unjust legal system and in the second case, of an economic system where jobs go to the places, China, Indonesia, where they can pay the lowest wages and the workers have no union protection. In both cases, I find the social systems to be deplorable and I don’t see that you are mentally ill because you despair when a social system screws you over and you see no way out.

      Now in the second case it probably would be smart for the workers to accept standard psychiatric treatment for their despair, to take the drugs that the doctor prescribes instead of the drugs that the dealer pushes. Still, they should not be seen as mentally ill.

      Finally, I believe that a social system has a responsibility to provide decent jobs for those who want to work and to retrain workers whose jobs no longer exist.

      Liked by 2 people

  6. labnut, thanks for your questions. Concerning your first comment, I think you may have misunderstood the focus of my critique. Certainly we need to examine the causes leading to increases in these, as the authors say, “deaths of despair.” I am in no way taking issue with the facts themselves, merely the way in which many are discussing them with the public. I don’t want to re-hash arguments I made in the essay, so I merely want to reinstate that, as I see it, the authors have missed the point. It’s clear that there is something concerning happening in that population, but many discussions of the matter jump to conclusions that leave out important considerations.

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  7. Defining the victims of a grievously unjust system, that they did not create, as needing mental treatment, is one of the most egregious examples of victim blaming that I have seen.

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    • Labnut: You think it’s victim-blaming to suggest that rampant levels of drug abuse, suicide, and other forms of self-harming indicate that we need to devote far more resources to mental health care? I don’t see how that follows at all.

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  8. I do most emphatically see how that follows. I have tasted despair, poverty, abandonment and total hopelessness. I have felt the extremes of emotion and lost all hope.

    My father abandoned my mother and her three children. We were left in a tiny room. My mother could not find work. We survived by queuing every day at a Salvation Army soup kitchen. You need to do that in real, desperate need to understand the awful depths of despair that one can feel.

    We were not saved by mental health care. We were saved by a Salvation Army soup kitchen. I cannot thank these wonderful, wonderful people too much.

    I cannot begin to tell you how much it enrages me to see such facile dismissal, by comfortable liberals, of the true needs of these desperate, suffering people.

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    • labnut: You can get enraged as much as you want. I think it makes perfect sense when confronted with an epidemic of drug abuse and self-harm to suggest that one of the things we need to do is a much better job at providing mental health services. Indeed, not to do so strikes me as ignorant and cruel.

      Liked by 1 person

      • If I may enter this conversation, while I agree that medical health services should be provided as a first aid treatment, the key to dealing with this situation is to create decent jobs for these people and as Labnut points out, not to blame the victim.

        Some huge corporations, with zero sense of social responsibility, took their investments from the U.S. where they had to pay decent wages and provide decent working conditions to countries like China where they pay miserable wages with working conditions that Dickens could have described. So if someone is to blame, it’s not the U.S. working class, but huge heartless corporations. Where is Dickens when we need him?

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  9. In my first sentence (first line), I wrote “medical health services” when I meant “mental health services”. Sorry.

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  10. So if someone is to blame, it’s not the U.S. working class, but huge heartless corporations.

    and the comfortable liberals who sotto voce practise deniable schadenfreude. I am so angry and also so disgusted that I cannot continue this discussion.

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    • labnut: Seems to me it might be a good idea to develop a bit more emotional self-control, if you are going to get this discombobulated by a discussion about an essay.

      I also notice there is no reply to the substantive point I made. Just more ejaculations of anger and dismay. Not exactly the way to have a conversation, at least not for a grown person.

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  11. Lillie:

    I know that the reaction to your essay has been pretty uniformly negative. I think some of the criticisms are unfair and/or miss some of the point, as I have indicated in my comments thus far. However, I do have two criticisms of my own.

    1: At the heart of your essay is a point that largely undermines the rest of your thesis. Your objection, in good part, is in focusing on the whiteness of the population in question: i.e. the population that suffers despair because of economic and social dislocation. You point out that groups other than white people suffer in the same way for the same reasons. Of course, this is true, and I agree with you that focusing on “white despair” should be replaced with a non-racialized focus on “despair.”

    The trouble is, the same goes in the opposite direction. Black people are not the only ones abused and unjustly killed by police. So, we should not be focused on police brutality against black people, but just police brutality.

    Now, I suspect that many are going to want to say, “Yes, but black people are disproportionately harmed in this way by police, so it’s justifiable to focus on police brutality against black people.” But by this logic, we should focus on “white despair” of the sort we are talking about, insofar as the data indicates that it disproportionately affects white people.”

    In short, if you approve of movements like “Black Lives Matter,” then you should also approve of efforts to address problems that disproportionately effect the white population. And if you disapprove of one, you should disapprove of the other.

    2. The second criticism has to do with what I suspect most of the others are reacting to and that is a callous, somewhat dismissive attitude that pervades the essay. As humanists and humanitarians we should care about human suffering, no matter which population it strikes, and this does not come through in the essay. It is unclear to me whether this is what you really think or whether it merely is a matter of a less-than-ideal execution in the writing, but regardless, the impression is left that you don’t really care very much about the suffering of the white working class in the rust belt and other economically devastated parts of the country. This may in part be political — that demographic voted disproportionately for Trump — but this is where we need to be better than our current politics, which is mired in hatred of one another. You may loathe Trump and be furious that someone voted for him, but if that person is poor and desperate and drug addicted and suicidal, your overriding sentiment should be one of sympathy for a fellow human being. And that remains true, even if the object of your sympathy is not himself sympathetic. This is one of the hardest learned lessons of maturity, but it is absolutely essential if decent, humane culture is to exist and flourish.

    Liked by 4 people

  12. Lillie,
    “Perhaps Case and Deaton should not be expected to provide us with such suggestions” – But it seems some motivation for writing this essay seems exactly some sense of frustration that there is no implied solution in the Case and Deaton study, no spark of a “dialogue of progress.” So it seems you feel they should provide us with suggestions. I don’t see. Far too many studies are offered with proffered suggestions that we can’t really use. or are politically untenable, or overly optimistic …. Eventually I just want to say, ‘give me the facts, let me make my own judgment.” Unless there is an overt political position of the paper; that is, unless the paper argues openly and specifically, ‘we are here advocating for….’

    And indeed your own paper ends where, in my opinion, it should have begun – advocating for greater expenditure of resources on education and on providing mental health services.

    As for the race issue: Case and Deaton are doing a demographic study. Are they unjustly comparing the statistics of differing demographic groups? I don’t see that; but my review of the material has been cursory. On the other hand, if this could be missed, you could have better pointed it out. But my understanding of such studies is that this is fairly mainstream performance.

    The crucial question of course is whether the socially/economically driven “despair” of certain peoples, responsive to historical context. is treatable on a ‘mental health’/pathology model. I think there is a place for such treatment, but also that we are looking at a long term problem requiring address by programs of many different sorts.

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  13. Dan,
    ” You may loathe Trump and be furious that someone voted for him, but if that person is poor and desperate and drug addicted and suicidal, your overriding sentiment should be one of sympathy for a fellow human being.” I think this point well made. Yes, I think many on both sides need remember that one of the things that makes a democratic republic at all viable is compassion for others of differing views. There are lines, but they should be kept as close to the outer margins of community as possible.

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  14. I don’t buy the analogy with BLM. Here we have one group, the police, targeting another group just because od their skin colour. Police brutality takes many forms and here BLM have identified one particular form and are working to stamp it out. That’s not the case with the white working class issues. Their whiteness is just a demographic detail and is not the reason for their plight. As such it’s not clear what the point of raising their skin colour is. As such, it seems more appropriate to discuss race neutral mechanisms such as expanding mental health services, drug and alcohol rehabilitation programs, counselling and further education opportunities, as a way of improving the lives of all americans.

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    • Bunsen: I disagree entirely. We take all sorts of special consideration for any number of demographics on the basis of negative statistical disparities, regardless of whether there is any evidence whatsoever of malicious intent.

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  15. In the UK, the movie I, Daniel Blake, showed the plight of modern British poor. Is there a similar movie for the US?

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  16. Dan K,

    I am really glad you bring up about the racializing of movements (essentially) against harm to others. I wish I had brought it up myself, because perhaps it could have prevented a lot of the misinterpretations here. My position is: yes, making race a part of the focus in ANY situation only serves to divide people on a subject in which no decent person should be divided.
    With regard to the Black Lives Matter movement, while I support those who advocate for it, I do not agree that it is the best way to talk about the problem. The problem, first and foremost, is that we have too many police officers unfit for their duties, and perhaps the reason for some of that is racism, but to eradicate the unwarranted killings of people, we need to focus on the most immediate solution, which is not to end racism, but to take better care in selecting officers.

    In regard to your second point, I don’t entirely stand by the frustrated (and I agree, dismissive) attitude in this essay. It is not that I don’t feel that way concerning this issue, but that I can see now how others easily could interpret that as being directed toward the people in question who are suffering.

    Rather than individually make this point in response to all the other comments accusing me of “blaming the victim” and similar things, let me just say this once here and let that be my piece:

    I am greatly sympathetic toward those who are experiencing hardships in life that lead them to substance abuse and suicide. These are not issues with which I don’t relate. I personally understand the state of mind that could lead a person to turn towards such things for relief. It’s terrible and tragic and devastating. I also have second-hand experience of the problem from working in acute and long-term care psych clinics. My heart broke for these people who had found themselves in unfortunate situations that they didn’t do anything to deserve to be in. Any of us could be born into poor or neglectful families and find ourselves in their exact position.

    It is not their fault that they are despaired. It is the fault of the system, as I stated before.

    I also do not despise those who voted for Trump for the same reasons that I don’t feel apathetic about those who are poor and suffering. Many of those people were/are subject to the same problem, i.e., a failing system.

    This essay is criticizing the language surrounding the problem above all else. The people who conducted the study likely do not understand what it is like to be poor and feel helpless in the middle of Missouri. They are the target of the dismissive tone and frustration with which I wrote this essay. The created the term “deaths of despair” to lump together real and prevalent issues that should not be lumped and abstracted until we can distance ourselves from the real problem enough to talk about it without feeling any need to help. That is what they did by talking about an “epidemic of despair” for white people. They sensationalized a real and immediate problem and instead of criticizing things that we can start fixing, they blamed a failing traditional structure, making a solution obsolete.

    The solution is only attainable as long as we are not getting distracted from the issue with politics and buzzwords. The problem is people in need of access to education, health care, food, and shelter. The solution is give that to them. They can’t work for it because they ARE in despair and they haven’t been given any of the tools to do anything about it. So, my point it, let’s help them instead of throwing around numbers and arbitrary statistics about race.

    Liked by 3 people