巨大的鸿沟: 教育、绝望与死亡
The Great Divide: Education, Despair and Death
Annual Review of Economics · 2021 · [{"name": "Anne Case", "affiliation": ["National Bureau of Economic Research", "Princeton University", "Princeton Public Schools"]}, {"name": "Angus Deaton", "affiliation": ["University of Southern California", "National Bureau of Economic Research", "Princeton University", "Princeton Public Schools"]}]
中文摘要
绝望致死、发病率与情绪困扰在美国持续上升，这一负担主要由没有大学学位的人群承担——他们占美国成年人的大多数——对其中许多人而言，经济和社会已不再能带来应有的回报。与此同时，美国全因死亡率正按受教育程度分化，这种趋势在其他富裕国家并未出现。我们回顾了没有学士学位人群中疼痛、绝望和自杀患病率上升的情况。疼痛和绝望为阿片类药物创造了基线需求，但成瘾问题的升级源于制药业及其政治纵容者。我们考察了绝望的政治，即受教育程度较低的人如何抛弃民主党、又被民主党抛弃。曾经是更健康的州在总统选举中投票给共和党，而现在则是较不健康的州如此投票。我们回顾了COVID-19疫情期间的死亡情况，发现2020年的死亡率维持甚至加剧了有无大学学位人群之间原有的相对死亡率差异。
Abstract
Deaths of despair, morbidity, and emotional distress continue to rise in the United States, largely borne by those without a college degree—the majority of American adults—for many of whom the economy and society are no longer delivering. Concurrently, all-cause mortality in the United States is diverging by education in a way not seen in other rich countries. We review the rising prevalence of pain, despair, and suicide among those without a bachelor's degree. Pain and despair created a baseline demand for opioids, but the escalation of addiction came from pharma and its political enablers. We examine the politics of despair, or how less-educated people have abandoned and been abandoned by the Democratic Party. Whereas healthier states once voted Republican in presidential elections, now the less-healthy states do. We review deaths during COVID-19, finding that mortality in 2020 maintained or exacerbated existing relative mortality differences between those with and without college degrees.