The National Academy of Sciences released a stunning report in December 2015. Coauthored by Princeton economists Anne Case and Angus Deaton, the paper revealed “a marked increase" in the mortality rate of middle-aged non-Hispanic white Americans between 1999 and 2013--a departure from "decades of progress" in which the mortality of this demographic had improved. The increase, Case and Deaton said, could be attributed to suicide, liver disease and cirrhosis, drug and alcohol poisoning, and other related effects of drug and alcohol abuse.
"Self-reported declines in health, mental health, and ability to conduct activities of daily living," they wrote, "and increases in chronic pain and inability to work, as well as clinically measured deteriorations in liver function, all point to growing distress in this population." The trend was visible among all non-Hispanic whites but most pronounced in those with less schooling. No other U.S. ethnic group, and no other country, experienced such a dramatic reversal of fortune.
These findings complemented the work of social scientist Charles Murray, whose 2012 book Coming Apart chronicled the immiseration of whites without college degrees and the emergence of a new upper class based on education level. Case and Deaton, like Murray, looked for economic explanations of the data, while noting the increasing availability and use of opioid pain medication.
"Median household incomes of white non-Hispanics began falling in the late 1990s," wrote Case and Deaton, "and the wage stagnation that began with the economic slowdown of the 1970s continues to hit especially hard those with a high school or less education." Murray has stated the matter more bluntly: "The real family income of people in the bottom half of the income distribution hasn't increased since the late 1960s."
Published a month before presidential caucuses and primaries, the Princeton data unsurprisingly became politicized. Yet the debate about the rising mortality of non-Hispanic whites was framed almost entirely in economic terms. Donald Trump blamed trade deals and illegal immigration for joblessness and addiction. Hillary Clinton said income inequality and congressional obstruction of President Obama's economic policies had harmed the middle class. Both candidates pledged to grow incomes and create jobs, assuming or perhaps just hoping that an improvement of material conditions would counteract harmful social trends.
It is worth asking whether this assumption is justified. The fact that the decline in longevity is limited to non-Hispanic whites, and is directly attributable to alcoholism and drug addiction, suggests a force larger than economics is at work. After all, most ethnicities and races in the United States have experienced lackluster economic growth over the last decade. Why haven't Hispanic and African Americans also seen their gains in lifespan reversed? The means of dissolution are noteworthy as well: One turns to drugs and alcohol to satisfy needs, dull pains, escape troubles that are not limited to the balance in a checking account. The perfervid rhetoric of the election season, filled with accusations of criminality, betrayal, disloyalty, and instability, and set against the backdrop of desire for change, fear of the future, racial tension, and terrorism, suggests that the dilemma cannot be entirely quantified. Nor is Charles Murray alone in using metaphors of disintegration and diffusion. Not only is America coming apart, it is, in the title of Yuval Levin's latest book, The Fractured Republic.
In 1839, Thomas Carlyle drew a distinction between the "standard-of-living question" answered by economic data and the "condition of England question," whose answer was more elusive. What was important, explains Gertrude Himmelfarb, "was the 'condition' and 'disposition' of the people: their beliefs and feelings, their sense of right and wrong, the attitudes and habits that would dispose them either to a 'wholesome composure, frugality, and prosperity,' or to an 'acrid unrest, recklessness, gin-drinking, and gradual ruin.'" As Carlyle asked nearly two centuries ago: "Is the condition of the English working people wrong; so wrong that rational working men cannot, will not, and even should not rest quiet under it?"
The answer to his question, in his day and ours, in his country and ours, appears to be yes.
This vast, populated, heterogeneous, dispersed, divided nation is not characterized easily. Yet even the most cursory examination of the four character-building institutions of family, vocation, community, and faith is enough to worry those of us interested in the condition of America question. If the picture is not as hellish as the one Donald Trump painted in his speech at the Republican convention, it also is not as tranquil as the one President Obama offered at the Democratic convention. There have been gains and losses, and the gains and losses are often quite different among social classes.
Family. On the positive side of the ledger, the teen birth rate continues to decline, and the rate of divorce is far lower than when it reached its peak in 1979. Overall, though, marriage continues to wane. More than 25 percent of the population lives alone. Men and women marry later in life and have fewer children. The percentage of children living at home with two married parents in their first marriage has fallen from 73 percent in 1960 to 46 percent in 2014. And the explosion in single parenthood has coincided with the growth of means-tested welfare spending such as food stamps, housing assistance, cash payments, the Earned Income Tax Credit, disability insurance, and Medicaid. Combined, the government spends on these programs more than $1 trillion per year.
Vocation. A recent White House study concludes, "For more than 60 years, the share of American men between the ages of 25 to 54, or 'prime-age men,' in the labor force has been declining." This decline is pronounced among prime-age white men without college degrees, whose participation in the workforce has fallen from 96 percent in 1968 to 79 percent in 2015, and is even more pronounced among African-American men. The liberal Democratic White House is of course reluctant to ascribe the change in workforce participation to public assistance and suggests that reductions in demand for low-skilled male labor are to blame. But the White House also ignores the diminution of the work requirement for welfare, as well as the relation between policies it supports—increases in the minimum wage, unionization, low-skilled immigration—and the decline it laments.
Community. Crime and gun violence remain at decade lows. But here too the nationwide statistic obscures pockets of degradation. The murder rates in certain cities are on the rise as tensions between police forces and the communities they patrol are inflamed. The percentage of high-school seniors who report using illicit drugs remains stuck at around 25 percent, while meth and heroin addiction ravage small towns and rural areas and drive men and women to overdose and suicide. The U.S. Centers for Disease Control and Prevention report that deaths from heroin overdoses increased 286 percent between 2002 and 2013, with a nearly 40 percent increase between 2012 and 2013. The booming trade has led to a spike in drug cartel and gang activity in places like the Maryland suburbs of Washington, D.C., St. Louis, Maine, and Chicago.
Social bonds are thin. Voter turnout this year is expected to be low. The percentage of adults who volunteer dropped four points over the last decade. In 2007, Harvard sociologist Robert Putnam found that as America has become more racially and ethnically diverse, its citizens and residents have trusted each other less. As the Boston Globe summarized his findings, "The greater the diversity in a community, the fewer people vote and the less they volunteer, the less they give to charity and work on community projects. In the most diverse communities, neighbors trust one another about half as much as they do in the most homogenous settings."
In 2013, just a third of Americans said most people can be trusted. Except for the military, small business, and police, Americans lack confidence in public institutions. As trust and confidence have declined, so has decorum: Public discourse, from the nominee of the Republican party to the anonymous trolls on social media, is debased, vulgar, rude, boorish, explicit, and proudly ignorant, obsessed with shock value. Pornography has been mainstreamed to the point where nude photographs of a potential first lady are greeted with nothing more than prurient interest and dismissed by her husband as "very fashionable and common."
Faith. The number of Americans with no religious affiliation is increasing rapidly. Weekly church attendance is at a low. Battered by adverse Supreme Court decisions, many evangelical Christians have thrown their support to a strongman who says he will serve their perceived economic interests. Roman Catholics, who comprise the largest church in the United States, argue over doctrine, what attitude to adopt toward Pope Francis, and how to recover from the sexual abuse scandals, while mainline Protestant churches expound a secularized theology of social justice and egalitarianism. As traditional religions are pushed further from the public square, new entrants claim status. The Washington Post reports that the Satanic Temple is petitioning public elementary schools across the country to open After School Satan Clubs in the coming school year.
The America that emerges from this brief examination may have recovered from the worst excesses of the cultural revolution of the 1960s, '70s, and '80s, but it has not recovered completely, nor has it formulated a national moral consensus to replace the one shattered by the baby boom. The condition of America is indeed fractured—"We have grown less conformist but more fragmented," writes Levin, "more diverse but less unified, more dynamic but less secure." And this fracturing has prevented many politicians and journalists from seeing, much less responding to, social breakdown and demoralization that remains acute. It is hard enough to see what is in front of one's nose. Try seeing what is far removed from it.
What is harder still is prescribing a treatment for long-term trends whose causes are myriad, deep-seated, global, and powerful. Murray longs for civic renewal, a Great Awakening in which elites leave their bubbles to preach the virtues they practice in everyday life. Levin calls for a "politics of decentralization and diffusion," a "modernized politics of subsidiarity," a revitalization of principles of federalism that would diminish the power of the national government, encourage policy experimentation, build thriving subcultures of traditionalists, and empower mediating institutions and civic associations. A third approach, offered by columnists Ross Douthat and Reihan Salam, would stress the "national interest abroad and national solidarity at home" through foreign-policy retrenchment, "support to workers buffeted by globalization," and setting "tax rates and immigration levels" to foster social cohesion.
All of these alternatives are thoughtful, thought provoking, and worthy of development. Let me offer another: the "Burkean liberalism" of Daniel Patrick Moynihan. This is liberalism, in the words of biographer Greg Weiner, of "locality and limitation." It embraces the New Deal but opposes the overreach of the Great Society. It understands that the market produces and the government distributes—but should do so reasonably, fairly, not perversely. It believes in subsidiarity and is respectful of traditional religion, family practices, and excellence in culture and education. It does not see liberty and equality as necessarily in conflict. It is inductive rather than deductive, and is unafraid to speak frankly about facts, and the lessons to be drawn from them. It promotes American ideals in a hostile and dangerous world.
Nicholas Eberstadt has likened the Moynihan approach to epidemiology:
The phenomenon of violent injury in modern American life is in some sense similar to a number of other public policy challenges with which Moynihan's name has become associated: It is a problem (or set of interrelated problems) with major consequences for the nation's well-being, surprisingly poorly understood even by specialists, and seemingly unsubmissive in the face of sustained policy intervention. Moynihan the epidemiologist did not discover cures to the afflictions he analyzed. In epidemiology, there usually are no "cures." A good epidemiologist, instead, can help to reduce the burden on the population from given health risks by devising strategies based on an informed assessment of the "etiology" (what social scientists might call "dynamics") of the hazard in question.
This points to the need for a social epidemiology of 21st-century America: an empirically informed analysis of harms—of addiction to drugs and alcoholism, prescription drug and opioid abuse, gang membership, family breakdown, mental illness, brittle communities, distrustful citizens, a corroded culture—and of the policies that may have exacerbated them. Only then might we see where government should do more, where it should do less, where the nonprofit sector might help, where the force of law and coercion might be all we can fall back on. Even then, we might not be able to prevent America from coming apart. But we might be able to blunt and lessen the consequences of the fracture and begin to answer more satisfactorily the condition of America question.
Matthew Continetti is editor in chief of the Washington Free Beacon and a contributing editor to The Weekly Standard.