THENEWYORKER, MARCH 23, 2020 61
to the rising incidence of obesity? Obe-
sity is known to increase chronic illness
and joint pain, and its regional and de-
mographic patterns track with deaths
of despair. But Case and Deaton report
that we’re seeing the same troubling
health trends “among the underweight,
normal weight, overweight, and obese.”
Is the problem poverty? Death rates
for the white working class have seen
no decline for nearly three decades, even
as poverty rates fell during the nineteen-
nineties, rose during the Great Reces-
sion, and fell again in the years after-
ward. Overdose deaths are most common
in high-poverty Appalachia and along
the low-poverty Eastern Seaboard, in
places such as Massachusetts, New
Hampshire, Delaware, and Connecti-
cut. Meanwhile, some high-poverty
states, such as Arkansas and Missis-
sippi, have been less affected. Black and
Hispanic populations are poorer but
less affected, too.
How about income inequality? Case
and Deaton have found that patterns
of inequality, like patterns of poverty,
simply don’t match the patterns of mor-
tality by race or region. California and
New York, for instance, have among
the highest inequality levels in the
country and the lowest mortality rates.
A consistently strong economic cor-
relate, by contrast, is the percentage of
a local population that is employed. The
numbers have undergone a long decline
nationally. In the late nineteen-sixties,
Case and Deaton note, all but five per
cent of men of prime working age, from
twenty-five to fifty-four, had jobs; by
2010, twenty per cent did not. In 2018,
well into the recovery from the Great
Recession, fourteen per cent were still
not at work. Of that fourteen per cent,
only a fifth reported that they were look-
ing for work and were therefore counted
in official statistics as “unemployed.”
The rest were not in the labor force.
What Case and Deaton have found is
that the places with a smaller fraction
of the working-age population in jobs
are places with higher rates of deaths
of despair—and that this holds true
even when you look at rates of suicide,
drug overdoses, and alcohol-related liver
disease separately. They all go up where
joblessness does.
Conservatives tend to offer cultural
explanations. You see this in J. D. Vance’s
BRIEFLY NOTED
Golden Gates, by Conor Dougherty (Penguin Press). Time and
again, in this sweeping account of San Francisco’s housing
crisis, warring constituencies—tenants, techies, homeowners,
builders, and activists—talk past one another, often with loud-
speakers. One woman suggests that the groups instead attend
their opponents’ meetings: “Just show up, shut up, and sit there
for half a year, listening.” To Dougherty, such calls for empa-
thy seem to offer hope both for Bay Area residents being
priced out and for city officials facing resistance to building
more housing. Although his book focusses on the zoning laws
and economic distortions that created the shortage in the first
place, at its core lies a subtle appeal against tribalism.These Fevered Days, by Martha Ackmann (Norton). The Emily
Dickinson who emerges in this vivid, affectionate chronicle
is a complex and warm-blooded individual—as curious, defiant
of convention, and passionate in life as in her poems. Ack-
mann selects ten transformative junctures, portraying the poet
as a sociable, self-assured teen-ager; as a student struggling
with religious faith; as a prolific artist building a body of work
and even beginning to publish. Despite Dickinson’s legend-
ary penchant for solitude, Ackmann sees the intensity of her
relationship with the world—a world devastated by the Civil
War but illuminated for her by correspondence with men-
tors and friends—as the ultimate sustenance of her poetry.The Resisters, by Gish Jen (Knopf ). In this dystopian work of
speculative fiction, a young girl named Gwen plays on the
coed baseball team of AutoAmerica as it competes against
ChinRussia at the Olympics. She has grown up in an au-
thoritarian society divided between the Netted, who are priv-
ileged and fair-skinned, and the Surplus, who live in swamps
or on water. Her talent at sports offers her a chance to join
the Netted class. The novel is narrated by her father, who
wants to see his “daughter, in all her giftedness and idiosyn-
cratic humanity, bloom.” As the family struggles in a frac-
tured society, the “hallowed meaning” of baseball “in our
American dreams” becomes pivotal: “Was this not the level
playing field we envisioned?”Romance in Marseille, by Claude McKay (Penguin Classics).
A noted figure of the Harlem Renaissance, McKay had an
itinerant career—travelling widely in Europe and North Af-
rica, and eventually forsaking the Marxism of his early years
for Catholicism. This vibrant satire, begun in 1929, later aban-
doned, and now published for the first time, follows a West
African stowaway on a boat from Marseille to New York.
Discovered by the crew and shut in a freezing room, he loses
both legs to frostbite, but, in a twist based on real cases, wins
a large settlement from the shipping company and is able
to return to Marseille a rich man. Encompassing a huge di-
versity of perspectives—including memorable evocations of
Marseille’s black Marxist scene and of its queer subculture—
the novel remains radical in its clear-eyed assessment of rac-
ism and unsentimental depiction of disability.