The authors, in their later years, have come up with a new and interesting subject for research - the increasing incidence of 'deaths of despair' (from alcohol, drugs and suicide) of white non-Hispanic US citizens without at least a four year university degree.
The book is very strong in establishing the case for their being a really interesting subject to study here - this group is not just demonstrably likely to die, but also demonstrably likely to be in more pain than their more educated White counterparts, and more likely to feel their life is not good and to be in poor health generally. They are still probably better off than their African American counterparts, but the trend is really for more of an educated/less educated divide in the US and less of a white/black divide.
When it comes to the causes of this, clearly economics has a role - not immigration, in fact, but certainly globalisation and automation. The question really is do these factors have a direct effect; and to what extent are they mediated via the breakdown of society (less adherence to organised religion; less propensity to vote and engage in civic action; less propensity to marry); and to what extent uniquely American social policy choices have an impact (the iniquities of US healthcare; 'Sheriff of Nottingham' redistribution; the political lobbying system).
One of the many virtues of the book is that it enables the reader to make up his or her own mind about these issues. But perhaps the authors tend too much towards 'it's a uniquely US phenomenon so seek the cause in the US' view of the world, given Brexit and recent trends in the UK and other countries with 'left behind' populations. The US causes may just act as an 'amplifier' to a global trend.
Overall, though, a really interesting book which I would strongly recommend to others.
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