Economics in America: An Immigrant Economist Explores the Land of Inequality, by Angus Deaton (Princeton University Press, 284 pp., $24.95)

Angus Deaton is a Princeton economist, a Nobel laureate, and the intellectual progenitor of the concept “deaths of despair,” describing the rise in mortality among non-Hispanic whites due to suicide and alcohol and drug abuse. His 2015 paper and 2019 book of that title, both cowritten with his wife and fellow scholar Anne Case, propelled the addiction-and-life-expectancy crisis within America’s white working class to the forefront of political discourse. The 2019 tome, though not without its flaws, was a searing account of working-class disintegration and its social ramifications.

It was with anticipation, therefore, that I picked up Deaton’s Economics in America: An Immigrant Economist Explores the Land of Inequality. Disappointingly, the book does not match its predecessor in focus or insight. Deaton pinballs between rehashes of his earlier work, gossip about his professional peers, and myopic commentary on partisan politics.

The few sections of value to readers interested in the American economy occur early in the book, particularly within Chapter 2, “Adventures in American Healthcare.” While Deaton’s award-winning academic work has covered broader topics of consumption, welfare, and poverty, health care has become his passion project in his recent publications for general audiences, and he writes about it compellingly. He correctly identifies runaway health-care spending—and the policy structures that cause it—as a heavy drag on the American economy. He describes how tethering health insurance to employment erects barriers to geographic mobility and how such a tethering hurts wages, and he notes that if the United States reduced its health-care expenditures to the level of the next highest per-capita spender, Switzerland, it would save $1 trillion per year. His more personal criticisms will resonate with anyone who has received a surprise medical bill or been told that the anesthesiologist preparing to administer drugs to a suffering loved one is out-of-network.

Yet, even at its best, Economics in America is stale. Deaton tells, for example, the same story about a chatty night-nurse that appears in Deaths of Despair. The gossipy parts (who coulda, shoulda, or woulda won a Nobel; jokes told in the faculty lounge long ago) will be of little interest to a general reader.

The book’s partisan tinge, though, is what’s most off-putting. In Deaths of Despair, Deaton attributed the rise of Donald Trump, in part, to declining opportunity for non-college-educated Americans. The hypothesis made Deaton and Case celebrities not only among fellow economists and in their own center-left political circles but also among right-wing populists, who mentioned Deaton and Case alongside heartland whisperers like Charles Murray and J. D. Vance.

Deaton and Case’s lamentation for left-behind America was simpatico with the platform articulated by the more thoughtful corners of the New Right—calling out the proliferation of drugs, the evaporation of dignifying work for the less educated, and concentrations of corporate power. The authors even cast a skeptical eye toward low-skill immigration and argue that U.S.-based international-aid donors should focus more on alleviating poverty at home. If not in style, then in substance, Deaths of Despair bolstered the case for many of Trump’s priorities.

In Economics in America, Deaton emphatically disavows any such association. He wants to make sure readers know that he gives that Trumpy stuff no quarter, littering the book with gratuitous potshots at the former president: “kids in cages,” “bleach as a cure for Covid-19,” and so on.

The opportunity cost of Deaton’s meandering is that the book fails to reckon with how the deaths-of-despair phenomenon has evolved since his 2016 paper and even the 2019 book. Though it had been the case for decades that white Americans were more likely to die by opioid overdose than black Americans (a counterintuitive wrinkle on commonly sounded racial-inequality themes), since 2020 the rate has been higher among black Americans. This shift somewhat undermines Deaton’s thesis that white status-anxiety was a driver of deaths of despair. Moreover, new work from economists Gerald Auten and David Splinter shows that income inequality, regardless of race, has been overestimated in recent decades. Deaton does not account for these new insights.

In the end, Economics in America—ostensibly about inequality—reveals itself as a book without a theme. It is little more than a series of adaptations and personal vignettes. While Deaton’s work on deaths of despair prompted both the Left and the Right to open numerous new lines of inquiry around the topic of what ails the United States, Economics in America leaves readers wanting much more.  

Photo by Jessica Kourkounis/Getty Images


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