Economist

펜타닐과 절망사, 세계화

무 중 2023. 10. 4. 07:23

America’s university graduates live much longer than non-graduates


Oct 2nd 2023

America’s economic record over the past 20 years has been impressive, outperforming other rich countries. Less impressive is its measure of wellness, or how long people live. A study by Anne Case and Angus Deaton, two economists at Princeton University, is a case in point. Their latest research shows that in America there is a huge and growing gap between the life expectancy of people with degrees and those without. In 2021, at age 25, Americans who do not have a four-year college degree (about two-thirds of the adult population) were expected to live on average about ten years less than those who do. In 1992 the gap was a third of that.
 


The authors, who previously made waves with their book on “Deaths of Despair and the Future of Capitalism”, speculate that the cause of this divergence is different status. “Jobs are allocated, not by matching necessary or useful skills, but by the use of the BA as [a] screen,” they say. That is persuasive, but not a complete answer. Greater despair might explain drug overdoses rising among the poor. It hardly explains why Americans are four times more likely to die in a car crash than people in Germany. As we recently reported, America does not do a very good job of keeping its people safe.

 

 
60만 명. 15만 8,000명. 앞의 숫자는 1999년부터 2017년 사이에 사망한 사람의 수고, 뒤의 숫자는 그중 2017년 한 해에 해당하는 사망자 수다. 미국 중년 백인층의 사망률에 돌연 반전이 일어나지 않았다면, 즉 20세기 들어 멈춤 없이 낮아지던 사망률의 흐름이 계속 유지되었다면 죽지 않았을 사람의 수.
 
노벨경제학상을 받은 경제학자 앵거스 디턴과 보건경제학의 귄위자 앤 케이스는 이처럼 일어나지 말았어야 하는 죽음에 ‘절망사’라는 이름을 붙인다. 이는 저소득·저학력 백인층에서 나타나는 현상으로 자살, 약물 중독, 알코올 중독으로 인한 죽음이다. 
 
나아가 두 저자는 절망사라는 단서에서 출발해 미국의 경제 시스템과 사회 전반을 해부하고 문제의 근본 원인을 파고들어, 우리가 보다 더 공정한 세계로 가기 위해 필요한 해법을 제시한다. 불평등과 불공정, 능력주의와 교육 양극화, 경기침체와 실업, 독과점과 정경유착, 공동체 붕괴와 가족 해체까지 한국의 상황이라고 해도 어색하지 않은 문제와 그에 대한 면밀한 분석이 담겨 있다. 
 

Economics in America: An Immigrant Economist Explores the Land of Inequality

by Angus Deaton (Author)

At last, a convincing explanation for America’s drug-death crisis


The synthetic opioid and its close chemical relatives were involved in about 70% of the country’s 110,000 overdose deaths in 2022. They are now almost certainly the biggest killer of Americans between the ages of 18 and 49. Every 14 months or so America loses more people to fentanyl than it has lost in all of its wars combined since the second world war, from Korea to Afghanistan.


It is thus regrettable that the economics has had little to say about fentanyl. A review of 150 economic studies in 2022 included just two that were focused on the drug.

The best-known explanation is the “deaths of despair” hypothesis, advanced by Anne Case and Angus Deaton of Princeton University.

This suffering, they argued, was related to economic insecurity. Yet their analysis had major defects, such as a failure to adjust for ageing populations. The arrival of fentanyl has highlighted a more fundamental flaw: it now kills black people at a higher rate than white people, the group supposedly gripped by anguish. An ill-defined notion of “despair” that leaps between different segments of the population does not carry much explanatory heft.

Some economists have homed in on the financial roots of the crisis. Justin Pierce of the Federal Reserve and Peter Schott of Yale University documented how areas most exposed to trade liberalisation suffered most. They found that counties exposed to import competition from China after 2000 had higher unemployment rates and more overdose deaths. Their analysis, however, ended in 2013, when the effects of this trade-related affliction were wearing off—and just before the fentanyl storm erupted.

Others have traced America’s addiction to the original sin of pharmaceutical firms pushing painkillers. In a paper published in 2019 Abby Alpert of the University of Pennsylvania and colleagues showed that states with looser prescription rules were targeted by Purdue Pharma in the late 1990s when it started selling OxyContin, its notorious opioid, and that they had nearly twice as many deaths from opioid overdoses as states with stricter rules over the following two decades. But recent years have been horrific everywhere: in California, a state with stricter rules, the opioid-overdose death rate roughly tripled between 2017 and 2021.


At last, economists are catching up with the awful turn in the opioid crisis. A new working paper by Timothy Moore of Purdue University, William Olney of Williams College and Benjamin Hansen of the University of Oregon offers a novel way of examining the spread of fentanyl. Rather than trying to account for demand for opioids, the focus of most research, they look squarely at the supply side of the equation, finding a strong correlation between aggregate import levels and opioid use. In states that import more than the national median, overdose deaths are roughly 40% higher. Put another way, 10% more imports per resident are associated with an 8.1% increase in fentanyl deaths from 2017 to 2020.


This is not because of some kind of trade-induced economic malaise. Many big importing states are wealthy, such as New Jersey and Maryland. Rather, the essential point is that these states bring in more stuff from abroad, and fentanyl is often part of the mix. It may ultimately travel around America, but much of it remains, and kills, in the states where it first arrived. None of the previous hypotheses—deaths of despair, competition from China or opioid marketing—have an impact on the relationship between trade flows and fentanyl deaths.


Policy responses often centre on the roles of China as a producer of fentanyl-related chemicals and Mexican drug gangs as distributors. America’s drug enforcers are especially active on its southern border; its diplomats want China to crack down on makers of synthetic opioid feedstocks. But Mr Moore and his colleagues conclude that more trade with pretty much anywhere is associated with fentanyl deaths. The probable explanation is that gangs are nimble and shift their smuggling routes.


This makes intuitive sense. Fentanyl’s danger stems from its potency: it is up to 50 times stronger than heroin. Criminals can sneak in tiny volumes, with devastating effects. And drug users can get one hell of a high for next to nothing: a single $5 pill contains a lethal dose. In business terms the overall picture is that of a classic positive supply shock—of a most negative product.
The forensic accounting of fentanyl’s spread by Mr Moore and his colleagues is important. It suggests that targeting China and Mexico risks a game of whack-a-mole. Any country at any given moment may be the trouble spot, so it is better to spread out enforcement resources more evenly. It also shows that legal trade is probably the main conduit for fentanyl smuggling, meaning that more sophisticated screening operations at all ports of entry would be wise. Last, it reveals that despite all the attention paid to the disadvantaged and the despairing, the core problem is at once simpler and more depressing: fentanyl is just too easy to get. ■