Brexit, Trump and the ‘deaths of despair’ – Sir Angus Deaton’s David Hume Lecture

By Jane-Frances Kelly
How do we explain the high levels of support for Brexit in the UK and Donald Trump in the US? Economics Nobel Laureate Professor Sir Angus Deaton, offered a possible explanation in his David Hume lecture Prosperity and inequality: from the Enlightenment to BREXIT and Donald Trump.
At the event, hosted by the David Hume Institute and the Royal Society of Edinburgh Sir Angus was accompanied by his wife Anne Case, the Alexander Stewart 1886 Professor of Economics and Public Policy also at Princeton. Their ground-breaking collaborative research on the high mortality rates among middle-aged white Americans underpinned many of the lecture’s arguments.
Although he has lived much of his adult life in the US, Sir Angus was born and brought up in Edinburgh, ‘a wonderful city in which to read, and to dream, and to explore’. At the age of ten his family moved to the Borders, where he spent some time at Hawick High School.
There, along with another former pupil, the theoretical physicist Sir David Wallace (who was in the audience), he was one of the ‘two brightest boys in the class’ – but not the smartest pupil; that was a girl ‘with whom we were locked in competition’. She became a doctor.
Turning to his subject, Sir Angus described today’s world as a difficult and uncertain place, characterised by continued faltering growth and breakdowns in familiar political arrangements. It is true that, since the Enlightenment, human progress has moved many of us from destitution, ill-health and premature death to long life and high material living standards. But as in the film The Great Escape (from which Sir Angus borrowed the title of his recent book), progress only some have escaped, leaving others behind. Progress itself has been an engine of inequality.
Looking at the role of inequality today, Sir Angus commented that in the US (as in the UK), inequality is increasing alongside low economic growth. This low growth means that fewer people prosper and flourish, and more get left behind with scant prospect for advancement.
Progress is not just about money, of course: health is just as important, if not more so, and the rich live longer than the poor in all countries, including ours. Sir Angus provided an analysis of the causes of mortality for different age and ethnic groups in the US since 1990, published last year in a paper co-authored by Anne Case.
A forensic drilling down into the data drew audible gasps as it revealed that, contrary to the trends for Hispanics and African Americans, mortality has been sharply increasing among whites in the US.
The increase in deaths, particularly pronounced in those with a high school education or less, has primarily been caused by suicide, drug and alcohol poisoning (particularly from opiate overdose), and alcoholic liver disease.
Speaking of the many people who are dead who would otherwise be alive today, Sir Angus called these ‘deaths of despair’. Following the publication of their paper, the Washington Post compared the location of the deaths with voting patterns in the US primaries, and showed that they are geographically correlated with votes for Donald Trump.
How do these findings compare to our experience in Britain? Sir Angus cautioned against over-facile comparisons between the US and the UK and that racial and ethnic issues in particular are very different. In the UK there has been an increase in drug and alcohol poisoning since just after 2000, but the effect is much smaller than that in the US. Similar political dissatisfaction was expressed in the recent Brexit referendum, however.
During question time, one member of the audience wondered whether the recent increase in political engagement in Scotland might be a protective factor, pointing out that Scotland voted to remain in the EU. On the other hand, the Scottish independence referendum provided an opportunity to vote against the status quo, one to which voters in the rest of the UK did not have access. Further research is clearly required, and the Scottish context was suggested as fertile ground for inquiry.
A final striking thought: Sir Angus wondered whether unfairness, rather than inequality per se, makes people most dissatisfied, and whether the widespread rent-seeking that characterises our economies is one of the major – and legitimate – causes of the kind of the kind of discontent that results in voting for Brexit or Donald Trump.

Hear Sir Angus’s lecture here: