I have a post on The Incidental Economist documenting the decades-long and continuing decline in life expectancy among poorly-educated white women in the US. The figure below (from J. Olshansky and colleagues) shows the sharp decline in life expectancy among white women who have not completed high school. Please read that post. Then I want to say something here about why this matters.
It matters first, and obviously, because lives matter and a decline in life expectancy is merely a statistic describing loss of life.
It also matters because a decline in life expectancy among poorly-educated US women bears on the legitimacy of the American social order. A commonly heard justification of US social inequality is that it is a necessary consequence of a rapidly growing economy that benefits all participants. Moreover, this growth is a good and possibly the best way to benefit poor Americans.
Therefore, if you believe that benefiting the poor should have priority in our social policy, then you can argue that despite its extraordinary inequality the US social order is nevertheless a legitimate social order. A Rawlsian might argue that the US fulfills the second condition of the second principle of justice:
Second Principle: Social and economic inequalities are to satisfy two conditions:
They are to be attached to offices and positions open to all under conditions of fair equality of opportunity;
They are to be to the greatest benefit of the least-advantaged members of society (the difference principle).
But when a large demographic group loses life expectancy despite decades of economic growth, the premise of the argument is wrong and these legitimizations cannot get off the ground. Arguments about whether ‘trickle down’ economics can justify US inequality are moot if well-being doesn’t trickle down.