Anne Case: The Longevity Economist

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Anne Case studies the intersection of health and economics, with an emphasis on how poorer people cope with adverse circumstances.
Education and career:
- Enrolled at the State University of New York in Albany; developed a strong interest in econometrics and statistics.
- Earned a master’s degree in public affairs from the Woodrow Wilson School at Princeton, worked for the World Bank for a year, and completed a PhD in economics in 1988.
- Holds the Alexander Stewart 1886 Professor of Economics and Public Affairs chair at Princeton.
Personal and formative context:
- Grew up in upstate New York in the 1960s and 70s, witnessing deindustrialization and local job losses (IBM “starting to move on and move out”).
- Spent time in South Africa in the 1990s researching AIDS and early-life health influences on later-life outcomes.

Historical improvements:
- By the late 1960s, advances in vaccines and antibiotics had helped extend the average American lifespan to nearly 70, about 50 percent longer than at the start of the century.
- By the 1980s, the introduction of antihypertensive drugs reduced cardiovascular disease.
Reversal in trends:
- The life expectancy for adults without a college degree reached its peak around 2010 and has been falling ever since.
- By 2021, people without a bachelor’s degree were living “roughly eight and a half years less than people with college degrees.”
Causes and correlates of rising mortality and pain:
- Rising causes of death identified by Case and Deaton: suicide, alcohol use (leading to liver disease), and drug overdoses.
- The opioid epidemic sequence highlighted: overprescribing of painkillers such as OxyContin in the late 1990s → availability of cheaper heroin → synthetic opioids such as fentanyl → unusual spike in overdose deaths.
- Economic and social drivers: job displacements, offshoring, weakening labor unions, fraying social ties, declining marriage rates, shrinking paychecks, hollowed-out communities, and diminished status for working-class Americans.
Demographic focus:
- Deterioration in well-being is particularly pronounced among middle-aged, working-class, less-educated Americans; middle-aged white Americans without college degrees are noted as especially affected in certain regions.

Interaction of economic distress and substance availability:
- Case argues that economic misfortune generated despair that fed into unhealthy behaviors, and the aggressive marketing and wide prescribing of opioids amplified harms.
- Case’s critique: the United States, unlike other rich-world countries, allowed Purdue Pharma and similar actors to heavily market opioids and enabled broad prescribing access.
Alternative interpretation:
- Some critics (e.g., Charles Fain Lehman) argue stronger street drugs and ease of access to potent drugs explain the rise in mortality more than the “despair” narrative.
Comparative point:
- Other developed economies faced globalization and automation but did not experience the same pharmaceutical marketing and prescribing patterns that Case emphasizes.

Education gap and labor market shifts:
- About two-thirds of the US working population does not have an undergraduate degree.
- Economic modernization creates jobs that increasingly require digital and technical skills, widening the divide by education.
- Social consequences: people without a BA “don’t see hope for themselves” and may perceive the system as rigged.
Policy developments and proposals cited:
- More than 20 states have expanded access to state government jobs by dropping requirements for an undergraduate degree, broadening hiring to workers who gained skills through community college, the military, partial college, certification programs, and on-the-job training.
- Case’s policy priorities:
- Prohibit discrimination based on educational attainment (expand hiring paths).
- Strengthen access and affordability of health care—“capitalism needs to be put back on the rails” with regard to health care access.
- Strengthen safety nets for those falling behind.
- Address the opioid epidemic and regulate pharmaceutical marketing and prescribing practices.

Public engagement:
- Case coauthored the 2020 New York Times bestseller Deaths of Despair and the Future of Capitalism with Angus Deaton.
- Their work sparked national discussion and drew attention from policymakers (anecdote of President Barack Obama engaging with Case and Deaton’s findings).
Scholarly assessment:
- Colleagues praise Case’s “attention to detail and ability to make data understandable” and her capacity to extract novel insights from US statistical data.
- Tim Besley characterizes Case and Deaton’s work as integrating social science to “join everything together.”
Human dimension:
- Case emphasizes personal correspondence she has received from many people describing the real-world impacts on families and communities.

Source: F&D Magazine — “Anne Case: The Longevity Economist,” Gary A. Seidman, December 2024.

The Longevity Economist
- The Longevity Economist (Markdown version)
- The Longevity Economist (PDF)