Instead, Case and Deaton advance a tentative theory — they emphasize tentative — that they call “cumulative deprivation.” The central problem is a “steady deterioration in job opportunities for people with low education.”

One setback leads to another. Poor skills result in poor jobs with low pay and spotty security. Workers with lousy jobs are poor marriage candidates; marriage rates decline. Cohabitation thrives, but these relationships often break down. “As a result,” write Case and Deaton, “more men lose regular contact with their children, which is bad for them, and bad for the children.”

To Case and Deaton, these “slow-acting and cumulative social forces” seem the best explanation for the rise in death rates. Because the causes are so deep-seated, they will (at best) “take many years to reverse.” But even if their theory survives scholarly scrutiny, it’s incomplete. It misses the peculiarly American aspect of this story.

The proper question may be: Is the American Dream killing us?