
Suicides in Rural America Increased More Than 40% in 16 Years - AaronFriel
http://acsh.org/news/2017/03/16/suicides-rural-america-increased-more-40-16-years-11010
======
jbhatab
The lack of opportunity in rural America is disheartening to say the least. I
feel the election of Trump is a direct reflection of the lack of empathy
people have from cities have for rural America.

I grew up in New Hampshire in a very rural town with a population of 4,000.
Rural life sat well with some of my peers, but I loved tech and quickly left
through college enabled by my parents ability to point me in the right
direction, which many of my peers didn't have. The difference in opportunity I
saw in the cities versus New Hampshire was staggering, not even comparable.
I've enjoyed my life as I've explored more of America and ended up in the Bay,
but every time I go back to New Hampshire there is always a tally of people I
knew who died to Heroin. That or one of my friends succumbing to their
addictions again. I know these people extremely well and I can confidently say
the only difference between me and them was opportunities to enable my mind
and parenting. It's disgusting honestly.

Now I would love to solve this problem, but the lack of empathy I've seen in
the cities for these people is the worst piece of this puzzle. People in
cities have the privilege of wealth and the ability to direct America in a way
rural America doesn't. The issues they face in rural America are completely
ignored. While they cite that the popular vote strongly favored Hilary, they
forget why the electoral college was created. To help rural America from being
completely ignored while the cities with denser populations sway the votes
towards their issues.

I encourage everyone to go talk to a person in a rural county that is provided
cheap heroin through foreign drug smuggling groups that don't have any
opportunities. Empathize with their problems. Do I think transgender deserve
equal rights? Absolutely. But go to a town ravaged by heroin and lack of
financial growth and bring up transgender bathrooms to them. They will be
baffled by your lack of knowledge of how their lives operate.

~~~
loeg
"People in the cities" (who tend to be strongly left-leaning) literally _want_
to give money to the less well-off people in rural areas to help support them.
It's the right-leaning candidates who are opposed to wealth redistribution.

Who is missing empathy for whom? From my perspective, the fiscal conservatives
from the rural areas have relatively less empathy than vice versa.

~~~
jbhatab
Giving money is not the issue in rural America. It's not social welfare such
as health insurance or anything of the sort. If anything I'd say there's a lot
of disgust with how many rural Americans live off the system.

It's lack of opportunity. What is your answer to that? Tesla isn't opening up
a factory in New Hampshire anytime soon. There certainly isn't as many amazing
colleges such as UC berkley there. Throwing money into unemployment and
welfare won't solve the problem at all.

Trump literally said I will fight to get you jobs back. Ignore if that is
true. Ignore if he is an idiot. Ignore if that works in the long term. He was
the only candidate that actually said a single idea that was directly aimed at
helping them.

~~~
w1ntermute
> It's lack of opportunity. What is your answer to that? Tesla isn't opening
> up a factory in New Hampshire anytime soon.

In generations past, Americans picked up and moved to where the opportunity
was, rather than staying put. Why is it unreasonable to expect the same now?

The economy has permanently changed - those jobs are never coming back. On the
other hand, moving is far, far easier in 2017 than it was for those on the
Oregon Trail or the Mayflower.

~~~
jbhatab
Yes so you want to have every move to the city where the opportunities are.
Which may be fine, but imagine for a second someone telling you that 'you
should just move from where you are because where you were born isn't good
enough'. Not very considerate. Also, they would be thrown into an environment
that is wildly different than there own with far less money than everyone else
and lack of skillets and knowledge to thrive.

They would be an extreme disadvatantage. Now I don't disagree that that may be
a solution, but seriously take a step back. Ask yourself if you think you just
said is empathatic towards people in rural America?

Ask yourself if you had said that about other issues in America. 'Why can't
black people just start learning how to code to catch up?' 'Why can't gays
just get over not being able to be officially married?'

Basically what you're saying is 'why cant people that aren't me adapt to how I
operate?'

~~~
TuringNYC
> imagine for a second someone telling you that 'you should just move from
> where you are because where you were born isn't good enough'

Now imagine telling a corporation that 'you must build your factory only in
City X' \-- why should they? They will build where they find space at good
rents and an industrial ecosystem and workers.

What if the factory owner lives in California. So he has to move his life
across the country and build in New Hampshire because a rural worker in New
Hampshire didn't want to move themselves? How does this make sense?

~~~
edraferi
Exactly!

Viewed by the capitalist system, these communities are useless. People hate
feeling useless, even if you give them everything they need to live (the
Democrat's solution)

So, how do you make economically irrelevant communities viable?

I have no idea.

~~~
rumcajz
Make remote work the standard option whenever possible. For example, all the
paper pushing work can be easily made remote and distributed to rural areas.

~~~
sokoloff
If you make remote work the standard, why wouldn't a company offshore it to
remote workers who are often wildly cheaper due to market forces and market
distortions (like minimum wage laws)?

There are plenty of English reading/writing/speaking people in India capable
of remote work.

------
ChuckMcM
I note that they attribute suicide to 'lingering effects of the great
recession' although they show no spike in suicides around the great recession,
just a steady increase.

The 'elephant' in this particular room is that America has been involved in a
prolonged military engagement in the middle east, nearly continuously since
2001. Further, the military and the national guard, tend to draw on young
people from rural areas disproportionately because of the otherwise lack of
opportunity to work. As a result we have sent over a million young people into
war and then dumped them back into their home towns when they chose not to re-
enlist or where discharged for other reasons. They commit suicide at a rate of
20 a day[1]. Take them out of the trend lines and see how that affects your
analysis.

[1] [http://www.militarytimes.com/story/veterans/2016/07/07/va-
su...](http://www.militarytimes.com/story/veterans/2016/07/07/va-
suicide-20-daily-research/86788332/)

~~~
malandrew
Excellent point. I'm also curious about comparing the demographic that
enlisted with the equivalent demographic cohort that stayed home in terms of
age, educational attainment and socioeconomic status. Was the military the
only hope they had for employment or did those that stayed home prosper
economically and do generally well.

~~~
Kalium
Military service is almost never the only option, but it's often the best one
for those who come back OK. Economic opportunity, travel, access to education,
and social status in one package? That's a combination that's otherwise
difficult to come by in rural Appalachia.

------
anovikov
When i was young, we were taught that Americans are used to moving and this is
the main reason why America is rich: people easily pack up and move to where
the opportunities are, so businesses don't starve without workers and people
don't sit in the dirt in the hopeless places for the rest of their lives. It
is strange to see that this seems to be no longer true and people feel so
attached to literally hopeless places they found themselves in.

~~~
leggomylibro
I completely agree, but there are good reasons not to want to move. If you've
lived and worked with the same people for the past 30 years, you may not want
to pack up and leave that tightly-knit community when the factory shuts down.
Further, if you have a mortgage, it may well go underwater as property values
plummet.

On the other hand, the US has (had?) an array of social programs to help
people in those situations transition into new roles. The Atlantic published a
pretty good piece* on why they haven't wound up working out as well as they
could, and it does sound like a major reason is that people won't move to
where the jobs are. And regardless of their reasons for wanting to stay, that
usually is on them, isn't it? Otherwise, they're essentially asking the
government to subsidize their lifestyle choices.

* [https://www.theatlantic.com/business/archive/2016/10/trade-w...](https://www.theatlantic.com/business/archive/2016/10/trade-winners-losers/504584/)

~~~
reubenswartz
I think the property value issue is important. If a major employer closes and
people want to leave/no one wants to move there, property values go down. Even
if you're not underwater, you're in a much worse position. To move to a place
with more opportunity is much more expensive, especially if you have no
guarantee of long term, stable employment.

~~~
anovikov
No one has that guarantee these days. Also you are in a much worse position
regardless of if you sell or not.

------
sgk284
While the 40% number is interesting, the average increase across the nation
was 30%.

The much bigger question here is why did the rate of suicide increase more
than 30% for the entire nation in a 16 year time span? It's a fairly
consistent trend across all sorts of economic environments regardless of
whether we were in a boom or bust.

It's a shame there isn't a deeper analysis here. I have so many questions. Is
the cause related to drug abuse? Would better healthcare help here? Is it
mostly economical? Is the trend consistent across similar nations? Or could
there be a link to something we mass consume and don't realize is harming us
(similar to just a few decades ago when everything had lead in it).

~~~
happy-go-lucky
The root cause seems to be lack of education and drug abuse epidemic.

~~~
mi_noi_noi
Let's say we got to a point where every single individual has a bachelors or
higher? What would that change? What about if everyone got a Masters or
higher?

You think this will change anything? I doubt it, there would just be an
increase in the job requirements due to credential inflation.

~~~
aianus
You're conflating education with credentials.

Imagine instead if every single individual could: read and write at a high
level, think critically, compare loan options rationally, perform their own
limited legal research (tenants' rights, welfare eligibility and application),
plan their own investment strategy for retirement, etc. It would be a huge
boon.

~~~
happy-go-lucky
True, education is to help realize one’s full potential. It’s not about
credentials.

------
itchyjunk
Is this suicide attempts included I wonder? Cities definitely have more help
groups and "watch" groups. Chances of survival are also more around cities if
someone spots you can calls emergency services. (Someone noticing their loved
one/roommate attempting something and calling the doctors for example: someone
I knew had their stomach pumped under 20 mins of them taking pills and
survived).

I think opioid addiction is a symptom and not the cause. Maybe disappearance
of rural environment where one grew up contributes to not being able to cope
even more.

Slightly offtopic but: [http://www.davidsongifted.org/Search-
Database/entry/A10554](http://www.davidsongifted.org/Search-
Database/entry/A10554)

~~~
DanBC
> Is this suicide attempts included I wonder?

I don't think so. It's hard to define what a suicide attempt is, but most
definitions would see far higher than 15 attempts per 100,000 population.

EDIT: 2013 saw about 40,000 to 50,000 deaths by suicide in the US, with about
450,000 hospital treatments for self inflicted injury.

~~~
itchyjunk
Ahh, thats pretty high. Also, accidental overdose is also not considered
attempted suicide and accidental OD is more likely to lead to death in rural
areas.

------
AaronFriel
An interesting challenge to me is: how are these numbers reconciled with
understanding the communities involved?

Most people on Hacker News, I think, would argue that NYC, Boston, and New
Haven have more in common with each other than say, a rural, sub-10k
population town in West Virginia.

But in this analysis of suicide rates, it's actually places like New Haven
County in Connecticut and Wirt County in West Virginia that are more
statistically similar than either is to Boston or New York City. In my own
state, Des Moines and Iowa City would both be in the same category as the very
rural towns with marked increases in suicide rates. If the suicide rate is a
regression to a mean, what is it about dense major cities that slowed that?

And what is it that makes what I - an Iowan - think of as a city statistically
similar to the poorest and most rural counties in America?

Discussion aside, I encourage anyone who has considered taking their own life
to reach out and talk to someone.

    
    
        National Suicide Prevention Hotline
        1-800-273-8255

~~~
khuey
Outside of the immediately surroundings of Yale, New Haven is a pretty bleak
town that has seen far better days.

------
averroes
This is consistent with Ann Case and Angus Deaton's work on rising mortality
rates in the US outside of major metro areas, especially among adults without
college degrees. Rising all-cause mortality rates, not just suicides, have
already become the rule for many of these places.

Many comments here mention opioid overdoses, and it's notable that, just as
with opioid deaths and hospitalizations, rising mortality rates are
distributed across almost all groups. But they are by far most severe among
whites, who are in their late working years (~45-65 years old), and who live
outside of major metro areas. (Education data are not included in this report
but it's probably a safe bet that we are disproportionately discussing the un-
degreed.)

Yet, if you look at the CDC's data on suicide methods, only a small portion of
the increase is explained by drug overdose suicides. Drug suicides are up
markedly, but they remain only about one-seventh of the total and one-third of
the increase. Instead, the largest increase is in deaths by
hanging/suffocation/strangulation, which is twice as large in raw terms as the
increase in deaths by drug overdoses. Suffocation, not drug overdoses, is the
main reason why non-firearms suicide deaths have become as common as firearms
suicide deaths.

What does this tell us? Well, for one thing, people who suffocate themselves
are frequently people who don't have access to firearms or lethal drugs - or
who aren't familiar with them. Anyone who wants to understand rising rates of
suicide should look especially carefully at why Americans are now suffocating
themselves at a much higher rate.

------
bougiefever
I was just commenting to a friend of mine that the trend towards remote
workers may reverse the shrinking of small towns. Not everyone wants to live
in a big city, and if they can work for a company that is not located there,
some will prefer smaller towns. Making sure that all of American has broadband
will be as important as RFD was in the day to preserve our rural areas. For
those who don't know what RFD is, it is Rural Free Delivery, and it meant that
people in rural areas didn't have to pay to have their mail delivered. It
completely revitalized the rural areas. Sears & Roebuck prospered because they
could sell to the whole country. Today, broadband internet access is needed
for everyone. I live in a rural area, and reliable, fast broadband has just
become available. I have a remote job, and broadband makes it possible for me
to stay living here. I can see where pockets of remote tech workers would want
to live in the same place, maybe having a co-working place to go to. I have a
co-working office I use several days a week that is all technical workers.
It's the perfect balance for me between being home all the time, and having an
office with other remote workers to work with.

If people can live in these communities with an income that is middle class,
they will help the communities to prosper, which may help reverse the trend
towards suicide and drug use. I sometimes eat at the restaurants and shop in
the stores of my small town. Our insurance agents and lawyers are there, and
we do our banking there. Having real opportunities to maybe open a store, or
work at the insurance office for the residents there might help their lives
improve.

My cousin's son died of a heroin overdose, and he was the nicest, funnest guy.
Everyone loved him. Do city people think that those who are suffering are just
losers who deserve their fate? That is simply not true. Many have families who
love them, and the potential to have a good life, but heroin is such a strong
addiction. They need help, not condemnation. I think the de-criminalizing it
is essential to solving the crisis. My cousin's son would maybe have survived
and gotten help if his friends would have brought him to an ER. I think they
were afraid of getting arrested and having their place raided by police, and
they rationalized that he would probably be ok by morning. If they didn't have
the threat of legal problems over their heads, they might have called 911 when
he was unresponsive. Instead, they decided to wait it out, and he died.

These are not easy problems to solve, and it will require people to challenge
their ideas about who needs fast internet, and who the people affected by the
heroin epidemic are.

~~~
therpe1
> Do city people think that those who are suffering are just losers who
> deserve their fate? That is simply not true. Many have families who love
> them, and the potential to have a good life, but heroin is such a strong
> addiction. They need help, not condemnation. I think the de-criminalizing it
> is essential to solving the crisis.

It's darkly amusing to read this because drugs have been ravaging the inner
cities for _decades_ and "city people" (as you call them) have been saying
this for about 50 years. The response from the rest of the country was the War
on Drugs. You might've heard of it? See, it was widely believed that black and
brown people suffered from problems of "culture" and the only solution was
mass incarceration.

Anyways, I don't see this sudden outpouring of sympathy for rural whites
accomplishing much of anything. There won't be a "egalitarian awakening" \--
political polarization and paralysis is only going to deepen and solidify. At
the end of the day Americans don't give a shit about the poor whether they're
inner city blacks and latinos or rural whites. The national conversation right
now, keep in mind, is about whether Meals on Wheels is "delivering results"
and how much to increase the military budget by.

But then even if America wanted to I doubt that America could handle the sort
of systemic disaster that is runaway inequality. It's a structural issue; the
country simply wasn't built for dealing with such a threat, it's too big, too
decentralized, and ultimately too capitalistic. The only thing that stopped
the runaway inequality of the 20s was the Depression and World War. In that
light, I suppose, one could actually think the GOP's destruction of of the
modern regulatory framework and the rabid anti-China rhetoric is a good thing.

~~~
bougiefever
Not everyone agrees with the War on Drugs - I certainly don't. I'm white, but
I was raised from a little girl to respect people, so I never had the idea
that "black and brown" people, as you put it, are not in the same boat as I
am. Not that I think your assessment is wrong for many people in America. I
also agree with your assessment about the political polarization. It's
depressing, and there aren't easy solutions. Like I said, I live in a rural
area, so I come into contact with some very bigoted people. They think because
I'm white and in that community, I must agree with them, so they end up saying
some pretty horrific things. I do try to engage them in a discussion, but I
feel like it's a drop in the ocean.

I don't know what our future is, but the inequality is not good. Are we headed
for a major catastrophe? I hope not, but look how bad Germany was before WW2,
and how rapidly they have changed since. I hope that's not what it takes to
turn things around.

------
boomboomsubban
I'm not saying it explains all of the rise, but I wonder how much of this is
more accurate reporting. I'm from rural America, and people dying of a "gun
malfunction" or similar accidental deaths was a common thing. Nobody local was
confused, but protecting the family was a large concern.

------
patrickg_zill
You can fix rural areas by leaving them alone. But it has to actually alone. I
mean, get rid of the residential building code and any zoning restrictions on
house construction.

It used to be that a man or man and wife could build a new house for
themselves, but the city regulations have been exported wholesale to the rural
areas, and the expense of subdivision of land drives up land prices.

So now it is virtually impossible to bootstrap by saving a lot of money by
buying a few cheap acres and building a small house: everything has to
permitted and to specification, reducing the comparative advantage that should
be present.

------
pmoriarty
How many of these suicides are war veterans?

Don't people from rural states have a disproportionate number of enlistees in
to the military? And hasn't there been a huge increase in veteran suicides
since the Iraq and Afghanistan wars?

~~~
aphextron
>I wonder how many of these suicides are war veterans.

The overall share of combat veterans within the population as a whole is much
smaller than most people think. It's less than 1%. While the suicide rates are
much higher than the general population, the total numbers are relatively
insignificant.

~~~
pmoriarty
1% of the total US population, but what percentage of rural America, and (more
to the point), what percentage of the suicides in rural America?

------
chx
Check
[https://morecrows.wordpress.com/2016/05/10/unnecessariat/](https://morecrows.wordpress.com/2016/05/10/unnecessariat/)
for more. One of the best posts in 2016.

~~~
rsa4046
Thanks for posting this ...

------
cyberferret
It appears to be a broader epidemic than just the US. Australian media also
report that rural suicides (particular polarised amongst older farm owners and
young people) has been on a marked increase over the past decade.

Over here it has been mostly attributed to the extended drought, and the
general decline of agriculture as a core factor of GDP, as well as the
popularity of hard drugs like ice in rural areas.

Not sure if that correlates with the conditions in rural US as well.

------
jimjimjim
In my opinion it's not a US only thing. Every country seems to have increased
rural->urban migration.

Couple this with the concentration/centralization of manufacturing and
economies-of-scale and there is less and less opportunity/jobs in rural
locations.

ps. There is NOTHING in any of trumps policies that will change this. e.g if
manufacturing is not in china/Mexico/Bangladesh then it will only go to major
population centers.

------
dredmorbius
The relationship between urban and rural regions is also interesting.

From 1910 to 1990, rural population grew from 50m to 61m, bobbling about a bit
in the process. Call it a 124% growth.

In the same period, _urban_ populations grew from 42m to 187m, a 445%
increase.

Among other things, this means that there's been a persistent shift of
political power from _people_ to _land_ , effectively, via the Electoral
College. Given the strongly conservative tendencies of rural populations, this
helps explain the voting and electoral patterns of the past several decades.

Having spent my share of time in and travelling through many of these regions,
the social welfare patterns are fairly easy to understand. The region _has_
visibly sagged over the past 30 years.

[https://www.census.gov/population/www/censusdata/files/table...](https://www.census.gov/population/www/censusdata/files/table-4.pdf)

------
norea-armozel
I think the biggest reason for this trend is the decline in health and human
services across the various states which have large rural populations because
it's been the politically expedient thing to do when budget crises happen
because it's assumed they rural pops will just move to the big city and get
the services there. Little do they realize that takes MONEY. So, when you're
dealing with the same economic downturns which cause the budget crises also
lead to underemployment and unemployment you're not going to see many of those
folks move because they have no money or very little of it. Ultimately, there
needs to be an honest discussion among the rank and file of the American
conservative movements on these matters. Specifically, they need to
acknowledge that their whole "pull yourself up by your bootstraps" mentality
isn't working and that a whole new program needs to be adopted. Specifically
one that acknowledges that Randian/Right-Libertarian approaches are dead ends
in terms of sustainability. Whether they like it or not they need to accept
that there needs to be some level of welfare in government especially now when
the greatest disruption to employment opportunities are ahead of us (not
behind us). We can't assume there will be plentiful well paying jobs that
can/will emerge in the rural sections of the US. We need to assume the
opposite as distance is costly to most industries and there's barely an
operable infrastructure to support building up those rural parts of the
country (especially when it comes to the Internet-based IT jobs). If there's
anything they should do I think an infrastructure bill that focuses on getting
Internet access and education programs out to the rural parts of the country
would be a good first step on top of rebuilding and augmenting existing
welfare programs.

------
stmfreak
Didn't we just go through two major recessions in 2000 and 2008? Is anyone
surprised that more people are giving up hope in recent times with all the
factories closing, major retailer closing, unemployment at incredibly high
levels (U6, not official statistics) and massive debt from student loans?

~~~
Sanddancer
Recessions on average happen every 8-10 years or so. There was a recession in
91-92, one in 81-82, etc. That part of the business cycle is pretty cyclical.

------
throw2016
Whoa! What a depressing thread. From the thread one would conclude this is not
a country but a collection of economic interests.

Hopefully this dry soulless perspective is limited to a small technical group
in the bay area.

You will simply not got this level of callousness in any country with a sense
of a 'collective history and shared existence'.

Sure there is 'callousness' in many places but there is also a sense it is
wrong. Here some seem to have not only shed the sense of guilt or collective
existence but celebrate their lack of empathy. No wonder this is the only
country that takes rand seriously.

~~~
gragas
>No wonder this is the only country that takes rand seriously.

Most of the people who show no empathy to rural America are actually extremely
left, self-righteous city dwellers who _hate_ Rand.

I often get the feeling that most left-leaning people who don't show empathy
towards rural America are actually only left-leaning because that's the
"morally correct" stance. Evidently, they don't care at all about others and
will take every chance they can get---that is, every situation in which it is
socially and politically acceptable for leftists---to feel superior.

I'm not saying the right has any more empathy. I'm not saying the world needs
more or less Rand.

------
dibanez
Without belittling the difficulties of rural areas, it seems just as
concerning to me that all the lines in this plot are trending upward.

------
pharrington
Pretty nice correlation between this and the advent of OxyContin.

------
w1ntermute
> imagine for a second someone telling you that 'you should just move from
> where you are because where you were born isn't good enough'

Sounds to me like how this country was created. Are rural Americans so weak
that they can't handle a tenth of the hardship their ancestors endured to
create this country? If so, then it sounds like they're the ones standing in
the way of Making America Great Again.

~~~
throwanem
Rural Americans are stronger than you know. We always have been.

But strength isn't enough, and it hasn't been for a long time. You have to be
smart, too, and ambitious - I was, when I moved to Baltimore right out of high
school, with the idea of turning my lifelong interest in programming into the
sort of career that Mississippi didn't, and so far as I know still doesn't,
have the industry to support. Lot of people where I'm from had ambition, often
beyond anything the local environment would support. Lot of them had the same
smarts I did, too, and in many cases better - behind all the pretty talk, I'm
really not all that bright.

But smarts and ambition aren't enough, either, and haven't been for a long
time. You have to be lucky - I was, when I discovered at age six the avocation
for programming that's since developed first into a marketable trade and then
into a solid career. Not that I knew that was what I was doing, of course. I
just knew I really loved writing code, and I was lucky enough to have had the
opportunity to find that out and luckier still to have a family able to
support it with an Apple II. Absent that luck, I'd have gone nowhere, because
I'd have had nowhere to go. Maybe to college instead, and had a small chance
of learning a marketable trade and a guarantee of decades' worth of debt.
Maybe just nowhere. And that's not all the luck I've had - not by a hell of a
long shot. That was just some of the earliest.

That's the thing about a life like the one I've built, the life you're saying
that everyone where I'm from should build, as though it were as simple as
choosing to do so - none too fancy a life, to be sure, but I'm in no debt, and
my career is stable and remunerative enough that I can afford to send
considerable money home to those among my family who haven't had my good
fortune - that life _is_ the result of good fortune, to an utterly implausible
extent. Had any of an enormous number of events turned out even _slightly_
differently than it did, I would not now be in a position to tell you what an
ignorant, prejudiced jackass you must be to have said something like what you
just did. At ten on a Sunday morning? I'd probably be Ubering people from
brunch to shopping, or something, in a car I'd have gone into debt to buy,
always counting in the back of my mind how many dollars I need to make today
in order to break somewhere close to even, and it'd be a miracle if I managed
in even one month to send home what I send home every month now. My laid-off
mother wouldn't be getting the right care for her Graves' disease, because who
could cover the co-pay? And my cousin, paralyzed last year in the sort of
"industrial accident" that happens when you're so hopeless broke that cooking
meth looks like an option? Well, he'd still have the communicating pressure
ulcers over ~15% of his body that he got from his first, incompetent, care
team. So odds are I'd have a couple of funerals to worry about pretty soon,
too, and that's far from cheap, quite aside from the fact that rednecks feel
the loss of loved ones every bit as much as real people do.

So, okay. You want to talk about rural people overcoming hardship to make
lives of worth in the modern world? Hi there. I've done it. Having done it,
I've had a great deal of opportunity to observe the degree to which doing so
requires overcoming vastly opposing odds. Lest I be mistaken as arrogant, let
me note this is not a boast. This luck is no cause for pride, any more than
would be to have bought a winning lottery ticket. That I happened to be well
placed to exploit the lucky breaks I got pales to insignificance alongside the
vast, _vast_ number of lucky breaks I've had - and much more so alongside the
fact that, had matters gone only slightly differently from how they in fact
have, all the smarts and ambition in the world wouldn't mean a damn thing.

And here you are, arguing whether you know it or not that that kind of
astonishing luck _scales_. Not only that, but slandering the people left
behind by the fact that that kind of astonishing luck _doesn 't_ scale, left
behind with no option but to make the best life they can under the
circumstances or give up, and whose circumstances have grown latterly so
hopeless that many of them _are_ giving up - and that's the thing you overlook
here, the crucial point on which your ignorance or carelessness renders all
the rest of your analysis worse than useless. When those of my ancestors who
immigrated did so, they did it because America was a nation capable of
offering them hope - hope of a better future, for themselves and their
descendants, than their home countries could any longer sustain. Even those
others of my ancestors who were transported under criminal sentence, who lived
years or decades or the rest of their lives under effective indenture, with
their liberties sharply circumscribed - even to them, America was a beacon of
hope for the future. But that was many years ago, and since then, America has
changed. Where my ancestors and the ancestors of my cohort found hope, that
hope has gone, to be replaced by hardship that seems everlasting and in far,
far too many cases is. Somehow, in spite of that, many of us survive - not
all, to be sure, and fewer every year, and in circumstances which I misdoubt
would horrify a lifelong city man. Shall I tell you about the shack where
lived some of my happiest childhood memories, and the way black mold gets into
chipboard walls? But that's not where I live any more. I had the good fortune
to go on to better things. Many among my cohort did not - people whom I loved
and ran with and hated and fought with all through my childhood and
adolescence, people who knew me and whom I knew in the way of children who
hold nothing back, in the way that later life never can quite offer, men and
women who taught me how to live and understand my place in the world, how to
be a worthwhile human being, who initiated me into all manner of mysteries
both wonderful and terrible, and made it possible for me to attain whatever
value I can ever hope to manage.

Those people, you're calling _weak_.

And then you wonder how a Trump happens.

Well, worse is coming, if things go on as they have. Worse first for you and
then for us all. I don't want that. No sane man with any grasp of history
could possibly want that. But the lie of progress, of the universe having an
arc that bends inexorably somewhere, is too seductive, and the closest thing
it offers to consolation is that I might get to see some people like you
dragged screaming into hell before my own turn comes. I don't want that. I'd
much rather none of us gets dragged into hell at all. I voted for Trump in
large part to try to stave that off - in the hope that such a shocking setback
might give rise to a general reevaluation of perspective on the left, to
something which might lead to the realization that you cannot, you _may_ not,
simply wash your hands of whole peoples in their millions and expect to carry
on as you please, never needing fear any consequence. But that hasn't happened
and I don't think it will. Instead of reevaluation we see exhortations of
greater energy for the cause, and instead of any gesture toward rapprochement
we see intensification of the same exclusionary rhetoric and behavior that's
brought us to the pretty pass we stand in now.

And I don't expect you to change your mind because of what I've said here,
either. It would astonish me if you did, not least because I've been much more
honest than kind, which is too common a failing on my part in any case;
effective rhetoric in this circumstance requires perhaps above all that the
fissures of a fragile ego not be struck. But here I've barely tried to be
otherwise, because I have in large part given up - be what I may, I'm hardly
insusceptible to an absence of hope in my own right, and I've long since
ceased to see much cause for _that_ in my efforts to warn people away from the
abyss into which they seem hell-bent on dragging us all. But if I've achieved
nothing else, as I so strongly suspect to be the case, then I may at least
find whatever consolation there is to be found in the fact that, when your
turn comes as a turn will come for all of us, you'll have no excuse for
failing to understand what is happening, and no ability truly to say that you
were never told. Meaningless as it is, if that's the best I've got, then I'll
take it. And who knows? Perhaps you will surprise me after all.

~~~
im_down_w_otp
Why does it take being lucky to learn how to program?

Access to a public library w/ a web browser would be enough to learn the
client-side of the world. A donated or sub-$200 laptop and a free GitHub
account would be enough for almost all the rest of it (save for some top-tier
ML or distributed-systems work).

Not that I'm suggesting everyone flood to being a programmer, per se, but
becoming one has to be amongst the absolute lowest barriers of entry to a
decent living that has ever existed short of being born into landed-gentry.

It requires no credentials. It requires almost no capital. It's trivially easy
to advertise your skills (via engagement in a popular open source project).
It's harder and more expensive to become a groundskeeper than it is to become
a programmer.

~~~
throwanem
Yes, all of this is true _today_. (Most of it, anyway. I strongly doubt that
"advertise your skills via open source participation and leverage that into a
paying career" scales as well as you seem to suggest. And 'watwut is right
about the rest. When did you last use a computer in a public library? It is
rarely an environment conducive to study.) None of this was true when I
started; perhaps you overlooked my mention of the model of machine on which I
did that.

But that's beside my point in any case. My point is that that wasn't the only
good fortune which mattered - necessary, to be sure, but not sufficient. Had I
not in later life happened upon a job with someone who made it possible for me
to transition from the second-shift telephone support role for which I'd been
hired into what became my first real dev job, and served as an apprenticeship
in business besides, I'd be driving that Uber today.

Again, my point is not that one or another specific piece of good luck made it
possible for me to build the professional life I have. My point is that to do
so has required _so many_ pieces of good luck, any one of which going
differently would have changed the entire course of affairs, that it is
impossible to imagine this approach could scale. It's like flipping a coin ten
times in a row fairly, and having it come up heads five times and land on edge
the other five. Clearly that can happen, or I'd be driving that Uber right
now. But you cannot reasonably expect it, or demand it, or require it, of
anyone.

~~~
chillwaves
Let's not forget your point about voting for Trump to "shock" our nation and
wanting to drag other folks to hell with you.

That's likely where you lost sympathy.

~~~
throwanem
Yours, perhaps. But your erroneous reading of my statements here suggests
strongly that I never had it, so that doesn't seem like too much of a loss.
Perhaps you'll convince me otherwise.

------
wtbob
> "People in the cities" (who tend to be strongly left-leaning) literally want
> to give money to the less well-off people in rural areas to help support
> them.

It's more accurate to say that they want to give _other people 's_ money to
the less-well-off. I don't know that it's terribly empathetic to use violence
to take someone else's wealth and give it to another in order to get warm
fuzzies or votes.

Last night, I went to a banquet for an organisation which is (AFAIK) entirely
funded voluntarily, and which helps folks in crises (natural and man-made
disasters, e.g. hurricanes, earthquakes and wars) all over the world,
regardless of creed. They only spend 8% of their revenue on fundraising, which
I think is pretty good. I voluntarily wrote them a cheque, and was glad to do
it.

The moral calculus would be completely different had I voted to send armed
agents to raid your bank account and give those funds to the organisation.

~~~
dang
We detached this subthread from
[https://news.ycombinator.com/item?id=13905286](https://news.ycombinator.com/item?id=13905286)
and marked it off-topic.

~~~
wtbob
I think it directly addressed the point re. empathy in
[https://news.ycombinator.com/item?id=13905286](https://news.ycombinator.com/item?id=13905286),
and was no more or less off-topic than that comment.

~~~
dang
It's the generic ideological talking point that's the problem. Those only ever
lead to generic tangents, which are the wrong kind of tangent—plus usually
flamewars.

~~~
wtbob
Thank you for responding; I do appreciate that.

Isn't '"People in the cities" (who tend to be strongly left-leaning) literally
want to give money to the less well-off people in rural areas to help support
them. It's the right-leaning candidates who are opposed to wealth
redistribution. Who is missing empathy for whom? From my perspective, the
fiscal conservatives from the rural areas have relatively less empathy than
vice versa.' _exactly_ as much of an generic ideological talking point?

It certainly led to a lot of heated discussion, e.g. the top-rated comment in
that thread, which stated in part 'If anything I'd say there's a lot of
disgust with how many rural Americans live off the system.'

------
taivare
I just read a tweet , that 1 of 5 given a 10 day supply of opiates will go on
to abuse it. I worked midnight shift in a big pharma chain in rural US. I have
seen 1st hand the damage the pill mills from (rural doctors )our having on our
rural populations. They have lost their jobs to NAFTA. I was able to get them
to stop selling brass pot scrubbies ,go (plastic) junkies would use for
screens. You could tell when they came in for the scrubbies, the checks came
out the dealers knew when to peddle. One of docs had a thriving Buis. Local
doc - highschool phys.- slum landlord (shell co.) and a pill mill for a day
job ! ps. one junkie was selling pils $15 a pop he said & that 8yrs back ;
said it took 20min lick coating off ; for grind & snort . . sad !

