In 2015, Monica Potts reconnected with an old friend named Darci on Facebook. The two of them had grown up in Clinton, a small rural town on the edge of the Ozarks in Arkansas, and had been best friends in high school. In their teens, both vowed they would leave and build a life away from the dysfunction and deprivation of their home town, but for Darci it didn’t pan out like that. While Potts, who is now in her 40s, gained a scholarship to a college in Philadelphia, and became an award-winning political journalist (she has written for the New York Times and the Atlantic, and is now senior politics reporter for FiveThirtyEight), Darci failed to graduate high school and, like many in their social circle, never left Clinton. Over the years, Potts heard on the grapevine that Darci was struggling. When she finally visited her friend on Christmas Eve, 2015, she found her in crisis: separated from her two children, battling addiction, living in a trailer with a man she barely knew and stuck in a repetitive loop of jail time, release, decline and rearrest.
At the time, Potts was already investigating a disturbing trend: in 2012, a team of population health experts at the University of Illinois Chicago had found that white women who failed to graduate high school were dying five years earlier than the generation before them. Subsequent studies revealed a sustained fall in life expectancy among the least educated white American women, and an increase in so-called “deaths of despair”: drug overdoses, suicide and complications from alcoholism. Further research in 2018 by economists at Dartmouth College also revealed rising numbers of deaths from cancer, heart disease and respiratory illness among women below the poverty line. One of the researchers, Charlie Rafkin, told Potts that women suffered from a range of disadvantages, making it hard to pinpoint a single cause for the mortality increase. Instead he attributed it to a “general malaise”.
