Death rates among less educated, working-class whites have caused life expectancy in the U.S. as a whole to fall.
Illustration by Eiko Ojala/The New Yorker

It all started with a bad back. For more than a decade, the Princeton economist Anne Case had suffered from chronic lower-back pain, and nothing seemed to help. She’d made her name studying the connections between health and economic patterns in people’s lives; her research showed, for instance, a connection between your health in early childhood, or even in utero, and your economic status later in life. So she decided to research the patterns of pain in the population. And as she pulled on this thread she found a bigger, more alarming story than she ever expected.

The question she began with, in 2014, was whether pain had grown more or less prevalent in the United States over the past few decades. Given advances in labor-saving technologies and in pain treatments, she expected that the […]