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Dr. Carol Graham is interim vice president and director of the Economic Studies program at Brookings, a professor at the University of Maryland, and a Senior Scientist at Gallup. She has spent much of her career studying happiness and wellbeing around the world. Carol joins the podcast to discuss what she calls ‘deaths of despair’ and explains why cultivating hope is essential for societies mired in deeply entrenched problems. Her latest book, The Power of Hope: How the Science of Well-Being Can Save Us from Despair, is available now.
Transcripts of our episodes are made available as soon as possible. They are not fully edited for grammar or spelling.
THOMAS BURNETT: Carol, welcome to the podcast.
CAROL GRAHAM: Thanks, Tom. It’s a pleasure to be here.
THOMAS BURNETT: I want to get to know you personally, as well as ask you questions about your research and your new book. So, if you could tell me about where you grew up, what was it like?
CAROL GRAHAM: Well, I had quite an unusual life journey because I grew up between Peru and Baltimore, two rather unlikely, odd matches, but my dad’s mother was Peruvian.
He was Peruvian American, and my mother’s parents were Swiss and French, but she was born in Peru. So, when I was three, my dad joined the medical school at Hopkins. He was an expert on infant malnutrition and started an institute for Malnourished infants in Peru. And so, all my elementary years I would spend six months in Baltimore and six months in Peru, which I enjoyed much more.
So, career-wise. I started off as a development economist, doing work on poverty and equality, public health issues, really focusing on poor people in poor places and through some surveys I was doing, I fell into the economics of happiness or being one of the people that started to study happiness or wellbeing in economics.
At the time, we were considered totally nuts by other economists. It helped that we were collaborating with some pretty cool people. One was Danny Conman, the first psychologist to win the Nobel Prize in economics. And then I was lucky enough to be on a National Academy of Sciences panel, to talk about wellbeing metrics in our statistics and policy.
At the time, the Brits were putting wellbeing metrics into their statistics and starting all kinds of evaluation interventions and seeing, you know what, what we could learn from wellbeing in addition to income-based measures. The OECD was developing its better life index and so, it was an exciting time, but I never thought the field would go as far as it’s gone since then. Turning into a really robust science, many, many governments around the world use wellbeing in their statistics, in their cost benefit analysis, in their budgeting and other policy decisions.
THOMAS BURNETT: When you entered the research world, did you find that you had a different outlook based on your early childhood experience in growing up in two countries, two cultures, two languages? How did you see the world differently than perhaps some of your peers?
CAROL GRAHAM: Oh, very much so. I came from a background where I, you know, my dad had started an institute for malnourished infants and he had an outpatient clinic in the slums, and I worked with those people early on. I got great respect for the hopefulness that people could have in very poor places and how entrepreneurial they were. And then that contrasted very much with what I found in the US later. But it affected me at a young age in the years where I split my time between Peru and the US, I felt a bit of a disconnect between what kids knew here, not academically because they knew a lot, but about how the rest of the world lives. And I think that really made a big difference in what I chose to do.
THOMAS BURNETT: What does it look like to do field work in Peru?
CAROL GRAHAM: Well, it involves a lot of humility. You know, you can’t just trump in and demand that people ask your questions. These are slums that don’t have paved streets or running water, so, going in, there’s kind of daunting. Even though I, you know, Spanish is my first language, you’re different.
And the other thing, I had an introduction. I was seen to be part of a respected, trusted place, and so that was a huge advantage. The other thing that really struck me was the generosity of the very poor. Like they wouldn’t have like soda in their house, but they would, if you went to interview them, they would send one of the kids out to the local store to buy some.
And then after that I realized how much harder it is to break into other places because in Peru I had automatic introduction, but I then did some field work. My first book was on safety nets around the world, and I worked in Chile, Bolivia, Peru, and then some African countries and some Eastern European countries. And the latter two were much more difficult because I was definitely tromping in uncharted ground. In Africa, I speak French, that that wasn’t as much of a problem. Eastern Europe was a whole different ballgame because I certainly don’t speak polish and people then didn’t really speak English. So it was, it was just it was much more challenging and I’m not sure how effective it was as opposed to places where you already have an in and speak the language, but I learned a lot.
THOMAS BURNETT: I want to ask you about a term that I regularly hear in news stories, deaths of despair. I know that you’re a research judge on that. Can you tell me what does deaths of despair mean so we have a better sense of maybe the bigger picture and how common are they?
CAROL GRAHAM: So, deaths of despair are premature deaths, and usually they’re either suicide, drug overdose, alcohol poisoning, other drugs, and Angus Deaton wrote a seminal article in 2015, about the same time I had started to work on lack of hope in the US, in which they found that these deaths were most common among lower middle-income whites in their middle ages. So essentially the white working class coinciding with the decline of manufacturing jobs, the related declining communities in marriage rates and all sorts of things, and the opioid crisis. Perfect storm of all those things. And so right now we’re up to almost a million a year if you include the how many overdose deaths we have each year, which has gone up dramatically since 2015.
This is a pretty unique phenomenon in the United States. Some other deindustrializing places, parts of the UK, Russia in the 1980s have had something like this, but nothing on this scale. I mean, this is big enough that from 2015 on our life expectancy has been going down, not up where the only rich country in the world where that is true, and that means that deaths of despair are eroding significant progress that’s being made in cancer deaths, in heart disease, all kinds of other things.
We're seeing a trend that's the tidal wave, and yet it's not in the press much.
With the introduction of fentanyl, which is easily available and quite cheap, the deaths have spread demographically. Now we’re at a point where African American men in particular, but Blacks and Hispanics are now represented in those categories, which they really were not before. And now their rate of deaths of despair, although at a lower level, the rate of increase has been about the same as whites, particularly among African American men.
THOMAS BURNETT: Would you say then that are deaths of despair a drug problem or is there something more fundamental to despair of which than drugs are a symptom rather than a cause?
CAROL GRAHAM: I think it’s much deeper than drugs. Drugs are definitely a symptom. Opioid manufacturers who pushed the sale of opioids in declining manufacturing communities where the people were in a lot of physical pain, people were also in a lot of psychological pain, they were targeting an audience that was being prescribed opioids at an alarming rate. And once they were addicted, they were addicted. Right. They continued to push pills, the so-called pill mills, you know, they focused on these places. But what’s happened since is fentanyl and other derivatives have now also increased, even the minorities are less likely to be prescribed opioids. The illegal stuff is really taken over.
But I would say the fundamental causes are more the decline of decent jobs and the related life, meaning that comes with those. When the jobs left, so did the communities around the big manufacturing firms, and so did marriage rates. Being unemployed when you want to be employed is terrible for well-being. It has psychological scarring. It’s worse for men than for women because women have sort of more, they’re used to juggling several different roles. Particularly men in blue collar work, and their identity is very rolled into their jobs, and so is their social life, the union, all those things are really gone.
And ironically, minorities, because they didn’t have as good access to jobs, still believe in education and higher education as a way to get out, much more than low-income whites. Because before they didn’t have to get higher education, and now their parents actively don’t think their kids need it, and yet in tomorrow’s labor markets, there aren’t many options.
THOMAS BURNETT: Tell me a little bit about the concept of despair. What makes it so, so dangerous and so threatening to people?
CAROL GRAHAM: Its threatening in lots of different ways. One is that if you are in despair, essentially the definitions, you don’t care whether you live or die. Right? And that’s why having no hope are being in despair, have very strong links to the deaths of despair. So that’s one thing. But the other thing is, it also means people don’t respond to opportunities. You know, you’re not going to get somebody in despair who’s living in rural Michigan to move to San Francisco, because there are more jobs there. I mean, they may as well move to the moon. Right? You’ve given up. But the other part of the story that I find very dangerous and really not well known, is that people in despair are much more likely to be radicalized. They’re much more vulnerable to misinformation.
And that happens for both structural reasons and because they’re in despair. So, the structural reasons are lack of local news sources living in a community with no higher education opportunities, living in a place surrounded by other people in despair. They don’t have an anchor. They don’t have something that they’re diverted from if they do slightly crazy things or they’re looking for maybe a reason to live, that’s fodder for radicalization. And so that’s really spilling over into our civil society and political problems.
THOMAS BURNETT: After the break, we talk about hope. Why it’s so essential, how to nurture it, and where Carol herself finds it in her own life.
THOMAS BURNETT: I want to ask you about your new book. It’s entitled The Power of Hope. I wonder if you could describe a bit about how do hope and despair relate to each other.
CAROL GRAHAM: Well, they’re very clearly analogs of each other, but they’re not the same exact concept. Where I think the big link is that hope has agentic qualities. So, people, it’s not that they just believe things will get better. They think that they can make their lives better. And there’s a quote in my book, I think at the beginning of the last chapter by Amanda Gorman in her inaugural poem, which says, hope is not a promise we give. It’s a promise we live.
That is what I would say is the most important part of the definition of hope at least as I see it. And then despair is exactly not having that right? Now the difference between not caring if you live or die and living a life that you really want to make better and you’re trying to make better, and that process in and of itself gives people a sense of purpose, a sense of meaning in life.
THOMAS BURNETT: I was reading in your book about the importance of aspirations. Can you tell me a little bit about some of those distinctive features of aspirations? I feel like that is something we’d intuitively connect with hope as well. What are, what are some of its characteristics?
CAROL GRAHAM: Well, aspirations are what you plan to do to make your life better, right? I mean, that’s a rough definition, but essentially you invest in higher education or your children’s higher education because you want them to live better lives or you want to live a better life, you want to have life opportunities. You don’t undergo risky behaviors like taking drugs or whatever. You try and avoid them because they will jeopardize this future that you care about that you aspire to have. Right? And so, they translate into very different outcomes for kids or young adults where they’re making decisions about what to do with their lives. And those with open aspirations tend to invest more in education and to avoid risky behaviors.
THOMAS BURNETT: Yeah. Could you tell me a little bit more in terms of different approaches that either individuals or communities can take if they recognize that there is a lot of hopelessness and a lot of despair in their community, what are some concrete steps that communities or groups can take to kind of get people at least pointed in the right direction?
CAROL GRAHAM: Right. We have programs where we encourage people to participate in their communities, and that works well for older people that you’re probably not going to retrain again, but you don’t want them to lead lives in despair or dive death of despair. And that also has a, what we call an economics, a positive externality in the sense that if you have more individuals who are participating in the community together and making connections and who’s basically, wellbeing is increasing that has spillover effects into the community, right?
THOMAS BURNETT: You’ve now spent decades studying wellbeing, happiness, looking at issues of hope, despair. What are some things that give you hope about the future?
CAROL GRAHAM: I think in a really ironic way, COVID, which is a horrible, horrible experience for so many people, but out of that came, I think a worldwide recognition that despite all our economic progress without having a healthy society, which includes mental health, we really can’t make progress and we can have really terrible outcomes. In the US it’s resulted in much more attention paid to mental health problems and slowly to death of despair and some of the outcomes. But I think it also provides us an opportunity to say we didn’t have the tools in place, other countries do, to take the temperature of our society, so to speak. We have the tools in place to measure economic progress in production terms, gross national product. It’s an important measure. Not suggesting we get rid of it by any means, but you know, on your car you have many indicators on your dashboard. You can be going fast and have a full tank of gas and yet your alternator’s about to croak or something, and you have a check engine light. Most people kind of stop and deal with it because not doing so can lead to bad outcomes, but it’s a warning indicator, right? And that’s in a way what wellbeing metrics can provide in both good and bad ways.
It can tell us who's doing well in our country, who's not, and I think that's one insight that the metrics provide that's really useful for policy and that gives me hope that we can get there.
There are also a lot of the work going on just in the research side of the field. Is getting better measures of things like what do people value at work? It turns out income, not so much. People value being respected and autonomous, people value connections at work, all these things that you would think are sort of soft and fuzzy turn out to matter the most to job satisfaction.
THOMAS BURNETT: Going back to where you started doing field work in Peru when you were young, before you even go into college, how would that self, the car of that time period? Look at where you are now?
CAROL GRAHAM: I’d certainly be surprised that I was working on wellbeing more than income inequality, although looking at other dimensions of wellbeing puts them in a bigger perspective. So, I think I’d be pretty surprised I was working on happiness. I’d be equally surprised that I was working on a lack of hope in the United States because when I grew up, I loved being in Peru. You know, Latin America has a vibe, it has energy, it has music, it has food, it has community. So, life there is not everywhere, but in a lot of places it’s rich and it shows up in their measures of wellbeing, regionwide. So, I’d never thought of the US as a place full of despair, political division, the kinds of things we have now. I wouldn’t recognize them, I don’t think I’d be upset that I was working on them. I’d probably be happy I was, but I couldn’t have envisioned that. I used to come back from Peru to the US and I was constantly thinking about the lessons going the other way. What we could learn in Peru about US democracy, what we could learn about economic stability in the US and macro management that worked and all sorts of things, safety nets that seem to work. And it’s sort of that picture’s on its head right now.
THOMAS BURNETT: Looking forward 20, 30 years from now in the United States, can you imagine what a hopeful scenario would look like where we kind of reverse some of the slide and have a brighter future.
CAROL GRAHAM: Well, I think we’re seeing it begin to happen. I think we’re seeing young people get engaged in trying to generate social change. Even the resurgence of unions now is so different from what it was before. It’s being driven by young people in completely non-traditional industries, Starbucks baristas or Amazon workers with genuine concern for how bad the working conditions are, but I think the idea is that it’s just part of getting involved, trying to just not sit there and watch bad things happen, and I think we’re seeing as the extremists in our politics get the most public attention because they’re loud and it’s, you know, that’s how it is, I think we’re seeing a real appreciation for what we’ve lost as a society that could solve problems, even though there were disagreements about how. And so, I think there is sort of a move to get the center back. So, I think it will be gradual, but I think that like anything else, recognizing what some of the problems are is the first step.
THOMAS BURNETT: Well, I appreciate you taking time to talk to me today. I really love reading the Power of Hope, and I look forward to seeing more hopeful expressions and sounds like we can start small and not despair, even if progress is in a slow pattern, but that working bit by bit together gives us a lot to be hopeful for.
CAROL GRAHAM: I totally agree with you, Tom, and thank you so much. I really enjoyed this.
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