"Oft expectation fails, and most oft there
Where most it promises; and oft it hits
Where hope is coldest, and despair most fits."
Where most it promises; and oft it hits
Where hope is coldest, and despair most fits."
All’s Well That Ends Well Act 2, scene 1
A recent post (link here) by Pia Malaney on the blog of the Institute for New Economic Thinking titled ‘Mortality Crisis Redux: the Economics of Despair focusses on recent research by economics Anne Case and Angus Deaton about the demographic crisis in middle America and compares it to a previous demographic crisis which followed the collapse of the Soviet Union, In both cases, there were significant upturns in mortality rates of middle class men and women.
In the US, these impacts were focussed on the white middle class, and Malaney notes that ‘Case and Deaton estimate that the upturn in mortality rates in the US is starkly divergent from other developed countries, and accounts for 96,000 deaths that could have been avoided between 1996 and 2013’.
Malaney, summarising Case and Deaton, suggests that these increased mortality rates – caused by suicide, drug overdose, and alcohol abuse - cannot be explained merely by declining or stagnant income levels, but are likely due to ‘declining outcomes not just in the labor market but also in health, marriage and child rearing. In other words, the stress accompanying the shock of downward mobility is likely driving this health crisis’.
Similar forces were at work in the Soviet Union, where Malaney suggests there were 1.3 to 1.7 million premature deaths, mainly of middle age men and women between 1989 and 1995. The proximate causes were increases in suicides and drug and alcohol abuse. The in depth research she refers to suggests that it was not deprivation driving these premature deaths, ‘Rather they could be traced to the psychological stress likely brought on by the shock of severe economic transition’
I recommend readers read Malaney’s short blog post in full.
Of course, Indigenous Australia and in particular remote Australia, exhibits many of the characteristics of the demographic crises in the US and the Soviet Union. Suicide levels are much higher than mainstream Australia, labour market outcomes much poorer, alcohol and drug abuse are substantial issues, health issues much worse, mental health issues are worse, overall mortality rates are much worse.
It is not my intention to closely analyse the relevant statistics, nor to undertake the fine demographic analysis which would identify which groups within Indigenous societies are most at risk and vulnerable.
Instead, I want to make an admittedly speculative, but intuitively appealing logical comparison between the causes of the demographic crises in the US, the Soviet Union and Indigenous Australia. That is to say, it seems more than plausible that the causes of deep seated inter-generational Indigenous disadvantage are to be found (if not entirely, then in substantial part) in the psychological stresses involved in the long process of transition from traditional to modern ways of life.
In particular, I want to focus on the role of expectations, and especially the role of unmet expectations in contributing to psychological stress in the Indigenous policy domain.
There are at least two types of expectations which may be relevant.
Indigenous citizens inevitably acquire and formulate expectations about the shape and form of the lives which they seek to live. These are a function of longstanding cultural and social norms, the expectations of family and peers, but also are increasingly influenced by access to social and public media, interactions with mainstream groups, corporations and individuals, and the operation of the market based economic system which is pervasive and ruthless in the rewards and penalties it allocates.
Any mismatch between individual expectations and actual outcomes is likely to cause psychological stress. While I am not aware of any research on this topic, my intuition tells me that in many cases, expectations of many Indigenous citizens (especially in remote regions) for the elements of a meaningful life will exceed actual outcomes.
A second set of expectations which operate is the increasing propensity of governments to seek to intervene, to direct specific courses of action, and to impose conditions on entitlements and program benefits. All this is reinforced by an encompassing rhetoric or ideology in favour of participation in market activities and economic development, seemingly oblivious to the ways in which markets can be tilted in favour or against particular interests and groups in society.
In fact, the vast majority of government programs are deliberately designed to influence changed behaviour of one kind or another. Sometimes the behavioural change might be justified, but often it is arguably not. But taken as a whole, the vast panoply of government programs impose an all-encompassing framework which sets up a complex array of expectations as to how Indigenous citizens are desired or even required by governments to act.
While individual programs interventions are almost always well intentioned and justifiable, and many have positive impacts of one kind or another, the totality of program interventions on Indigenous citizens has a cumulative impact which in effect signals to the Indigenous targets (and I use the term advisedly) that their life course is not acceptable, that they are expected to change, and that they are somehow defective or second-class. Many Indigenous citizens are simply overwhelmed by these expectations, unable to operate, and in effect are pushed over the precipice by the cumulative weight of amorphous mainstream expectations.
It is no coincidence that not only do we see widespread symptoms of deep psychological stress referred to above, but that in many cases, Indigenous citizens vote with their feet to reject specific program interventions even where it would seem to be counter-productive.
For example, Indigenous ‘jobseekers’ (in reality welfare recipients) are being penalised at astronomical rates in the remote income support / jobs program (cynically named the Community Development Program) for lack of compliance (with rules which are more onerous than non-remote rules applicable to mainstream citizens) even though it means reduced or delayed payments.
Parents fail to see the point of sending their children to school.
Young people are blithely oblivious to benefits of adopting safe sexual practices despite the efforts of policymakers to communicate safe sex information.
What then are the policy implications of this line of conceptual (but unproven) analysis?
First, it seems to me that there is a case for governments, and particularly the Federal Government, to step back and reconsider its overarching approach. In the light of the research results referenced above in relation to the USA and the USSR, the federal Government may wish to commission the Productivity Commission (or some other reputable research body) to undertake a similar research analysis focussed on Indigenous disadvantage.
Second, I would argue that two essential precepts which should underpin all government actions in the Indigenous policy domain are to maximise Indigenous agency and informed choice as paramount values in all indigenous policies.
Third, there is an urgent need to reassess the cumulative impact of programs on Indigenous citizens. This is no easy matter as many programs operate in the mainstream and cannot legally be denied to any relevant citizens. They can however be designed in such a way so as to minimise the likelihood that they impose unreachable expectations. Implicit in this assessment of the cumulative impact of programs is that the solution does not lie in better evaluation of individual programs (which happens to be the Government’s solution du jour to Indigenous disadvantage).
Fourth, it follows that governments may well be better off in focusing on creating frameworks within which Indigenous citizens can make their own choices. This goes to questions of existing institutional design, but might also involve the creation and establishment of new institutions. For example, there is much to be said for relying much more on incentives rather than penalties in all sorts of contexts on the premise that ‘nudging’ citizens to adopt different behaviours is likely to be more successful than mandating the new behaviour and finding that it engenders resistance and opposition.
A fifth policy implication is that governments should be extremely careful about raising expectations which they cannot deliver. The Indigenous policy domain is replete with examples of governments doing just that (think Bob Hawke’s commitment to negotiate a treaty; or the present interminable discussion about constitutional recognition).
A sixth and final implication is that policymakers need to give much greater attention to the role of expectations, both endogenous and exogenous, in shaping the Indigenous policy domain. There needs to be a greater sense of humility amongst policymakers and governments about what is achievable by external action.
But we cannot expect Indigenous agency and choice to resolve Indigenous disadvantage if the institutional framework is not a level playing field, such that reasonable Indigenous expectations are in fact not achievable. In these circumstances, dashed expectations lead to deep psychological stress, and ultimately (as has been demonstrated in the US and the USSR) to large numbers of preventable deaths.
The Federal Government recently announced its intention to appoint an Indigenous Productivity Commissioner, but has so far not made an appointment. While there has been virtually no public discussion of the proposed focus of the new Commissioner, the issues raised here would provide a good starting for her agenda.