The United States is suffering from significant social disintegration. Social mobility is declining, as are workforce-participation rates. Drug abuse is rampant, and suicide rates have risen dramatically. Life expectancy has been dropping since 2014, the first time such a trend has appeared since World War I and the Spanish influenza epidemic a century ago.

Interpretations of causes and recommendations for remedies vary significantly, especially as one moves across the political spectrum. There is a long list of initiatives, both public and private, that have tried to address aspects of the problem — all without success. Expansions in health-care coverage have not reversed the depressing health statistics for the white working class. Improvements in educational opportunity have not reversed decades of decline in social mobility. New training schemes and income-support policies have not reversed declining workforce-participation rates. And increases in the number of non-governmental organizations working on some aspect of social breakdown have not reversed its growth.