Is It Better to Be Poor in Bangladesh or the Mississippi Delta?

Angus Deaton studies the grand questions not just of economics but of life. What makes people happy? How should we measure well-being? Should countries give foreign aid? What can and should experiments do? Is inequality increasing or decreasing? Is the world getting better or worse?

Better, he believes, truly better. But not everywhere or for everyone. This week, in a speech at a conference held by the National Association for Business Economics, Deaton, the Nobel laureate and emeritus Princeton economist, pointed out that inequality among countries is decreasing, while inequality within countries is increasing. China and India are making dramatic economic improvements, while parts of sub-Saharan Africa are seeing much more modest gains. In developed countries, the rich have gotten much richer while the middle class has shriveled. A study he coauthored with the famed Princeton economist Anne Case highlights one particularly dire outcome: Mortality is actually increasing for middle-aged white Americans, due in no small part to overdoses and suicides—so-called “deaths of despair.” (Case also happens to be Deaton’s wife. More on that later.)

Deaton sat down with me after his speech. We talked about whether poor people are better off here or in low-income countries, the moral ambiguities of companies making money off of Medicaid-financed OxyContin prescriptions, which is the nicest conservative think tank in Washington, what is going on with white people and mortality, and the charms of former-President Obama. The transcript below has been edited for concision and clarity.

In your speech, you said