Are living in a different environment completely and you have reported on World Affairs from all different kinds of directions in the worst tragedies on the planet but you focus on a class and oregon. Why . My mom still on a family farm in the fac place of a humanitarn crisis unfolding there. A quarter of the kids ar that we on my old number six schoolbus are now drawn from this and weve tried to process that. [inaudible] in from hepatitis he survived because he was in the Oregon State Penitentiary and we wondered for a while is this something and then we realized it is a National Problem we have depths of despair. It was kind of a microcosm to which to see that across america. You solve this through the lens of returning home and it could have been titled School Bus Number six. So many are from the friends you had growing up there and expanding from there. And you grew up in manhattan upper middle east and that is a whole different world early in the relationship you saw it on the folding over these last couple of decades. How did the lens i dont think you can get farther than manhattan. I grew up on the upper side of manhattan and it was different than the urban world and so when i first approached, i was a little bit like where these people like. It was basically like we think of what is going on right now as the tale of two americas. On the top is the party back into the bottom is where all these people are struggling trying to figure out how to work the flute. I think manhattan in many ways many of them are in the party and they dont know what is going on the word back so for me it took a while once i started learning about these people and meeting them and learning about their backgrounds and talking to them i realized they are very complicated beings. The stories we learned about their households and their backgrounds into the journey is that they took were so alarming and heartbreaking we couldnt help but say weve got to tell the rest of the world. So you use the energy of the upper deck and lower deck and your book uses another title, tightrope and some of my speeches i talk about trying to pave a solid path and here it isnt just a narrow path, but a tightrope. Guest the whole point is those in the upper middleclass and those that are above are well educated and abuse graduated from high school and college. We have a wide path ahead of us and so if we thought we pick ourselves up. But in the small towns across america in the rural areas and around america people are walking on a tightrope. But then there is no safety net. Host is a pretty bleak picture and there is a dynamic that you wrestle with about is this personal responsibility they just need to walk the tightrope that are or is it their fault they got on for the personal response ability versus collective responsibility. What have you concluded . Personal responsibility is absolutely real. I think that we can make the case that progressives like myself sometimes dont fully appreciate that personal responsibility is real. Theres nothing wrong with this narrative blaming the people that fall of the tightrope or for the catastrophes that followed. You can predict with some accuracy the outcomes of the. In the response of the conversation come if we do that with also have the conversation about the collective responsibilities to try to help the people. Host paul ryan you quote in the book says they do not determine the outcome of your life and in the book you introduced this term or youve shared this term which you are basically saying if you have collected several experiences, youre on of succeeding drop dramatically that you portray as being in poverty and increase substantially. So, explain how these adversities impact your life. A guest it is well documented by the scientists analyzed the situation. Many of us have an adverse experience. Parents get divorced. Theres a move from one state to the next that is traumatic for a child but when you start piling up six, seven, eight, even three or four, that could have a traumatic experience depending upon the age of the child is the child is between zero and five is when the brain is developing at its most rapid pace for the rest of the persons life. We think of children as very resilient but they are not as resilient as we think that in fact when there is violence and yelling and abuse that create stress and that means the hormone is coursing through the brain so if that isnt corrected the brain isnt going to develop so if we can address these issues early on and there are treatments and ways we can put them on a better course so we dont see them two decades later in poverty or drugs. It is a huge cost to society as well. When we think about america for the trajectory mentioned we think about this sequence that they can sometimes mention and its true if somebody does three things if they graduate from high school and if they get a fulltime job than they have kids only after marrying and only 2 live in poverty and it does involve an element but they also reflect a what we do. So i think they have neglected the public side were policy side of the equation. So with the experience stressors and childhood to go back to have the brain is rewired so how does that compromise . A lot of it has to do with the development of the brain architecture so the cortisol like adults it happens for a little bit and then goes away. But because the babys brain develops a rapidly during that time it is much more fragile than we think it could impair the development. Doesnt make them more susceptible to addiction or a committed relationship. Multiple effects and it shows all these things that you talk about later is more likely to suffer from things like adhd a number of elements it does make it harder for the child growing up so thats why pediatricians are so focused certainly in california with the surgeon german on Surgeon General is one of her missions. So all this cortisol what it does it prepares children for a turbulent environment and puts them on the hairtrigger fight or flight response in one consequences it makes it harder to concentrate on the blackboard because they are trained to look for potential threats. So that seems to be one pathway that impairs education and concentration. I believe in the book you say Warren Buffett talks about the over area lottery and born under different circumstances he wouldnt be a multi billionaire but because of the circumstances of his birth set the path for him to do well. So it is disturbing in so many ways the United States as a developed country seems to be doing a poor job than other democracies or republics that could have similar problems and you note that with Drinking Water and 61st and High School Enrollment and we suffer more than the average person in venezuela and the Life Expectancy so here is the United States working on these issues from the county commission how is it we are having such horrific outcomes . The one hand we have all of these Economic Statistics and the stock market is rock at high and then say we are doing really really well but to also look at other statistics and letters of the full picture so a lot of men just dropped out of the workforce and wont even be counted many are selfmedicating they dont have the confidence to jump back in. We know what is happening they are not even looking. But then look at the life expectancies statistics, that is another broader measure by which it is because of the depth and despair that we are characterized by the two economists to look at the census data and they saw really deaths related to alcoholism and Drug Overdose were at record highs suicide rate since world war ii. They dropped a little bit in 2018 but it still 67,058,000 that die from Drug Overdose so that ways on the entire nation average Life Expectancy so its pretty dramatic. We see those failures with those outcomes so why is United States not doing better job to get people onto a solid paved road . I think this is the fiftyyear erroneous course the us took it has something to do with the nixon southern strategy in 1968 to destigmatize investments in Human Capital and benefit programs on the basis africanamericans would disproportionately benefit word the to the underinvestment of Human Capital and benefits across the us and also to president reagans narrative that government can do no good and as part of the problem and business taking power of corporations coupled with the war on drugs of mass incarceration. A few of these trends came to gather so until the 1970s, the us was in line with other countries but the Life Expectancy was higher. And then since the other countries have surpassed us with underinvestment of american citizens. We need developed countries similar to our own so i only through a little bit of a thought because i see this through the lens of trying to change policy of government and what i am seeing are the institutions have been changing in ways to create power for the powerful and you touched on this in the book where you have high will divisions the wealthy have disproportionate political power which leads to rules that benefit the wealthy and if we think about America Today and the inequality we are seeing between the rich and the poor its a very high ratio compared to these other countries so is it possible our inequality and wealth is a critical system in ways to prevent us from those resources that pave the path for success . You are right inequality that self perpetuates through the mechanism of economic power turning into political power thats like the gilded age in American History and this is where progressivism followed. It took a world war. That is a little scary it took that type of intervention to put us back on the path for three decades after world war ii to have the investment and programs that lift up the middle class. Not everyone. And then to make some progress in that realm. But in order to have those policy components do we need to change the structure . We do need more enlightenment with society and they are totally being ignored partly because they point to the high gdp but with the average is going well but if jeff those walks into the room then everybody would. It doesnt make any difference to the people who are not and thats the problem but just to recognize there is a need to lift up all americans and also maybe it helps policymakers to recognize to compete against the rest of the world other countries like china and india with billions of people power dont have that people power especially we have much less if we dont lift up all americans as many as possible reaching their full potential to be productive and innovative to bring america back to number one. My parents talked about the unity coming out of world war ii how in their lifetime my mother came from extraordinary poverty and she lost her three children to the county in the middle of the Great Depression who could imagine my grandmother. Realizing a grandson might serve in the u. S. Senate but they saw much of the impact of moving forward during these years and in the mid seventies they started to stall out. So what happened in the mid seventies to drive this reversa reversal . First of all many people word attribute their past success to rugged individualism and certainly a lot of that but frankly historically there was a certain amount of government plans the reason people came to places like this where the home stead programs and electrification, the g. I. Bill of rights. So those programs invest in people and in communities help. And so essentially the root cause of things going downhill because local employers like the local factory closed down. Some new jobs had come in but they cannot get the new jobs and men in particular felt the loss of jobs not only in a monetary sense but local institutions like churches could handle the trauma people self medicated they had criminal records in the Family Structure that was very tight knit to unravel spec of the white manufacturing and then the consequences and a big portion of that was the Mortgage Program for veterans returning and i thank you are absolutely right being critical to the strength of the family because it does give structure and dignity and resources and when you are unemployed so for example one town you see some people move right away you see others dwell the Domestic Violence and alcoholism and jobs are critical. And in a lot of White Communities around the us in the 19 nineties there were a lot of comments made about africanamerican communities struggling at that time and sanctimonious talk how the problem was black culture which was the word for what we call deadbeat dads or making bad choices but they said no its about jobs leaving and he is right when they left appalachia or maine it all unfolded it wasnt culture it was jobs. You can see that very easily with the comparison and canada when they laid off the autoworkers and often by the same company you can see that was because of the financial crisis but they lost their job and they also lost their healthcare but over in canada they lost their job but not their healthcare because they have universal healthcare then the government intervened and saw the demand for other types of jobs and found out nursing had a demand so they arrange for Training Programs for the autoworkers to read train to go into the nursing field. That is not their dream job but they could get back into the working world and now they are not selfmedicating or to brett one depressed or isolating. So want to talk about the loss of jobs in the area we all might have different opinions. Because what i saw happening in the mid seventies was opening the market to chinese production and the chinese benefited from competing with americans from lower wages and lower labor standards act make things more cheaply and the glove factory said we cant compete with the chinese making gloves or maybe we can now but we will benefit and then the sales price will be the same and will make more money we have seen a lot of factories go overseas. Maybe we made a mistake to be so quick to open the market in the way we did driving this job los loss. On the one hand globalization could have been a force that we cannot prevent from happening because individual factories will make their decisions on the best return so they were going to other places like latin america or asia they wouldnt but there is competition from other countries going out on Companies Going overseas. But nonetheless we did not adjust very well it cap down inflation because cost were kept lower so those benefits were spread among 20 million americans rather than those losing their job that was felt much more intensely. But other countries also had politicalization or automation but partly because of the policies that you dont adapt quickly to job loss as a society to help the people that have been laid off you have to find your own job now but other Companies Like universal healthcare they do much better at job retraining to help the laidoff workers read train for other types of jobs. You want to touch on that . [laughter] i think a lot of us did not appreciate how we talked about Creative Destruction its great in a textbook we did appreciate those that lost their jobs in the Old Industries to self medicate and with the us prize as a whole became all the more important to make sure that we supported those that was a part of that Creative Destruction to lose their jobs and invest in their education so they could adapt to new jobs and we blew it the winners do not compensate the losers at all. I remember very well studying economics the argument was if you have a trade deficit the Exchange Rates will adjust over time. The trade deficit will adjust dont have a net loss of jobs. That turned out to be wrong the one we are slow to respond to. So with universal healthcare you mentioned in the book i talk about the four foundations you have the house in the four sides of foundation with health care and housing and education and good paying jobs when the final chapter we start to address various issues and they fall into those four categories starting with universal healthcare and unwanted pregnancies which goes back to having access to healthcare and Family Planning and why does the United States do so poorly for pregnancies versus other countries . And you have noted thats a huge impact on the success of the next generation or the structure early in life. So with a teen pregnancy the people in the 19 nineties we recognize the problem it has come down by a lot which shows we put our mind to it we actually can and then including homelessness veteran homelessness by nearly half continues to down under the Current Administration as well so we really can do very well its the matter of having political will so it is very important so it should be available to everybody because they can help america compete against the rest of the world. As i travel around rural oregon i hear people note the extension of medicaid has really helped in rural areas. For one thing it doesnt have a deductible so therefore you avoid going to the doctor in the beginning and now they can pay bills to the local clinic it has expanded in size and now can address mental health. So is the strengthening of rural healthcare something that affected or improved healthcare . Absolutely. We say they are so grateful their healthcare is paid for a friend of ours ended up dying that he was in the hospital several times before he passed away so the family was very grateful he could be in the hospital have more time with family. So those that were struggling to get help. Absolutely i dont know if that oregon didnt expand medicaid at of they made those connections but. I am starting to see that reaction and certainly the premises of the exchange the policy at the same price even with a preexisting condition are highly valued factors. We make the case the politics may be changing but we argue that as some of the social problems have become associated with workingclass whites it has made it easier to address that is hypocritical and more compassionate as well so on issues like medicaid for exampl example, the politics may be it is socially conservative and economically more liberal. Absolutely people use to say im just trying to get to 65 and stay alive to get on medicare. I dont hear that anymore. The rural parts of oregon the Oregon Health plan has had the biggest impact i thank you would have a hard time to pry that out of their hands because it has been a very positive impact in healthcare jobs is a significant contribution to communities as well but what i hear about now is the high cost of drugs and why is it a situation if youre not on the Oregon Health plan is so stressful. How do i get healthcare my spouse has it but im not on the plan but then we were dropped. What about my kids . So the complexity of our system and i hear people say the other challenge to hear this throughout rural oregon is wider have to fight with the Insurance Company . So maybe you are struggling with cancer were trying to figure out how to play pay the deductible and shouldnt this be covered . Healthcare is one piece 80 percent of americans are ready to see shut the same fair price as any other developed country but congress cannot get it done. The lobby can exercise political power with the super majority in the senate that means a very fundamental problem. So now lets go from healthcare to education to universal High School Graduation how can we do better . So we are used to being number one in high school and how we become number one in terms of the economy. But over the years and that they use different data but right now only one of seven or one in six graduate high school and that is appalling we could require kids to stay in school until the age of 18 and say if you want a drivers license you have to be enrolled in high school. There is no one Silver Bullet but those that you have to get in many different ways just like car driving safety we implemented seatbelts we didnt do seatbelts at all but that was very dangerous and we added a dashboard but it was that narrative that equivalent to say those needles inside the dashboard the what we need to do instead is have the Safety Measures nudging the kids to stay in school. You mentioned the structure and we learned a lot about that. And in the book you all touch on how Early Education has a huge Multiplier Effect some are seven times the return of the investment we have seen studies of magnitude higher like 42 times how more taxes are paid and so forth. So when we see that laid out like that and to say we will invest a lot more on Early Childhood. Absolutely that is the highest return of investment available in the us. And they cant afford Early Childhood and i would argue the bigger reason to do it but there is a huge benefit to the parents to provide the ability to work. When we were kids there were two of us we can barely figure out how does a single parent do it . And then you mention keeping kids in high school. Our high school was expelling kids to smoke so i went to the administration and i said is this the right thing to do . They will not get a high school education. There are some high schools in the area that decided to have a smoking room for students is better to keep them in school and graduating if they wouldnt stop smoking. As an interesting thing and went around a bunch of high schools. To help keep kids engaged in school. When i was in my bluecollar school growing up in have to pay anything for the sports speech, tennis, zero fees now my kids have graduated from this on the same school and everything has a fee attached which really reduces student engagement. Get rid of the fees to help students stay in school. That is a real issue. And administrators are caught between we know the czar the kids we want to keep in school on the other hand that is disrupting entirely she cannot teach 20 other kids is that good as well . If we dont charge then how will we pay for these other teachers for what they need to get and pay them for their time . Lets quickly touch on to other areas you talk about in the book for the housing factor so how do we improve in those two areas . The cost especially for children are enormous. And homelessness we could reduce veteran homelessness by half between 2010 and 2016 but that was unconscionable but recently founded unconscionable so on any given night we could eliminate that with that combination of vouchers or priorities. And then you say raise my taxes. And they are homeless because of that ovarian lottery you mentioned earlier. And then to get these people house. And those mortgage deductions. And those that pay for millions of dollars for a condo in the middle of new york city and they are getting the subsidy there. And even with the tax code the tax code has all kinds of subsidies to the very welloff and to see the impact and for the need to have homes a stable home because i never had a great place to be in the base with their parents and then to contribute more in taxes. And lets make that happen and with those for areas of health and housing and jobs so how should we look at that . So we could reduce Child Poverty beginning in 1999 basically payment and that Michael Bennett cosponsored and along those lines the National Academy suggested that and other strategies would reach the us with a Million Dollars per year and then to reverberate that enables them to have a child. And actually congress was called individual Development Accounts and they involved a payment to a savings account where the savings were put in. And with that habitat of humanity with rental and Affordable Housing so how do people get a stake in this . So i started the Investment Program and then we publicize that a lot and with the poverty and middleclass and with that conversation and explore the challenges that we have of the struggling role community i hear there may be a film associated with this book . And that we hope will be on tv in the fall. And examining the challenges. I do think jobs are at the heart of so much. That seems to be a common theme and policymakers can be very influential. Your examination of thes issues that reminded me very much of Robert Kennedy going to appalachia that here in america such poverty and stretch on stresses and to be on par in cant we do better and that help to launch thinking to make the country work better for all americans. So thank you for exploring this it has been a pleasure that we are in the middle of a policy discussion as a president ial Campaign Year well done. Thank you very much [applause] hello there guess who i young . [laughter] this is tara westover. Just get out of the hole you are living if you have not