Different directions and some of the worst tragedies on the planet, but you chose to really focus on a small town in oregon. Why . We were running around the world covering humanitarian crises and then we would periodically go back to my beloved hometown where my mom is still on the family farm and we saw a humanitarian crisis unfolding there. A quarter of the kids on my old Number Six School bus are now gone from drugs and alcohol and suicide and carolyn i tried to process that. The guys who got on the bus right after me were the map kid kids. Nathan and keelan and their sister regina, smart, talented kids. One died in a house fire passed out drunk, another blew himself up cooking math and regina died from hepatitis from shooting up. So for a while we wondered is there something about my bus, about yamhill and then we realize this is a National Problem that we have been in despair and the Life Expectancy has been falling for three years of a row and its a microcosm to see that panic and champagne across america. You saw this through the lens of visiting home and i think this could be entitled school bus six. So many memories were drawn from your time there and you grew up in manhattan on the Upper West Side and thats a whole different world and early in your relationship you got to see yamhill and you saw it unfolding over these past couple decades. How did the lens from what you saw it differ from what nick was seeing. First of all i dont think you can get further from yamhill then manhattan. I grew up on the Upper West Side and it really is smack in the urban world. So when i first approached yamhill i was a little bit, what are these people like. [inaudible] it was hard the first time she came on the farm. But it was basically listen to whats going on right now is a tale of two americas. On the top deck of the vote theres a party going on. On the bottom is where all these people are struggling trying to figure out what to do and how to stay afloat. I think manhattan, in many ways, the people of manhattan, many of them are in that party and they just dont know whats going on in the lower deck. For me it took a while, once i started learning these people and meeting them in learning about their backgrounds and talking to them, i realize they are very complicated human beings and the stories that we learned about their household in the background and the journeys they took, really was so alarming and so touching and heartbreaking that we just couldnt help. [inaudible] so you moved between the upper deck and the lower deck and whats going on below and your book uses another analogy, the tight rope. In some of my speeches and in congress i talk about trying to pave a wide path for families to thrive, and here its not just a narrow path, but a tight rope. What are you conveying by that. Absolutely. The whole point is that some of those of us in the uppermiddleclass and above who are very well educated, at least graduated from high school and some college, we have a path, fairly wide path ahead of us. So if we fall we can pick ourselves up, but these people at yamhill in the small towns around america and the rural areas around america, people are walking on a tight rope and one missing they fall. Theres no safety net. And their falling into a chaz him that you describe in this book as involving drugs, alcohol, domestic violence, suicide and its a pretty bleak picture. There is a dynamic that you wrestle with about well, is this personal responsibility, do we need to walk that tight rope better or is that there they got on the tight rout rope instead of a nice walking path so personal responsibility versus collective responsibility. What have you concluded. So, look, personal responsibility is absolutely real. I think we can make the case that progressives like myself sometimes dont fully appreciate that personal responsibility is real, that one has to give agency to people, but i think that over the last 50 years we have vastly overdone it and become kind of obsessed with this personal responsibility narrative, blaming the people who fall off the tight rope for the catastrophes that follow. At this point you can predict, with some accuracy, the outcomes of a newborn infant, and when you can do that, its not because that infant is making bad choices or showing irresponsibility, and so, look, we can have a personal responsibility conversation but if we do that lets have a conversation about our collective responsibility to try and help those who were on my bus number six. There are so many ways that can help them and benefit society. Paul ryan who you quote in the book says in our country the conditions of your birth do not determine the outcome of your life. In the book you introduced this term, or you share this term adverse childhood experiences, and what youre basically saying is if you have several adverse childhood experiences, your odds of succeeding drop dramatically, which you portray as the odds of being in poverty increased substantially, so explain how these childhood adversities really impact your personal life. Its pretty well documented by scientists who have analyzed the situation so many of us have had adverse childhood experience. Parents get divorced, theres a big move things that are traumatic for a child but when you pile up six, seven, eight, that can have a Significant Impact on a child specifically if they are between the age of zero and five. That is when the brain is developing at its most rapid pace for the rest of that persons life. Thats when our brain develops quickly. We think of children as being resilient, but you know something theyre not as resilient as we think. In fact, when there is stress in the house and violence and yelling and abuse, that create stress in the baby, and that means the cortisol hormone is coursing through that brain, and as that brain is growing, this cortisol impacts the develop of the brain architecture for this little baby so if this is not corrected, that babys brain is not going to develop properly. If we can address these issues early on, and there are treatments, there are ways using therapy, counseling, we can actually put that baby, that young child onto a better course so that we dont see them two decades later in poverty or in drugs or dropping out of college. Or high school even. Its not just that. Its also not just the psychological trauma and troubles, its also health so, in fact, people who have stacked up aces are much more likely, later off in life, to have heart disease, chronic disease like diabetes. That is the huge cost on society as well. [inaudible] in thinking about the personal responsibility narrative or the trajectory that carol mentions, usually we talk about the success sequence, and its true, if somebody does three things they largely o avoid poverty. If they graduate from high school, get a fulltime job and then they have kids only after marrying and only 2 live in poverty if. If they do none of those. [inaudible] clearly those involve an element of bad choices, personal responsibility, but they also reflect what we as a society do. One reason, so American Kids have sex at the same rate as european but have babies three times more often because we dont make comprehensive Sex Education available and dont make Birth Control available. Our High School Graduation rates are substantially lower than those in many other countries because we dont place a premium on it. There are certainly ways we can shift this. Its not because American Kids are dumber than others are less diligent, and so, i think this obsession has neglected the public side of the equation, the policy side of the equation. So the odds are stacked against folks who are raised with these various stressors in childhood. I wanted to go back for just a moment to your conversation about how the brain is actually rewired. In what ways is that rewiring compromised when successes altered. A lot of it has to do with the development of the brain architecture. The cortisol, the stressor hormone, most of us as adults it happens for a little bit, then it goes away, it flows right through us but because the babys brain is developing rapidly at that time, and also because its so long, its much more fragile than we think that it really does impair the development. Does it make those children more susceptible to addiction, less able to have, if you will, a committed relationship or just multiple effects. Multiple effects, and they do show later on that all of these things that you talk about are also more likely to not graduate from high school. More likely to have things like adhd. A number of ailments that just make it harder for the child growing up to actually succeed so thats why pediatricians are so focused on trying to address aces and the new Surgeon General in california, thats. [inaudible] is there evidence from the university of oregon that all this cortisone. [inaudible] on the blackboard because they are being trained to look for potential threats behind them, and so that seems to be one pathway in which this cortisol impairs education and concentration. I believe that you note that warren buffett, the ovarian lottery and ive heard them speak if he had been born under different circumstances he wouldnt be a multibillionaire both because of the infrastructure that others established and because of the circumstances of his birth that is a path for him to do well so, its disturbing that in so many ways the United States, as a developed country, seems to be doing a poor job than other democracies, other republics that could have similar problems, and you note that with Drinking Water and Child Mortality and 61st on High School Enrollment and that we suffered more stress than the average person in venezuela and our Life Expectancy is dropping so heres the United States with our Congress Working on these issue, our state legislator and county commissioner is working on these issues. How is it that were having such terrific outcome. It is a tale of america. So on one hand we have all these Economic Statistics showing us gdp is doing well, stock market is rocket high so we look at these measures, inflation is low and we think were doing really, really well, but then if you actually peel behind the statistics and also look at other broader statistics you can see thats not the full picture. A lot of men, for instance have dropped out of the workforce so they wont even be counted. These men may be selfmedicating, they could be out of a job for a while, they dont have the confidence to jump back in and we interviewed a number of them in yamhill. You know that is whats happening. Theyre not even looking, and so theyre not going to be counted as looking. Then if you look at the Life Expectancy statistics, as nick mentioned, that is another broader measure, its because of these depths of despair which are three types of despair that are characterized by two economists at princeton and they looked at the census data and they saw that the depths of despair were related to alcoholism and Drug Overdose and suicide, record high suicide rates since world war ii, and yes they dropped a little bit, the Drug Overdose deaths dropped a little bit in 2018 so thats a good sign, but is still 58000 people who died from Drug Overdose. Thats not a small figure. That weighs on the entire nation average Life Expectancy. It was pretty dramatic. So we are seeing a very dramatic. [inaudible] to pave those good outcomes. Why is the United States not doing a better job in getting the ball off the tight. Getting people onto a solid paved road. I think this is really a 50 year erroneous course that the u. S. Took. I think it has something to do with nixon strategy in 1968 and a tendency to stigmatize investments in Human Capital and in benefit programs on the basis that there would be africanamericans who disproportionately benefit. I think that leads to underinvestment in Human Capital and in benefits across the u. S. I think it also relates to president reagans narrative where government can do no good and is invariably part of the problem, and glorification of business taking of power from labor unions, corporations, coupled with the war on drugs, mass incarceration. I think a few of these trends came together and so until the 1970s, the u. S. Was essentially in line with other countries. Our Life Expectancy was actually higher than the median, and then since 1970s, the other countries have surpassed us and i think the root cause is an underinvestment in american citizens. Developed countries similar to our own, and i only throw out a little bit of a thought because i see this through the lens of trying to change policy and government. What i am seeing that her institutions have been changing in ways that create power for the powerful. You do touch on this in your book. You know that one point that when you have high wealth divisions, the wealthy then have disproportionate political power which leads to rules that benefit the wealthy. Now if we think about America Today and the inequality that we are seeing between the rich and the poor, we are at a very high racial compared to these other countries. Is it possible that our inequality and wealth is influencing the clinical system in ways that is preventing us, if you will, investing in resources of fundamentals that paved the path for success were ordinary families. I think thats exactly right. You create this inequality that in itself perpetuates through the mechanism of economic power turning into political power. I think its a little bit similar to what happened in the golden age in american history, and i hope so because of course then aggressive ism followed. It took a world war and thats a little scary that it took that type of intervention to put us back on a path where really for the three decades after world war ii we had an investment in programs that really did lift up the middle class, not everyone, discrimination was still rampant in other sectors but we made some progress in that realm as well. In order to implement some of the various policy proposals that we will get to in a moment, do we need to change the structure of political power . While i do think that we need more enlightenment when it comes to the segment of society, and i think they are being totally ignored him apparently because everybody can point to the high gdp and theres no need to change anything because on average everything is going well, but if jeff walks into a room of a hundred people, everyone will have a higher level of wealth. [laughter] it doesnt make any different to the people who are not jeff. Thats the problem, just recognizing that there is this need to lift up all americans, and i think also its really important that maybe it helps policymakers to recognize that if the u. S. Wants to compete against the rest of the world, other countries with the billion plus people in power, we dont have that people power, especially we have much lefless if we dont try to lift up all americans and have as many as possible reaching their full potential to be productive and innovative and really bring america back to number one. I know my parents really talked about the sense of unity coming out of world war ii and they relayed how, in their lifetime they experienced this great leap forward. My mother came from extraordinary level of poverty. Her mother with her first three children, loss of three children to the county in the middle of the great depression, who could imagine my grandmother realizing that a grandson might serve in the u. S. Senate. Extraordinary change for both sides of the family. You describe in this book how the community saw much of this impact of moving forward during those years and how in roughly the mid 70s started to stall out and then decline. What happened in the mid 70s that started to drive this reversal. First of all, i think many people and probably in your hometown would attribute their past success to rugged individualism and certainly a lot of that, but frankly, historically, it was also a certain amount of brilliant government plans, the reason people came to places like yamhill was the homestead programs. Then places like that were transformed. The g. I. Bill of rights, likewise so i think those programs to invest in people and communities certainly helped. When things, potentially the root cause of things going downhill was good jobs going away. Biggest local employer in yamhill, greater yamhill area was a glove factory. It closed down and there were some new jobs that came in but the people that worked at the glove factory were not able to get those new jobs. Men in particular felt the loss of jobs not only in monetary sense but psychologically as well. Local institutions like churches were not able to handle the trauma, people self medicated, they got criminal records which made them less employable and less marriageable, Family Structure collapsed quite quickly and it unraveled very quickly. So we have the white manufacturing, we had gloves and we had the consequences you mentioned, the bill of rights and the Mortgage Program for veterans returning and behavin able to buy a house, have equity in savings. I think youre absolutely right about jobs being critical to the strength of the family because it does give structure, it gives dignity and it gives resources. When you are unemployed, bad things start to happen. Weve seen this in towns across oregon when for example a lumber town loses its sawmill, you see some people move right away. You see others who dwell in domestic violence, alcoholism, drug use increases. So jobs are critical. I think in yamhill and probably a lot of communities in the u. S. Back in the 1990s, there were a lot of comments made about africanamerican communities that were struggling at that time and there was a lot of sanctimonious talk about how the problem was black culture which was a byword for what we call deadbeat dad or people making bad choices, et cetera. Meanwhile they said no its about jobs leaving. He was exactly right.