YAMHILL, Ore. Chaos reigned daily on the No. 6 school bus, with working-class boys and girls flirting and gossiping and dreaming, brimming with mischief, bravado and optimism. Nick rode it every day in the 1970s with neighbors here in rural Oregon, neighbors like Farlan, Zealan, Rogena, Nathan and Keylan Knapp.

They were bright, rambunctious, upwardly mobile youngsters whose father had a good job installing pipes. The Knapps were thrilled to have just bought their own home, and everyone oohed and aahed when Farlan received a Ford Mustang for his 16th birthday.

Yet today about one-quarter of the children on that No. 6 bus are dead, mostly from drugs, suicide, alcohol or reckless accidents. Of the five Knapp kids who had once been so cheery, Farlan died of liver failure from drink and drugs, Zealan burned to death in a house fire while passed out drunk, Rogena died from hepatitis linked to drug use and Nathan blew himself up cooking meth. Keylan survived partly because he spent 13 years in a state penitentiary.

Among other kids on the bus, Mike died from suicide, Steve from the aftermath of a motorcycle accident, Cindy from depression and a heart attack, Jeff from a daredevil car crash, Billy from diabetes in prison, Kevin from obesity-related ailments, Tim from a construction accident, Sue from undetermined causes. And then theres Chris, who is presumed dead after years of alcoholism and homelessness. At least one more is in prison, and another is homeless.

We Americans are locked in political combat and focused on President Trump, but there is a cancer gnawing at the nation that predates Trump and is larger than him. Suicides are at their highest rate since World War II; one child in seven is living with a parent suffering from substance abuse; a baby is born every 15 minutes after prenatal exposure to opioids; America is slipping as a great power.

We have deep structural problems that have been a half century in the making, under both political parties, and that are often transmitted from generation to generation. Only in America has life expectancy now fallen three years in a row, for the first time in a century, because of deaths of despair.

The meaningfulness of the working-class life seems to have evaporated, Angus Deaton, the Nobel Prize-winning economist, told us. The economy just seems to have stopped delivering for these people. Deaton and the economist Anne Case, who is also his wife, coined the term deaths of despair to describe the surge of mortality from alcohol, drugs and suicide.

The kids on the No. 6 bus rode into a cataclysm as working-class communities disintegrated across America because of lost jobs, broken families, gloom and failed policies. The suffering was invisible to affluent Americans, but the consequences are now evident to all: The survivors mostly voted for Trump, some in hopes that he would rescue them, but under him the number of children without health insurance has risen by more than 400,000.

The stock market is near record highs, but working-class Americans (often defined as those without college degrees) continue to struggle. If youre only a high school graduate, or worse, a dropout, work no longer pays. If the federal minimum wage in 1968 had kept up with inflation and productivity, it would now be $22 an hour. Instead, its $7.25.

We were foreign correspondents together for many years, periodically covering humanitarian crises in distant countries. Then we would return to the Kristof family farm in Yamhill and see a humanitarian crisis unfolding in a community we loved and a similar unraveling was happening in towns across the country. This was not one towns problem, but a crisis in the American system.

Im a capitalist, and even I think capitalism is broken, says Ray Dalio, the founder of Bridgewater, the worlds largest hedge fund.

Even in this presidential campaign, the unraveling of working-class communities receives little attention. There is talk about the middle class, but very little about the working class; we discuss college access but not the one in seven children who dont graduate from high school. America is like a boat that is half-capsized, but those partying above water seem oblivious.

We have to stop being obsessed over impeachment and start actually digging in and solving the problems that got Donald Trump elected in the first place, Andrew Yang argued in the last Democratic presidential debate. Whatever you think of Yang as a candidate, on this he is dead right: We have to treat Americas cancer.

In some ways, the situation is worsening, because families have imploded under the pressure of drug and alcohol abuse, and children are growing up in desperate circumstances. One of our dearest friends in Yamhill, Clayton Green, a brilliant mechanic who was three years behind Nick in school, died last January, leaving five grandchildren and all have been removed from their parents by the state for their protection. A local school official sighs that some children are feral.

Farlan, the oldest of the Knapp children, was in Nicks grade. A talented woodworker, he dreamed of opening a business called Farlans Far Out Fantastic Freaky Furniture. But Farlan ended up dropping out of school after the ninth grade.

Although he never took high school chemistry, Farlan became a first-rate chemist: He was one of the first people in the Yamhill area to cook meth. For a time he was a successful entrepreneur known for his high quality merchandise. This is what I was made for, he once announced with quiet pride. But he abused his own drugs and by his 40s was gaunt and frail.

In some ways, he was a great dad, for he loved his two daughters, Amber and Andrea, and they idolized him. But theirs was not an optimal upbringing: In one of Ambers baby pictures, theres a plate of cocaine in the background.

Farlan died of liver failure in 2009, just after his 51st birthday, and his death devastated both daughters. Andrea, who was smart, talented, gorgeous and entrepreneurial, ran her own real estate business but accelerated her drinking after her dad died. She drank herself to death, her uncle Keylan told us. She was buried in 2013 at the age of 29.

In the 1970s and 80s it was common to hear derogatory suggestions that the forces ripping apart African-American communities were rooted in black culture. The idea was that deadbeat dads, self-destructive drug abuse and family breakdown were the fundamental causes, and that all people needed to do was show personal responsibility.

A Harvard sociologist, William Julius Wilson, countered that the true underlying problem was lost jobs, and he turned out to be right. When good jobs left white towns like Yamhill a couple of decades later because of globalization and automation, the same pathologies unfolded there. Men in particular felt the loss not only of income but also of dignity that accompanied a good job. Lonely and troubled, they self-medicated with alcohol or drugs, and they accumulated criminal records that left them less employable and less marriageable. Family structure collapsed.

It would be easy but too simplistic to blame just automation and lost jobs: The problems are also rooted in disastrous policy choices over 50 years. The United States wrested power from labor and gave it to business, and it suppressed wages and cut taxes rather than invest in human capital, as our peer countries did. As other countries embraced universal health care, we did not; several counties in the United States have life expectancies shorter than those in Cambodia or Bangladesh.

One consequence is that the bottom end of Americas labor force is not very productive, in ways that reduce our countrys competitiveness. A low-end worker may not have a high school diploma and is often barely literate or numerate while also struggling with a dependency; more than seven million Americans also have suspended drivers licenses for failing to pay child support or court-related debt, meaning that they may not reliably show up at work.

Americans also bought into a misconceived personal responsibility narrative that blamed people for being poor. Its true, of course, that personal responsibility matters: People we spoke to often acknowledged engaging in self-destructive behaviors. But when you can predict wretched outcomes based on the ZIP code where a child is born, the problem is not bad choices the infant is making. If were going to obsess about personal responsibility, lets also have a conversation about social responsibility.

Why did deaths of despair claim Farlan, Zealan, Nathan, Rogena and so many others? We see three important factors.

First, well-paying jobs disappeared, partly because of technology and globalization but also because of political pressure on unions and a general redistribution of power toward the wealthy and corporations.

Second, there was an explosion of drugs oxycodone, meth, heroin, crack cocaine and fentanyl aggravated by the reckless marketing of prescription painkillers by pharmaceutical companies.

Third, the war on drugs sent fathers and mothers to jail, shattering families.

Theres plenty of blame to go around. Both political parties embraced mass incarceration and the war on drugs, which was particularly devastating for black Americans, and ignored an education system that often consigned the poor especially children of color to failing schools. Since 1988, American schools have become increasingly segregated by race, and kids in poor districts perform on average four grade levels behind those in rich districts.

Farlans daughter Amber seemed to be the member of the Knapp family most poised for success. She was the first Knapp ever to graduate from high school, and then she took a job at a telecommunications company, managing databases and training staff members to use computer systems. We were struck by her intellect and interpersonal skills; it was easy to imagine her as a lawyer or a business executive.

PowerPoint presentations and Excel and pivot charts and matrix analytics, thats what I like to do, she told us. She married and had three children, and for a time was thriving.

Then in grief after her father and sister died, she imploded. A doctor had prescribed medications like Xanax, and she became dependent on them. After running out of them, she began smoking meth for the first time when she was 32.

I was dead set against it my whole life, she remembered. I hated it. Id seen what it did to everybody. My dad was a junkie who cooked meth and lost everything. You would think that was enough. It wasnt. She bounced in and out of jail and lost her kids.

Amber knew she had blown it, but she was determined to recover her life and her children. We had hoped that Amber would claw her way back, proof that it is possible to escape the messiness of the Knapp family story and build a successful life. We texted Amber a few times to arrange to get photos of Farlan, and then she stopped replying to our texts. Finally, her daughter responded: Amber was back in jail.

Yet its not hopeless. America is polarized with ferocious arguments about social issues, but we should be able to agree on what doesnt work: neglect and underinvestment in children. Heres what does work.

Job training and retraining give people dignity as well as an economic lifeline. Such jobs programs are common in other countries.

For instance, autoworkers were laid off during the 2008-9 economic crisis both in Detroit and across the Canadian border in nearby Windsor, Ontario. As the scholar Victor Tan Chen has showed, the two countries responded differently. The United States focused on money, providing extended unemployment benefits. Canada emphasized job retraining, rapidly steering workers into new jobs in fields like health care, and Canadian workers also did not have to worry about losing health insurance.

Canadas approach succeeded. The focus on job placement meant that Canadian workers were ushered more quickly back into workaday society and thus today seem less entangled in drugs and family breakdown.

Another successful strategy is investing not just in prisons but also in human capital to keep people out of prisons. The highest-return investments available in America may be in early education for disadvantaged children, but there are also valuable interventions available for adolescents and adults. We attended a thrilling graduation in Tulsa, Okla., for 17 women completing an impressive local drug treatment program called Women in Recovery.

The graduates had an average of 15 years of addiction each, and all were on probation after committing crimes. Yet they had quit drugs and started jobs, and 300 people in the audience including police officers who had arrested them and judges who had sentenced them gave the women a standing ovation. The state attorney general served as the commencement speaker and called them heroes, drawing tearful smiles from women more accustomed to being called junkies or whores.

I thought wed be planning a funeral instead, said one audience member whose younger sister had started using meth at age 12 and was now graduating at 35. Women in Recovery has a recidivism rate after three years of only 4 percent, and consequently has saved Oklahoma $70 million in prison spending, according to the George Kaiser Family Foundation.

Bravo for philanthropy, but the United States would never build interstate highways through volunteers and donations, and we cant build a national preschool program or a national drug recovery program with private money. We need the government to step up and jump-start nationwide programs in early childhood education, job retraining, drug treatment and more.

For individuals trying to break an addiction, a first step is to face up to the problem and thats what America should do as well. Our own reporting in the past focused on foreigners, affording us an emotional distance, while this time we spoke with old friends and had no armor. It has been wrenching to see them struggle. But ultimately we saw pathways forward that leave us hopeful.

One of our dear friends in Yamhill was Rick (Ricochet) Goff, who was part Indian and never had a chance: His mom died when he was 5 and his dad was, as he put it, a professional drunk who abandoned the family. Ricochet was a whiz at solving puzzles and so dependable a friend that he would lend pals money even when he couldnt afford medicine for himself. We deeply felt Ricochets loss when he died four years ago, and we also worried about his adult son, Drew, who is smart and charismatic but had been messing with drugs since he was 12.

Drews son, Ashtyn, was born with drugs in his system, and we feared that the cycle of distress was now being passed on to the next generation. We exchanged letters with Drew while he was in prison but lost touch.

Then, when we were visiting a drug-treatment program in Oregon called Provoking Hope, a young man bounded over to us. Its me, Drew, he said.

We have been close with Drew since, and he fills us with optimism. With the help of Provoking Hope, Drew will soon celebrate two years free of drugs, and he holds a responsible job at the front desk of a hotel. He has custody of Ashtyn and is now an outstanding dad, constantly speaking to him and playing with him. Drew still has a tempestuous side, and occasionally he has some rash impulse but then he thinks of Ashtyn and reins himself in.

Im a work in progress, he told us. The old me wants to act out, and I wont allow that.

Drew keeps moving forward, and we believe hes going to thrive along with Ashtyn, breaking the cycle that had enmeshed his family for generations. With support and balance, this can be done if we as a society are willing to offer help, not just handcuffs.

Its a tightrope Im walking on, Drew said. And sometimes it seems to be made of fishing line.

Nicholas Kristof is an Opinion columnist. Sheryl WuDunn is a business consultant. Their book, Tightrope: Americans Reaching for Hope, will be published Jan. 14.

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Who Killed the Knapp Family? - The New York Times