When Nicholas Kristof was growing up in rural Yamhill County, he would board the No. 6 school bus alongside his neighbors and friends. Now, about one-quarter of the kids who rode the bus with Kristof are dead. They’ve died from drugs and alcohol, accidents and suicides.

Kristof, now a columnist for The New York Times, explores what went wrong for his classmates and thousands of other rural Americans in his new book, “Tightrope: Americans Reaching For Hope.” The book was co-written with his wife, journalist and business consultant Sheryl WuDunn.

New York Times columnist Nicholas Kristof and Sheryl WuDunn coauthored the book "Tightrope," which tells the story of poor, rural Americans.

New York Times columnist Nicholas Kristof and Sheryl WuDunn coauthored the book “Tightrope,” which tells the story of poor, rural Americans.

Allison Frost/OPB

In their book, WuDunn and Kristof interviewed many of Kristof’s childhood friends about their lives and their struggles in rural Oregon. And they lay out how decades of United States policy have led to high rates of poverty, incarceration and addiction among Americans.

WuDunn and Kristof spoke with “Think Out Loud” host Dave Miller about their book, what they learned from their reporting in Yamhill County and the policy changes they believe could help save Americans’ lives. Here are some of the highlights from the conversation:

On why the U.S. lags behind other wealthy countries in health and success metrics:

WuDunn: It really started to change in the 1970s. We had been doing really, really well. … We were on par with all of our peer countries. … Then, in the 1970s, the economy started to struggle … and so [American leaders] started deregulation. They actually had tax breaks, tax cuts. And they took a lot of power from unions and gave it to business. They kind of overshot. Also, at that time, there was a personal narrative, a social narrative that captivated the country, is this narrative of personal responsibility. Everything is up to you. … And now we’re far behind on many metrics.

On declining life expectancy rates in the U.S.:

WuDunn: [Economists] studied the census data over a long period of time, and they discovered that what is driving a lot of the average life expectancy is deaths of despair, meaning deaths from alcohol-related diseases, overdoses, drug overdoses and suicides. Suicides are at their post-World War II high, and so clearly there’s an underlying trend that is not favorable to the United States.

Kristof: Deaths of despair. Those of the kids on the No. 6 bus. And if you were on a No. 6 bus in Canada, in Germany, almost anywhere else in the world, you did not have those outcomes.

On reducing child poverty: 

Kristof: It’s fundamentally a question of priorities. [In the United States], we accept child poverty at a rate that would not be tolerated in the rest of the world. And there was a major commission in the U. S., the National Commissions, that issued a report about a year ago that said, “OK, here’s how we can reduce child poverty by half in the U.S. It would cost $100 billion a year.” And everybody shrugged. Nobody is embracing that because apparently we’re not willing to pay $100 billion to reduce child poverty. But we are willing to pay much, much more than that for corporate tax cuts.

On why they chose to report on Kristof’s childhood home: 

Kristof: We wanted to humanize the problem. … We think the big problem in the U.S. has been the tendency to point fingers at those who fall off the tightrope and to obsess with the personal responsibility narrative. I think it does help to put human faces on these, to show them in all their complexity. But I gotta say, Sheryl and I also worried about focusing on a community that we love so much. We worried about airing Yamhill’s dirty laundry. We worried about how people we write about … would read the sections about them. We worried about how other people would read those sections and we didn’t want them to pigeonhole old friends as screw-ups who cooked meth and were obese. … [But] we wanted to tell the complex truth. And friends confided in us. And so we tried to navigate that. Our friends really trusted us with that responsibility. And we tried very hard to discharge that honorably.

To listen to the full interview with Nicholas Kristof and Sheryl WuDunn, click the play button in the audio player at the top of the page.