Why are women dropping out of the workforce?

Japan, many people believe, is a country of rigid, traditional gender norms, where men work and women are homemakers. But this stereotype is passe. Despite the continued prevalence of traditional gender roles in television shows, Japanese culture has undergone a sea change — most women now have jobs.

Japan isn’t alone. In recent years, female labor force participation has been rising across almost all industrialized countries. There’s at least one big exception, though — the U.S.

The decline of women’s labor-force participation in the U.S. represents quite a reversal. At the turn of the century, American women were more likely to be in the work force than their Japanese or British counterparts; now, the opposite is true. Nor does the Great Recession appear to be the culprit — the U.S. decline started years earlier, and the recession didn’t force women out of the labor force in Japan, Germany, the U.K. or France.

Related: Women losing on workforce participation

Writing for the Peterson Institute for International Economics, economists Jason Furman and Wilson Powell III illustrate how big and important this divergence has been. They write:

Female employment rates…[are] responsible for 77 percent of the aging-adjusted difference in employment performance between the United States and other advanced economies…adjusted for aging, women had almost zero net impact on employment rates in the United States, but they raised employment rates by 2.0 percentage points in other advanced economies.

That employment difference translates into lower economic output and lower standards of living for Americans. The difference is mitigated by the fact that when people do their own housework and child care, it doesn’t get counted in gross domestic product — this “home production,” as economists call it, is mitigating the economic impact of women staying home. But the difference between the U.S. and other countries is still a concern, because it indicates that the U.S. economic system could have some kind of special dysfunction.

One benign possibility is a cultural shift — more American women might be choosing family over career, of their own free will. This is consistent with the fact that Hispanic women, who tend to have larger families and lower labor-force participation rates, now make up 18.9 percent of the population aged 25-54, as compared to 11.3 percent back in the year 2000. As Matt Bruenig of the People’s Policy Project has shown, this can account for about 43 percent of the absolute decline in women’s labor force participation. But the much bigger puzzle — the gap between the U.S. and other rich nations — remains unexplained.

The idea that American women are choosing family over work is also challenged by the decline in U.S. fertility rates:

This decline has occurred among all races and ethnicities, but has been much bigger among Hispanics. It’s theoretically possible that American women are choosing family over work, while also choosing smaller families, perhaps due to the increased costs of college, rent and child care. But the story doesn’t quite fit, especially when the increasing cultural impact of feminism is taken into account.

A more ominous possibility is that American women are being forced to choose between motherhood and careers. The U.S. is the only rich country that doesn’t guarantee some amount of paid parental leave. The U.S. government also spends less on child care and early childhood education than almost any other developed nation, and even this small amount has been shrinking in many places. In 2013, economists Francine Blau and Lawrence Kahn estimated that differences in family-friendly government policies could explain 29 percent of deterioration in U.S. female labor-force participation relative to its peers.

Another potential factor is the opioid epidemic. Women have tended to be prescribed larger doses of opioid painkillers for longer periods of time, which often leads to addiction, or to use of stronger substitute drugs like heroin. Between 1999 and 2015, female death rates from opioid-related causes rose by 850 percent — twice as big an increase as for men. Opioid addiction and the various associated health consequences almost certainly make it a lot harder to stay in the workforce.

So American women are in trouble from drugs and being abandoned by the government. Given this adversity, it’s a testament to American women’s grit and drive that even more haven’t dropped out of the workforce. The U.S. government needs to come to the rescue of the country’s women, both for the sake of the economy and — more importantly — for the sake of the citizenry. Paid parental leave should become a national policy, and child-care subsidies should go up substantially. And the opioid epidemic should be treated as a national health crisis. With a big effort, it should be possible to get American women healthy and working again.

Noah Smith is a Bloomberg Opinion columnist. He was an assistant professor of finance at Stony Brook University, and he blogs at Noahpinion. This column does not necessarily reflect the opinion of the editorial board or Bloomberg LP and its owners.

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