Over the past three decades, Nicholas Kristof and Sheryl WuDunn have ticked off a few accomplishments. The husband-and-wife journalists have written five books, won a Pulitzer, and raised three kids. It’s not a bad return for two people who have dedicated much of their lives to turning a lens on those less fortunate.

In their latest book, Tightrope, WuDunn and Kristof tackle familiar issues, if in a less familiar place. Known for exposing the harsh realities of life in far-flung locales, the authors’ focus here is on the plight of working class Americans. The statistics that kick off the book put that plight into grim relief. Life expectancy in America today has fallen for three years in a row. Suicides are at a 70-year high. In 2017, more than 70,000 people died from drug overdoses––a figure that is rising.

These are shocking numbers for a country that is still one of the wealthiest in the world. That paradox is not lost on the authors. Subtitled Americans Reaching for Hope, the book explores what Kristof calls “a level of staggering suffering” across the country that many people “have been largely oblivious to.” He pauses. “The country, as a whole, is sick.”

Kristof and WuDunn, both 60, are talking to me over Skype from the home they share in Westchester County, N.Y. He has a head of scruffy brown hair and wears a Villanova sweatshirt and black-framed glasses with the neck strap. She also wears a sweatshirt, her shiny black hair held up in a loose ponytail.

For WuDunn, Tightrope offered the couple the chance to use their experience as foreign correspondents to report on the alarming state of affairs at home. It’s experience they have garnered over decades and continents.

The two met in Los Angeles in the summer of 1986, introduced by friends. But dating, as Kristof explains, was “complicated.” The would-be lovebirds were rival journalists; Kristof worked for the New York Times covering business, while WuDunn was on the same beat for the Wall Street Journal. Although their work lives prevented them from dis- cussing the office, it didn’t prevent their courtship.

They wed in 1988 and moved to China in 1989. At that point, both were working for the Times—Kristof as Beijing bureau chief and WuDunn as a correspondent. From China, they covered the Tiananmen Square massacre, and their reporting won them the 1990 Pulitzer Prize in journalism. (It was the first Pulitzer in journalism awarded to a married couple, and WuDunn was the first Asian-American to win a Pulitzer in journalism.)

In 1993 the couple decided to leave China. Kristof says they were “being tailed everywhere” and were increasingly worried that “state security would find and imprison our sources.” They took an assignment in Tokyo, and in Japan they co-wrote their first book, China Wakes: The Struggle for the Soul of a Rising Power.

Kristof is best known, arguably, for his long-standing op-ed column in the New York Times. WuDunn’s career path has been more of a winding one. She didn’t stay in journalism for the long haul; she had worked in banking earlier in her career and in 2007 returned to the field, taking a job at Goldman Sachs. She currently works at an investment firm in New York City.

Throughout all of their job changes and relocations, Kristof and WuDunn’s work as authors has remained a constant. They have continued to write books together, focusing on human rights issues across the globe. And it’s in their reporting for these books that their different backgrounds have served them so well.

Kristof has called himself a “farm boy from Oregon.” WuDunn grew up a third-generation Chinese-American on the Upper West Side. These disparate experiences likely influence their different approaches in the field; he tends to focus on the personal, while she often thinks about what’s happening behind the scenes, especially as it relates to finances. She says she asks herself, “How is this person making money? How is their job working out?”

For Tightrope, Kristof focused largely on talking to people from his hometown of Yamhill, Ore. WuDunn talked to many of the book’s subjects from other parts of the country. They were also taken aback by different things. He was overwhelmed by the everyday hardships he saw, while she was absorbed with her subjects’ lack of solid job opportunities.

When there are no jobs, problems become compounded, WuDunn says. This issue, in part, inspired the book’s title; so many people they interviewed, WuDunn says, felt their life “is like a tightrope,” because if they have “one miss, they’re tumbling into the abyss.”

For Kristof, reporting on the fates of those in his hometown proved difficult. “I hadn’t appreciated just how much the social fabric had come apart,” he says. He knew, for example, that his friend Mary Mayor, whom he profiles in the book, was having a tough time. He had no idea, though, that she had been homeless.

Mayor’s problems speak to larger issues facing working-class Americans. And, as Kristof believes, “the disintegration of the working class is the central problem that America faces.” Yamhill, he says, offers “a microcosm of the problem.”

So what’s happened in Yamhill? “Jobs went away, people lost their dignity, they self-medicated, families fell apart,” Kristof says. “There are huge common threads there.”

Of course, not everyone in Yamhill has struggled equally—some, who the authors dub “escape artists,” managed to get out. Kristof largely credits the military for offering an alternate path. Even accounting for deaths during service, he tells me, “mortality rates for those who stayed behind were much higher than for those who went to the military.”

It’s statistics like this one, which seems so unlikely in America, that are a specialty of the authors. Beth Macy, author of Dopesick, a 2018 bestseller about the opioid epidemic, says Kristof and WuDunn are “pros at making us care about the marginalized in other parts of the world.” For this reason, Macy is hopeful that Tightrope will make more Americans pay attention to what’s happening to their fellow citizens.

“We see the pain and suffering and poverty in the developing world,” WuDunn says. But “we’re the wealthiest nation on the globe, and it’s happening here.”

“If you’re in a refugee camp in South Sudan, the world doesn’t care about you,” Kristof says. “If you’re Clayton Green, the fourth kid in your family to die young after a life of drug abuse, the world, like- wise, doesn’t really care about you.”

And even though Green is now memorialized in Tightrope, Kristof still worries about whether anyone will care. He still fears that in Green, readers will see “a guy who made a bunch of terrible choices and screwed up.” He pauses. “It’s so much more complicated than that.”

Hope Reese is a journalist, currently based in Budapest, who contributes to JSTOR Daily, Longreads, Undark, Vice, Vox, and other publications.