Case and Deaton (2015), both economists from Princeton, found that mortality rates for middle-aged white Americans have risen since 1999. In contrast, the death rate for middle-aged blacks and Hispanics continued to decline during the same period, as did death rates for younger and older people of all races and ethnic groups. They analyzed health and mortality data from the Centers for Disease Control and Prevention and other sources.
First, the authors ruled out an increase in deaths from chronic diseases such as heart disease, cancer, and diabetes. Those numbers were all either stable or trending downward. Murder and accidents were also declining. The authors concluded the rising annual death rates among this group are being driven by an epidemic of suicides. Most of the drug-related deaths in America are now caused by prescription medicines, and nearly three-quarters of those deaths are from opioid painkillers. Reliance on opioid painkillers is an epidemic that started in the late 1990s. Chronic liver diseases related to drug and alcohol use in this group were also on the rise.
Studies have found white patients with pain are more likely to be prescribed opioid painkillers. And whites have been more likely to attempt suicide when faced with physical or mental hardships. The New York Times reported 90 percent of people who tried heroin in the last decade were white. Drug addiction in black communities ultimately resulted in mass incarceration, while heroin and prescription drug abuse has been met with a more sympathetic approach, possibly because its victims are white. The only other time that death rates increased among middle-aged whites in the last century was in the 1960s because of smoking-related diseases. There was also a spike in mortality among younger adults in the 1980s during the AIDS epidemic.
One possible factor behind the substance abuse is this demographic group has faced a rise in economic insecurity over the past decade, driven by things like the financial crisis and the collapse of manufacturing. Education is also a factor. The effect was largely confined to people with a high school education or less. In that group, death rates rose by 22 percent while they actually fell for those with a college education. Mortality among the middle-aged population plummeted in the six other countries that the authors examined: Australia, Canada, France, Germany, United Kingdom, and Sweden. Although these countries also had economic problems in recent years, its residents might have been less affected because they have more social safety nets in terms of unemployment benefits and health care.
References:
Case, A. & Deaton, A. (2015) Rising morbidity and mortality in midlife among non-Hispanic Americans in the 21st century. Proceedings of the National Academy of Sciences. Retrieved from http://www.pnas.org/content/early/2015/10/29/1518393112.full.pdf
Gold, A. (2015, November 4). Why is death rate rising for white, middle-aged Americans? BBC News, Washington. Retrieved from http://www.bbc.com/news/world-us-canada-34714842
Kolata, G. (2015, November 2). Death Rates Rising for Middle-Aged White Americans, Study Finds. The New York Times. Retrieved from http://www.nytimes.com/2015/11/03/health/death-rates-rising-for-middle-aged-white-americans-study-finds.html
Storrs, C. (2015, November 4). Death rate on the rise for middle-aged white Americans. Retrieved from http://www.cnn.com/2015/11/03/health/death-rate-middle-age-white-americans/
Jonathan Torres, M.S.
WKPIC Doctoral Intern
