Why The Increased Deaths For Middle-Aged White Americans?

Graph showing trend of U.S. death rate for middle-aged whites vs. those in other nations.

What's going on with middle-aged, poorly-educated whites in the US of A, dying at a yearly rate (from 1999 - 2013) now rivaling that of HIV/AIDS?  (Before 1999, this demographic had enjoyed 2 percent per yr. lowered death rates.) Sociologists have to inquire - as do curious inquiring citizens - given that unlike every other age group, or every other racial and ethnic group - and most notably - unlike their counterparts in other rich countries, the death rates in this group have been rising, not falling.

That disturbing mortality finding was reported Monday by two Princeton economists, Angus Deaton, who last month won the 2015 Nobel Memorial Prize in Economic Science, and Anne Case. Analyzing health and mortality data from the Centers for Disease Control and Prevention and from other sources, they concluded that rising annual death rates among this group are being driven not by the big killers like heart disease and diabetes but by an epidemic of suicides and afflictions stemming from substance abuse: alcoholic liver disease and overdoses of heroin and prescription opioids.

What the hell gives? Why are Americans perishing so much more than Europeans in the same age range? Is it that life is much harder, wages and benefits too low? Addictions too great?

The analysis by Drs. Deaton and Case offers the most rigorous evidence to date of both the causes and implications of a development that has been puzzling demographers in recent years: the declining health and fortunes of poorly educated , middle-aged American whites.  Note they are now dying at such a high rate that they are increasing the death rate for the entire group of middle-aged white Americans, Dr. Deaton and Dr. Case found.

The mortality rate for whites 45 to 54 years old with no more than a high school education increased by 134 deaths per 100,000 people from 1999 to 2014. In a commentary on the Deaton-Case analysis that was published in Proceedings of the National Academy of Sciences, two Dartmouth economists, Ellen Meara and Jonathan S. Skinner, wrote:

“It is difficult to find modern settings with survival losses of this magnitude,”

Samuel Preston, a professor of sociology at the University of Pennsylvania and an expert on mortality trends, not involved in the research, exclaimed:

“Wow.  This is a vivid indication that something is awry in these American households.”

The parallel invoked bv Dr. Deaton was H.I.V./AIDS  the only thing in contemporary times " that has done anything like this,” he said.

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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.

Drs. Deaton and Case (husband and wife) said they stumbled on their finding by accident, looking at a variety of national data sets on mortality rates and federal surveys that asked people about their levels of pain, disability and general ill health.

Dr. Deaton was looking at statistics on suicide and happiness, skeptical about whether states with a high happiness level have a low suicide rate. (They do not, he discovered; in fact, the opposite is true.) Dr. Case was interested in poor health, including chronic pain because she has suffered for 12 years from disabling and untreatable lower back pain.

Dr. Deaton noticed in national data sets that middle-aged whites were committing suicide at an unprecedented rate and that the all-cause mortality in this group was rising. But suicides alone, he and Dr. Case realized, were not enough to push up overall death rates, so they began looking at other causes of death. That led them to the discovery that deaths from drug and alcohol poisoning also increased in this group.

Dr. Case, investigating indicators of poor health, found that middle-aged people, unlike the young and unlike the elderly, were reporting more pain in recent years than in the past. A third in this group reported they had chronic joint pain over the years 2011 to 2013, and one in seven said they had sciatica. Those with the least education reported the most pain and the worst general health.

Also, not too surprising, the least educated also had the most financial distress, Dr. Meara and Dr. Skinner noted in their commentary. In the period examined by Dr. Deaton and Dr. Case, the inflation-adjusted income for households headed by a high school graduate fell by 19 percent.

Dr. Case found that the number of whites with mental illnesses and the number reporting they had difficulty socializing increased in tandem. Along with that, increasing numbers of middle-aged whites said they were unable to work. She also saw matching increases in the numbers reporting pain and the numbers reporting difficulty socializing, difficulty shopping, difficulty walking for two blocks.

In the WSJ today, the connection of this group of Americans has also now been tied to the proportion no longer participating in the labor force. In other words, these pain-plagued, lower educated 45-54 year olds are contributing to the lower labor participation rate in that age group.

With the pain and mental distress data, Dr. Deaton said, “we had the two halves of the story.” Increases in mortality rates in middle-aged whites rose in parallel with their increasing reports of pain, poor health and distress, he explained. They provided a rationale for the increase in deaths from substance abuse and suicides.

Dr. Preston of the University of Pennsylvania noted that the National Academy of Sciences had published two monographs reporting that the United States had fallen behind other rich countries in improvements in life expectancy. One was on mortality below age 50 and the other on mortality above age 50. He coedited one of those reports. But, he said, because of the age divisions, the researchers analyzing the data missed what Dr. Deaton and Dr. Case found hiding in plain sight.

Ronald D. Lee, professor of economics, professor of demography and director of the Center on Economics and Demography of Aging at the University of California, Berkeley, was among those taken aback by what Dr. Deaton and Dr. Case discovered.

“Seldom have I felt as affected by a paper. It seems so sad.”

Sad indeed that a half million more people died in the 14-year time interval that shouldn't have, according to one economist.

My own take is that this group is one that has been majorly left behind in the Neoliberal economy so that the one percenters can grab more of the national 'cake'. This is yet another reason to vote for Bernie Sanders, without whom the death rate for these middle-aged folks will likely triple.  Bear in mind that to make ends meet many have had to hold two or more jobs to get a living wage - especially to pay for housing. Years of that kind of labor are bound to wear out their backs, lead to addictive behavior and even serious medical problems. And now, they've been warned by the repukes that Medicare eligibility is "on the block" and ought to be delayed until 68 or 70. No wonder they see little hope for life quality betterment.