Death Among Middle -Aged Whites
The Editorial Board (NY Times) November 2015
Two Princeton economists startled other Americans — and themselves — when they uncovered a trend that had escaped the medical and scientific world: Between 1999 and 2013, white middle-aged men and women in the United States, especially those with only a high school education, began dying at a sharply increased rate, largely a result of problems with legal and illegal drugs, alcohol-related liver disease and suicide. The health and financial implications are disturbing for the country, and for what the two economists called a “lost generation.”
The discovery was made by Angus Deaton, who won the Nobel Memorial Prize in Economic Science this year, and his wife, Anne Case. In a paper published by the Proceedings of the National Academy of Sciences, they said the finding nearly blew them off their chairs.
Death rates have continued to decline in every other age group and racial or ethnic group in the United States, and this particular group had shown no unusual problems in the preceding years. (Middle-aged blacks still have a higher mortality rate than middle-aged whites but the gap is closing. Middle-aged Hispanics have a far lower mortality rate than whites.)
When the economists sliced and diced the data, they found that the mortality rate for all white Americans from 45 to 54 years, which fell by 2 percent a year between 1978 and 1998, began rising at an annual rate of 0.5 percent beginning in 1999. The toll was especially high for the less educated. Death rates rose by 22 percent for people with a high school education or less, while they continued to decline for those with a college education or better.
The Princeton economists attributed the increase in death rates to suicides and drug and alcohol poisonings, problems that may have been exacerbated by the economic downturn. After the 2008 recession and slow recovery, the inflation-adjusted income for households headed by a person with only a high school degree fell by 19 percent, according to experts at Dartmouth who were asked to comment on the paper.
Other rich nations suffered similar or even worse economic slowdowns without a change in mortality rates, and blacks and Hispanics in the United States were harmed more than whites by the recession but did not experience an increase in mortality rates. Even so, the economic effects were potent.
The Princeton economists detected signs of growing distress among middle-aged whites, who express pessimism about their futures and report declines in their physical and mental health and ability to function. They also report increases in chronic pain, which many alleviate with prescription opioids and heroin.
If sickness and death rates continue to rise in this age group, an influx of chronically ill people will strain Medicare, Medicaid and the Social Security disability insurance program. There is no single remedy. A real plan for action is not easy to achieve. Economic growth that creates more high-paying jobs would solve some of the problem. Policies to promote affordable college educations and universal access to mental health clinics and addiction treatment centers could help.
If nothing is done, those now in midlife can expect trouble, and the next generation to hit that age could suffer a similar fate. We must not let that happen.
