A new study finds that the mortality rate for less educated middle-aged white Americans is rising, in part because of an epidemic of suicides and afflictions stemming from substance abuse, the New York Times reports.
According to an analysis by two Princeton University economists, 2015 Nobel laureate Angus Deaton and Anne Case, the annual mortality rate for white Americans between the ages of 45 and 54 with a high school education or less increased by 134 deaths per 100,000 people, or 22 percent, from 1999 to 2014, while the rate fell for those with a college education. The mortality rate for African Americans, Latinos, and younger and older age groups of all races/ethnicities also fell during the same period. Based on data from the Centers for Disease Control and Prevention and other sources, Deaton and Case concluded that rising mortality among middle-aged whites with a high school education or less is being driven not by heart disease and diabetes but by unprecedented levels of suicide, alcohol-related liver disease, and overdoses of heroin and prescription opioids.
In examining indicators of poor health, including chronic pain, Case found that middle-aged people reported more pain in recent years, with those with the least education reporting the most pain and the worst general health. Case also found parallel increases in the number of whites with mental illnesses, of those who had difficulty socializing, and those who were middle-aged and unable to work. In a commentary on the study, which was published in Proceedings of the National Academy of Sciences, Dartmouth College economists Ellen Meara and Jonathan S. Skinner noted that the least educated also faced the most financial distress. Increases in mortality rates for middle-aged whites rose in parallel with increases in indicators of pain, poor health, and distress, said Deaton, which provided the rationale for the increase in deaths from substance abuse and suicides.
In their commentary, Meara and Skinner considered a variety of explanations for the trend — including a pronounced racial difference in the prescription of opioid drugs and their misuse, and a more pessimistic outlook among middle-aged whites about their financial futures — but said they could not fully account for the effect. "It is difficult," they wrote, "to find modern settings with survival losses of this magnitude."