The disease killing white Americans goes way deeper than opioids

The disease killing white Americans goes way deeper than opioids

In rich countries, death rates are supposed to decline. But in the past decade and a half, middle-aged white Americans have actually been dying faster. Princeton economists Anne Case and Angus Deaton first pointed out this disturbing trend in a 2015 study that highlighted three “diseases of despair”: drugs, drinking and suicide. 

On Thursday, the pair released a deeper analysis that clears up one of the biggest misconceptions about their earlier research.

The problem of dying whites can’t only be blamed on rising rates of drug overdoses, suicides and chronic alcoholism, they say. More and more, middle-aged white Americans are dying for all kinds of reasons — and the underlying issue may have less to do with opioids and more to do with how society has left behind the working class.

“Ultimately, we see our story as about the collapse of the white, high school educated, working class after its heyday in the 1970s, and the pathologies that accompany that decline,” they write.

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This is slightly different than what they said in their first paper, where they emphasized that the trend of rising white mortality was “largely accounted for by increasing death rates from drug and alcohol poisonings, suicide, and chronic liver diseases and cirrhosis.” That’s technically correct — but by focusing only on the increase in death rates, Case and Deaton distracted from the larger picture.

The alarming fact isn’t just that middle-aged whites are dying faster, but also that mortality rates have been dramatically declining in nearly every other rich country. The United States is getting left behind.

In the last 15 years, a chasm opened up between middle aged whites in America and citizens of European countries like France, Germany and the United Kingdom. While white death rates in America rose slightly, death rates in those other countries continued to plummet. In comparison to what happened in Europe, the situation for American whites starts looks much more dire — and it’s a bigger problem than opioids or suicides can explain. It’s not just about what went wrong in America, but what stopped going right.

Fifteen years ago, middle-aged whites in the United States were neck and neck with their German counterparts. Now, middle-aged white Americans are 45 percent more likely to die than middle-aged Germans.

As Case and Deaton show, the gap in mortality between white middle-aged Americans and middle-aged Germans is about 125 deaths per 100,000 people now. Every year, of 100,000 Germans between the ages of 45 and 54, about 285 die. In the United States, it’s more than 410.

Out of those 125 additional American deaths, only about 40 might be explained by the spike in deadly drug use, drinking and suicides. And the rest? It’s hard to say. In their latest paper, Case and Deaton say that heart disease is part of the problem. While other countries have cut down heart disease deaths by over 40 percent in the past 15 years, heart disease remains a significant killer for white middle-aged Americans.

There’s still much left unexplained, but the latest data tell a larger — and more troubling — story. Most of the increase in white deaths is concentrated among those who never finished college. These are the same people who have been pummeled by the economy in recent decades. It’s gotten more difficult for them to find jobs, and what jobs they do come across nowadays don’t pay as well.

Yet, it’s not entirely a matter of income either. Some of these same economic trends — driven by globalization and automation — afflicted countries like the U.K. and Germany, where the death rate has been dropping. Besides, according to a Washington Post analysis of recent Census Bureau data, white American men without a college degree still earn 36 percent more than their black counterparts. But the death rate among less-educated black Americans has actually been decreasing. In recent years, the two groups have converged — they are dying at about the same rate — even though white Americans still earn more.

So the theory comes back to despair. Case and Deaton believe that white Americans may be suffering from a lack of hope. The pain in their bodies might reflect a “spiritual” pain caused by “cumulative distress, and the failure of life to turn out as expected.” If they’re right, then the problem will be much harder to solve. Politicians can pass laws to keep opioids out of people’s hands or require insurers to cover mental health costs, but they can’t turn back the clock to 1955.

3 Responses

  1. I said this long ago,,,American workers are pushed wayyyyyyyyy to far,,and when our bodies break,,,they want u dead,,,ie,,,above comment on suicide deaths going up 20,000 in the last decade,,Now if that aint GENOCIDE,,, what is??!!!!! This is NOT our parents America,,,where u stick w/the same company ,,,u retire w/a decent pension and health insurance for life,,,not for thee average joe’s anymore,,As I stated before,,,my mother in law,,,who’s hubby worked for the government for 30 years,,,NEVER EVER SEE’S A BILL,,, from her numerous health issues,,,ie,,,true government insurance,,,,,now if that aint corrupt,,,,,give ALL OF US THEE EXACT SAME INSURANCE OUR POLITICIANS HAVE!!!now MY HUBBY IS AT THE BOTTUM OF A GOVERNMENT EMPLOYEE,,, solid waste,,,he is a garbage man,,,for thee county,,,,his insurance is ok,,and I am grateful for it,,but his wage sucks,32,100,,, a year,,which disqualifies us by 100 dollars for any government subsidies,,,,don’t tell me they did not do that on purpose,,point being,,,They do not give the middle class/working poor,,,the same opportunities they did back from 1950’s thru 1980’s.,,,,His once private employer,,Waste Management,,,got rid of 5 guys,,alll with-in 2 years of 25 years,,ie retirement,,,when the 401k’s took a tank in 2009,,,,my hubby was at 24.6 years,,some lame ass reasons for termination,,but it was all about not paying out retirements to the ,”workers,” and saving it for their executives!!!its all corrupted,,it no-longer ,,for the good of our ,”fellow man,”’ IT ABOUT,, keeping the rich richer,,and now a days,,literally killing the sick,,the poor,and the hungry,,,,,,as thee evidence has now proven,,,with this type of America,,,the violence will only get worse,,maryw

  2. Living is so stressful, i’m in America. Constant worry. Employer’s want administrative policies and procedures that are completely one sided. They want to be able to screw you over without having to deal with a process. That’s fine when you have a level headed person in charge. But what happens when dick master 5000 gets hired. or always worry that next time the economy has issues, will they cut your job. people barely have enough money to save

  3. Here is a stat they will never publish,,,BUT I WILL,,,,Since the invention of pain management,,1990 to the year 2000,,,,,suicide DROPPED BY 4 %,,,,TOTAL,20,000 IN 2000,,,,,THE YEAR,2015-44,193.0 TOTAL SUICIDES,,SINCE the government has bullied there way into our private medical decision concerning MEDICINE,, suicide have increase 55% ,,,,,70%,,,to us in the age bracket of 45 thru 65,,,,,,,Anotherwards PAIN MANAGEMENT WAS WORKING JUST FINE,,,,,BEFORE,,,DR.government FORCED THERE WAY IN,,LITERALLY,,,,,TORTURER AND KILLING US,,,IE GENOCIDE,,ie death to a group of people,,,,,,I agree w/Mr.Lawhern,,,there never was a opiate epedemic,,,just a arrogant abuse of power by our government,,willfully tortureing and genocide onto a group of medically ill human beings in united states ,,Again,,,TORTURE BY ANY GOVERNMENT EMPLOYEE CARRIES A LIFE SENTENCE IN PRISON,,,, rightfully soo!!!!MARY,
    PSS,,IF ANY ONE CAN FIND THEE EXACT AMOUNT OF TOTAL DEATH IN 1990,IN U.S.A.,,,PLEASE LET ME KNOW,,,,,IT ONLY SHOWS PER 100,000,FOR 1990 thru 2000,,,,,,,CAN’T FIND TOTAL FOR 1990,only the year 2000,,,WEIRD,,

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