(2015-11-03) Increasing White Middle Age Mortality

Something startling is happening to middle-aged white Americans. Unlike every other age group, unlike every other racial and ethnic group, unlike their counterparts in other rich countries, death rates in this group have been rising, not falling. That 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.

Original paper. *

• Concurrent declines in self-reported health, mental health, and ability to work, increased reports of pain, and deteriorating mea- sures of liver function all point to increasing midlife distress.
• The table also presents changes in mortality rates for white non-Hispanics by three broad education groups: those with a high school degree or less (37% of this subpopulation over this period), those with some college, but no bachelor’s (BA) degree (31%), and those with a BA or more (32%). The fraction of 45- to 54-y-olds in the three education groups was stable over this period.
  • Although all three educational groups saw increases in mortality from suicide and poisonings, and an overall increase in external cause mortality, increases were largest for those with the least education.
• Fig3: Census region-level suicide and poisoning mortality rates 1999–2013. Census regions are Northeast (blue), Midwest (red), South (black), and West (green).
  • cf Mike Caulfield on Suicide Belt cluster
• Fig4: Mortality by poisoning, suicide, chronic liver disease, and cirrhosis, white non-Hispanics by 5-y age group.
• The epidemic of pain which the opioids were designed to treat is real enough, although the data here cannot establish whether the increase in opioid use or the increase in pain came first. Both increased rapidly after the mid-1990s.
• "the productivity slowdown is common to many rich countries, some of which have seen even slower growth in median earnings than the United States, yet none have had the same mortality experience

Note that a lot of the morbidity measures are based on self-reports (of pain, ADL-difficulty, etc.). Which means there could be real changes, or there could be "just" changes in perception.