Article 43


Tuesday, April 05, 2016

Despair Deaths


Middle-Aged White Americans Are Dying of Despair

By Olga Khazan
The Atlantic
November 4, 2015

Even as longevity increases across the rich world, uneducated white Americans are living sicker and dying earlier. Two economists speculate on the reasons why.

Since 1998, people all over the world have been living healthier and living longer. But middle-aged, white non-Hispanics in the United States have been getting sicker and dying in greater numbers. The trend is being driven primarily by people with a high-school degree or less.

That’s the sobering takeaway from a paper in the Proceedings of the National Academy of Sciences published this week.

Even as longevity increases across the rich world, uneducated white Americans are living sicker and dying earlier. Two economists speculate on the reasons why.

The study authors sum it up:

Between 1978 to 1998, the mortality rate for U.S. whites aged 45 to 54 fell by 2 percent per year on average, which matched the average rate of decline in the six countries shown, and the average over all other industrialized countries. After 1998, other rich countries mortality rates continued to decline by 2 percent a year. In contrast, U.S. white non-Hispanic mortality rose by half a percent a year. No other rich country saw a similar turnaround.

That means “half a million people are dead who should not be dead,” Angus Deaton, the 2015 Nobel laureate in economics and co-author of the paper, TOLD The Washington Post. “About 40 times the Ebola stats. Youre getting up there with HIV-AIDS.”

The reasons for the increased death rate are not the usual things that kill Americans, like diabetes and heart disease. Rather, its suicide, alcohol and drug poisonings, and alcohol-related liver disease.

The least-educated are worst off: All-cause mortality among middle-aged Americans with a high-school degree or less increased by 134 deaths per 100,000 people between 1999 and 2013, but there was little change in mortality for people with some college. The death rate for the college-educated fell slightly.

White Americans in this age category are also experiencing worse self-reported health, the authors write, and one in three say they experience chronic joint pain.

The PNAS analysis represents a confluence of several public-health disasters that have slammed white Baby Boomers in recent years.

Deaths from drug overdoses among people aged 45 through 64 INCREASED 11-FOLD between 1990 and 2010, and nearly 90 PERCENT of people who try heroin for the first time these days are white. (Most FOUND HEROIN through prescription painkillers, which treat the chronic pain this age group struggles with, but can also make it worse.)

In January, a CDC VITAL SIGN REPORT FOUND that alcohol poisoning kills more than 2,200 Americans a year, three-quarters of them adults aged 35 to 64. A 2012 HEALTH AFFAIRS STUDY found that life expectancy for white, female high-school dropouts has fallen so much over the past 18 years that these women are now expected to die five years younger than their mothers did.

Obviously, no one can be blamed for his own addiction or depression. But the causes of death this study highlights are the kinds of things - drinking, doping, suicide - that people who feel good about their lives don’t tend to do.

So, WHAT’S EATING ess-educated Boomers?

One persuasive explanation, and one the researchers put forth, is financial strain. Jobs in fields like manufacturing and construction, which were historically filled by people without college degrees, have been evaporating quickly over the past 15 years. As I’ve written previously, less-educated people are more likely to be unemployed and to make less, so they struggle to afford things like therapy, GYM MEMBERSHIPS, and recreation that isn’t drugs. Without jobs, they may lack the social networks and sense of purpose that have shown to reduce mortality.

Nearly half of Americans in their 40s and 50s don’t have enough money saved for retirement to live as they’re accustomed to, even if they work until they’re 65. All of this is crashing down on Boomers, who were raised on the promise of the American Dream.

As Deaton and his co-author, his wife and fellow Princeton economist Anne Case, put it, After the productivity slowdown in the early 1970s, and with widening income inequality, many of the baby-boom generation are the first to find, in midlife, that they will not be better off than were their parents.

Deaton and Case note that middle-aged people in other countries also faced dire financial straits, especially during the 2009 recession. Yet they’re not dying like American 50-somethings are. One difference is that in those countries, comfortable pensions for retirees are guaranteed, so the prospect of an impoverished retirement might not loom as large in Europe as it does here.

“The U.S. has moved primarily to defined-contribution pension plans with associated stock market risk, whereas, in Europe, defined-benefit pensions are still the norm,” Deaton and Case write. “Future financial insecurity may weigh more heavily on U.S. workers.”

Tragically, that weight seems to be crushing these Americans before they can even retire.



Why Are So Many Middle-Aged White Americans Dying?
A new report offers one explanation as to why the mortality rate for uneducated white Americans has risen - even as people elsewhere are living longer and healthier.

By Olga Khazan
The Atlantic
January 29, 2016

Late last year, A STUDY in the Proceedings of the National Academy of Sciences found that middle-aged, white Americans have been getting sicker and dying in greater numbers, even as the rest of the world is living longer and healthier.
The authors of that study attributed the trend to what we called DESPAIR DEATHS: mainly SUICIDES, drug overdoses, and alcohol-related liver disease.

Now, a new analysis from the Commonwealth Fund suggests there’s more to the story. The report, by David Squires and David Blumenthal, notes that between 1999 and 2014, mortality rates in the U.S. rose for white Americans aged 22 and 56. Before that, death rates had been falling by nearly 2 percent each year since 1968. Squires and Blumenthal call the difference between the those two mortality trend lines - the expected, declining one and the actual, rising onethe “mortality gap.”

In 2014, they write, the mortality gap was so big that it accounted for an extra 100 dead, middle-aged white people for every 100,000.

By digging through CDC data, they saw that the reason death rates failed to decline as expected was not entirely due to suicide and substance abuse. Although those factors explained about 40 percent of the gap, the rest was attributable to the leading causes of death - things like heart disease, diabetes, and respiratory disease. Though there are still fewer people dying from those diseases than there were in the 1960s, according to this analysis, the rate of decline has slowed.

That means not only are middle-aged white people drinking more, using more opioids, and killing themselves at higher rates, more of them are getting sick with the diseases that usually kill older people. And when they do get sick, they dont get better.

This trend was especially concentrated in the South, they found. In seven southern states - West Virginia, Mississippi, Oklahoma, Tennessee, Kentucky, Alabama, and Arkansas - the gap between actual and expected mortality in 2014 exceeded 200 deaths per 100,000 people. In West Virginia, mortality rates were higher than at any time since 1980, they write. The report was not published in a peer-reviewed journal, and its raw data was not made available.

It’s worth noting that, because of historic racial injustice, health outcomes for African Americans still lag behind those of white Americans in many areas. African Americans die an average of four years younger than white Americans do, for example. However, the mortality rate for African Americans is declining, and that of white Americans is increasing a historically anomalous trend.

Squires and Blumenthal think the worsening economic standing of uneducated, middle-aged whites might have played a role.

“On a range of social and economic indicators, middle-aged whites have been falling behind in the 21st century,” they write. “They have lower incomes, fewer are employed, and fewer are married.”

This does not mean whites are worse off than minorities, they note. But it could mean that they are the canaries of a coal mine of broader societal problems that have deleterious health effects, such as “less-educated workers increasing disengagement from the mainstream economy; declining levels of social connectedness; weakened communal institutions; and the splintering of society along class, geographic, and cultural lines,” they write.

The findings are also concerning BECAUSE FOUR of the seven worst-off states the researchers highlighted have opted not to expand Medicaid as part of Obamacare. And although health insurance alone likely won’t be enough to turn the tide of premature deaths, it’s certainly one of the few immediate interventions that could help.


Posted by Elvis on 04/05/16 •
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