A new divide in American death

By Joel Achenbach, Dan Keating

Anne Case and her husband Angus Deaton, both Princeton University economists, published a study late last year that drew national attention to rising mortality among middle-aged whites.
Anne Case and her husband Angus Deaton, both Princeton University economists, published a study late last year that drew national attention to rising mortality among middle-aged whites.

White women have been dying prematurely at higher rates since the turn of this century, passing away in their 30s, 40s and 50s in a slow-motion crisis driven by decaying health in small-town America, according to an analysis of national health and mortality statistics by The Washington Post.

Among African Americans, Hispanics and even the oldest white Americans, death rates have continued to fall. But for white women in what should be the prime of their lives, death rates have spiked upward. In one of the hardest-hit groups – rural white women in their late 40s – the death rate has risen by 30 percent.

The Post’s analysis, which builds on academic research published last year, shows a clear divide in the health of urban and rural Americans, with the gap widening most dramatically among whites. The statistics reveal two Americas diverging, neither as healthy as it should be but one much sicker than the other.

In modern times, rising death rates are extremely rare and typically involve countries in upheaval, such as Russia immediately after the collapse of the Soviet Union. In affluent countries, people generally enjoy increasingly long lives, thanks to better cancer treatments; drugs that lower cholesterol and the risk of heart attacks; fewer fatal car accidents; and less violent crime.

But progress for middle-aged white Americans is lagging in many places – and has stopped entirely in smaller cities and towns and the vast open reaches of the country. The things that reduce the risk of death are now being overwhelmed by things that elevate it, including opioid abuse, heavy drinking, smoking and other self-destructive behaviors.

White men are also dying in midlife at unexpectedly high rates. But the most extreme changes in mortality have occurred among white women, who are far more likely than their grandmothers to be smokers, suffer from obesity or drink themselves to death.

White women still outlive white men and African Americans of both sexes. But for the generations of white women who have come of age since the 1960s, that health advantage appears to be evaporating.

This reversal may be fueling anger among white voters: The Post last month found a correlation between places with high white death rates and support for GOP presidential candidate Donald Trump.

Public health experts say the rising white death rate reflects a broader health crisis, one that has made the United States the least healthy affluent nation in the world over the past 20 years. The reason these early deaths are so conspicuous among white women, these experts say, is because in the past the members of this comparatively privileged group have been unlikely to die prematurely.

Laudy Aron, a researcher with the Urban Institute, said rising white death rates show that the United States’ slide in overall health is not being driven simply by poor health in historically impoverished communities.

“You can’t explain it away as, ‘It’s those people over there who are pulling us down,’ ” Aron said. “We’re all going down.”

For this article, The Post examined death records from the Centers for Disease Control and Prevention, breaking the information down geographically, county by county, by level of urbanization and by cause of death.

Big cities and their suburbs – metropolitan areas of more than 1 million people – looked strikingly different from the rest of the country. The Post divided these populations into urban and rural categories, with the rural population encompassing smaller cities as well as small towns and the most remote places.

Beverly Layman
Beverly Layman, 58, died in March from complications due to liver failure. Layman’s liver failed as the result of long-term use of alcohol, painkillers, anti-anxiety medications and illicit drugs. She died two weeks before her 59th birthday.

It’s Not Just Middle-Aged Men Who Are Dying Younger

By

That paper by Angus Deaton and Anne Case about middle-aged white men dying at higher rates seems to be having a second life, so I want to highlight something that I might have buried in my initial post about it: it’s not just middle-aged men. This is right in the paper, with a colorful chart and everything. Every single white age group, from 30 to 65, has seen a big spike in deaths from alcohol, suicide, and drug overdoses:

mortality_age_group_1

And it’s white women too:

The change in all-cause mortality for white non-Hispanics 45–54 is largely accounted for by an increasing death rate from external causes, mostly increases in drug and alcohol poisonings and in suicide. (Patterns are similar for men and women when analyzed separately.)

So why is everyone focusing solely on middle-aged men? Because that’s what the paper focuses on. However, the authors make it very clear that every age group is affected:

The focus of this paper is on changes in mortality and morbidity for those aged 45–54. However, as Fig. 4 makes clear, all 5-y age groups between 30–34 and 60–64 have witnessed marked and similar increases in mortality from the sum of drug and alcohol poisoning, suicide, and chronic liver disease and cirrhosis over the period 1999–2013; the midlife group is different only in that the sum of these deaths is large enough that the common growth rate changes the direction of all-cause mortality.

In other words, the phenomenon they describe applies to all white men and women between the ages of 30-65. The only difference among midlife white men is that declining overall mortality has turned into increasing overall mortality. Among other groups, declining mortality presumably turns flat, or perhaps declines less rapidly—though the authors don’t say.

In other words, midlife men make for a more dramatic chart because the line actually changes direction. But there’s nothing magic about zero. If you go from a slope of -5 to -1, that’s still a lot even if the line hasn’t changed direction. What’s more, whatever it is that makes the change in overall mortality bigger for midlife men, it’s not the suicide, alcohol, and drug overdoses that the authors focus on. The chart above makes that clear. In fact, the midlife group appears to have seen a smaller growth in those things than both the younger group and the older groups. This would be clearer if the chart were drawn differently, but since the authors don’t include a table with raw data, I can’t do that.

Bottom line: There’s been a sharp increase in death by suicide/alcohol/drugs among all whites of all age groups from 30-65. Whatever the reason, it’s not something that applies solely to middle-aged white men.

Complete Article HERE!

Causes of death

This is pretty interesting…

 

causes of death

 

“I love this graph because it shows that while the number of people dying from communicable diseases is still far too high, those numbers continue to come down. In fact, fewer kids are dying, more kids are going to school and more diseases are on their way to being eliminated. But there remains much to do to cut down the deaths in that yellow block even more dramatically. We have the solutions. But we need to keep the up support where they’re being deployed, and pressure to get them into places where they’re desperately needed.”
– Bill Gates is Co-Chair of the Bill and Melinda Gates Foundation.