The death rate among white middle-aged Americans is rising at an alarming rate, even as death rates for all other Americans are falling. The increase is concentrated among whites with meager educations and is “largely accounted for by increasing death rates from drug and alcohol poisonings, suicide and chronic liver diseases and cirrhosis,” according to two Princeton University scholars, one of whom was just awarded the Nobel in economics.
Their findings should awaken Americans to the price we pay for pursuing economic policies that enrich the few at the expense of the many.
Drug and alcohol use that results in death from either poisoning or chronic disease, as well as increased self-extermination, point to social pathologies fostered by government policies that favor moving jobs offshore, reducing wages, restricting access to health care and enabling age discrimination in hiring.
There is good reason to think worsening economic conditions are at the heart of what the Princeton economists — Anne Case and Angus Deaton, the new Nobel laureate — found by simply analyzing published mortality data.
Case and Deaton, who are married, found “declines in self-reported health, mental health and ability to work, increased reports of pain, and deteriorating measures of liver function all point to increasing midlife distress,” according to their paper published in The Proceedings of the National Academy of Sciences.
We’ll return to that in a moment, but first, let’s get a handle on the enormity of this macabre trend among middle-aged white Americans.
Every 75 minutes, a white middle-aged American dies who would be alive had the United States simply maintained the mortality level of that group in 1998. That’s about 7,000 unnecessary deaths per year.
Worse, every 16 minutes, a white middle-aged American dies who would be alive had the trend of falling death rates from 1979 through 1998 continued its downward trajectory for the next 15 years.
That comes to a half million extra deaths among middle-aged white Americans from 1999 to 2013.
Many of these added deaths stem from drug and alcohol poisoning and diseases from chronic use, the data show.
The use of prescription painkillers, as well as illegal drugs such as heroin that tamp down emotional pain, is on the rise, especially in states where limited educations are common. In Alabama, among the poorest states, doctors wrote 143 prescriptions for opioids such as Oxycontin for every 100 residents in 2012 — the highest rate in the nation. Tennessee doctors write such prescriptions at more than 21 times the rate of Minnesota doctors.
That the death rate for middle-aged American whites, especially those with meager educations, started rising at the turn of the century fits the economic data that I have been analyzing for years. The harsh reality is that our economy is in many ways stuck in 1998 and that for poorly educated Americans, the economy has become a living nightmare with no expectation of a brighter tomorrow.
The rise in drug and alcohol poisonings as well as the rising tide of suicides should not surprise. But these trends should disturb.
In a society based on paid work, long-term unemployment can be devastating to self-esteem, social attachment and life planning. Joblessness and uncertain work promote despair and alcohol abuse.
Alcohol dependence is worst among the unemployed and is higher among those with a high school education or less than among those with a college degree or more, the federal Centers for Disease Control and Prevention reports.
Suicide is the 10th-leading cause of death in America and accounts for a large portion of the rising death toll among middle-aged whites. In 2013, CDC data show, more than 41,000 people took their own lives, more than 32,000 of them men. Suicide is far more common among white men than black men.
While people commit suicide for many reasons, suicides are a canary-in-the-mineshaft indicator of societal pathologies. Economic shocks, especially the loss of reliable income, can result in a significant increase in suicides, as Russian society experienced soon after the collapse of the Soviet empire.
The wages of inequality
For the vast majority of Americans, economic and social conditions have been in decline for years.
The median wage, adjusted for inflation, has been stuck at about $550 a week since 1999. The pretax incomes reported on 90 percent of tax returns in 2013 were in real terms about the same as way back in 1966, up just $191, or six-tenths of 1 percent, after 47 years.
The big income gains were among the top 1 percent, especially the upper reaches of that group. Among the top hundredth of 1 percent, average real income soared from $5.5 million to $25 million over those 47 years. That’s a growth rate 590 times greater than what the bottom 90 percent experienced, a disparity made even greater because those at the top saw their federal income tax burdens fall by about three times as much as the bottom 90 percent.
The Congressional Research Service looked at people who had been out of work for two years or more in 2013 and found they were more likely to be male and older. Among the unemployed, 8.2 percent of workers under age 35 had spent two years or more without a job. For workers age 45 or older, that rate more than doubled, to 18.2 percent.
Here is an even more disturbing fact: Long-term unemployment rates were essentially the same for those with a high school diploma and those with a four-year college degree.
Through those we elect, we have chosen to create a society in which there are not enough jobs and many of those in middle age find themselves forced into lower status and uncertain employment or are unable to find any work, even with advanced education.
The rise in drug and alcohol poisonings and in fatalities from diseases related to chronic drug and alcohol abuse, as well as the rising tide of suicides, should not surprise. But these trends should disturb.
Hopefully, we will be so disturbed that we will choose to change, electing politicians who will jettison our failed policies for the rich at the expense of everyone else so that, among other benefits, far fewer of us die prematurely because life is too miserable to carry on.