The disease killing white Americans goes way deeper than opioids
By Jeff Guo
Mar 24 2017
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.