As the mortality for middle-aged citizens in other wealthy nations continues to precipitously decline, the death rate of middle-aged white Americans is rising. The problem, according to a new analysis, is deeper than a surface level assessment of the nation's rising rates of drug abuse.
The new analysis, published in the Brookings Papers on Economic Activity and covered by The Washington Post, suggests that while more middle-aged white Americans are dying "deaths of despair" — drug overdoses and suicides — this may have less to do with opioids and more to do with sweeping cultural and economic changes.
Here are five things to know.
1. The new analysis builds on a 2015 paper penned by economists from Princeton (N.J.) University and published in the Proceedings of the National Academy of Sciences of the United States of America. The 2015 paper highlighted rising rates of opioid use, suicide and alcohol abuse as primary drivers in the rising rates of middle-aged white mortality.
2. The new paper identified major disparities in mortality rates between middle-aged white Americans and middle-aged residents of European nations like Germany, which were comparable 15 years ago. Now, 285 per 100,000 people between 45 and 54 years of age die in Germany each year. In the U.S., the number of deaths per 100,000 whites among this age group is more than 410. Among the deaths, approximately 40 are attributable to drug overdoses, drinking and suicides in the U.S.
3. Heart disease is another possible driver in the increasing death rates. While other wealthy nations have reduced deaths attributable to heart disease by 40 percent in the last 15 years, the U.S. has not seen the same type of improvement. As the deaths in the U.S. due to suicide and drug abuse were climbing, progress in reducing heart disease among this population fizzled, suggest the paper's authors.
4. While the authors identify economic trends like globalization and automation — which have contributed to a reduction in economic vitality among the middle class — as driving factors in the rise of middle-aged mortality among whites, they are only a part of the equation. White American men without college degrees still earn approximately 36 percent more than their black male counterparts. However, the death rate among black males without a college education has been declining while morality among whites has increased. The two demographics have converged and are now dying at approximately the same rate, according to the Post. The paper's authors assert the rising rates of "deaths of despair" among whites may be linked to an overarching loss of hope.
5. "What our data show is that the patterns of mortality and morbidity for white non-Hispanics without a college degree move together over lifetimes and birth cohorts, and that they move in tandem with other social dysfunctions, including the decline of marriage, social isolation, and detachment from the labor force," wrote the paper's authors. "Ultimately, we see our story as about the collapse of the white, high school educated, working class after its heyday in the early 1970s, and the pathologies that accompany that decline."
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