A toxic combination of declining social status, poor health and failed relationships is being blamed for the troubling uptick in mortality rates among white Americans in middle and working classes, according to new data from demographers.
Princeton University economists Anne Case and Angus Deaton refer to the reversal in historic mortality trends as “deaths of despair” — the predictable outcome of declining economic opportunities coupled with rising levels of drug abuse, obesity, drinking and suicide among non-college educated whites.
One startling finding from their survey: In 2015, mortality rates for non-Hispanic whites with a high school degree or less was 30 percent higher than blacks (927 versus 703 per 100,000 people). In 1999, rates for non-Hispanic whites of the same group were 30 percent lower than for blacks.
The researchers published their findings Thursday in the Brookings Papers on Economic Activity, as a follow-up to their 2015 study which first documented the increase in mortality.
“This is a story of the collapse of the white working class,” Mr. Deaton, who won a Nobel Prize for economics in 2015 for his work on poverty, told the Associated Press in an interview. “The labor market has very much turned against them.”
A decline in economic and social well-being are contributing factors to the high rates of death among both white men and women aged 45-54 without a college degree, the researchers found. The causes of death ranged from disease and suicide to complications with drug and alcohol use.
Instances of death are not confined to a particular location, with high rates in both rural and urban areas.
The most important variable uncovered by the survey is education. “Mortality is rising for those without, and falling for those with, a college degree,” the researchers wrote in the paper’s summary.
In their original 2015 study, the researchers said they were shocked to learn that while mortality rates declined for every other ethnic group in the U.S., they were increasing among non-Hispanic whites.
“Mortality rates have been going down over 100 years or more, and then for all this to suddenly go into reverse, we just thought this must be wrong,” Mr. Deaton told NPR.
Ms. Case added that the recently published work seeks to thread a narrative to explain the factors leading to the increase. “It’s consistent with the labor market collapsing for people with less than a college degree and then in turn that having effects on the kind of economic and social supports that we usually think people need in order to thrive.”
The most obvious way the government can address the crisis, the authors write, is to stem the over-prescription of opioids — blamed for the deaths of over 33,000 in 2015.
“There’s a lot of literature that suggests that people who have poor socio-economic support, possible financial struggles are at a higher risk for addiction,” said Dr. Rishi Kakar, a psychiatrist at the Segal Institute in Fort Lauderhill, Florida, and a specialist in addiction treatment. “My view is that a lot of these individuals do not have proper access to treatment for their opioid addiction. These are the individuals who are financially stressed and do not have enough resources.”
The difference in mortality rates between whites and other races can be partly explained by the differences in expectations, according to sociologist and author Andrew Cherlin. He explained the phenomenon, “Reference Group Theory,” in the New York Times last year.
“It’s likely that many non-college-educated whites are comparing themselves to a generation that had more opportunities than they have, whereas many blacks and Hispanics are comparing themselves to a generation that had fewer opportunities,” Cherlin wrote. “Reference group theory explains why people who have more may feel that they have less. What matters is to whom you are comparing yourself.”
For those with little education and low job prospects, changing societal norms have eroded an important safety net once afforded by family and religion.
“These changes left people with less structure when they came to choose their careers, their religion, and the nature of their family lives,” Case and Deaton write.
The authors also put a high priority on marriage as a “stabilizing factor” that fosters a continuing role for fathers in the lives of their children.
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