Via NPR's Shots blog, an interview with Anne Case and Angus Deaton, authors of a new study on the rising mortality rates of poorly educated American whites: Explaining The Rising Death Rate In Middle-Aged White People. Excerpt:
Deaton: We're thinking of this in terms of something that's been going on for a long time, something that's emerged as the iceberg has risen out of the water. We think of this as part of the decline of the white working class. If you go back to the early '70s when you had the so-called blue-collar aristocrats, those jobs have slowly crumbled away and many more men are finding themselves in a much more hostile labor market with lower wages, lower quality and less permanent jobs. That's made it harder for them to get married. They don't get to know their own kids. There's a lot of social dysfunction building up over time. There's a sense that these people have lost this sense of status and belonging. And these are classic preconditions for suicide.
Case: The rates of suicide are much higher among men [than women]. And drug overdoses and alcohol-related liver death are higher among men, too. But the [mortality] trends are identical for men and women with a high school degree or less. So we think of this as people, either quickly with a gun or slowly with drugs and alcohol, are killing themselves. Under that body count there's a lot of social dysfunction that we think ultimately we may be able to pin to poor job prospects over the life course.
On how mortality rates differ among races
Deaton: Hispanics [have always had lower mortality rates] than whites. It's a bit of a puzzle that's not fully resolved, to put it mildly. It's always been true that mortality rates have been higher and life expectancy shorter for African-Americans than for whites. What is happening now is that gap is closing and, for some groups, it's actually crossed. What we see in the new work is if you compare whites with a high school degree or less, at least their mortality rates are now higher than mortality rates for African-Americans as a whole. If you compare whites with a high school degree or less with blacks with a high school degree or less, their mortality rates have converged. It's as if poorly educated whites have now taken over from blacks as the lowest rung of society in terms of mortality rates.
On the geography of mortality rates
Case: There's not a part of the country that has not been touched by this. We like to make the comparison between Nevada and Utah to look at the extent to which good health behaviors lead to longer life. Two-thirds of Utahans are Mormons. They don't drink, they don't smoke and they don't drink tea or coffee. Two-thirds of Nevadans live in Las Vegas paradise, where there is a little more of everything, so the heart disease mortality rates are twice as high in Nevada as they are in Utah.
But both states are [in the] top 10 for deaths of despair. Utah has had a terrifically hard time dealing with the opioid crisis, and suicide rates [are] going up as well. There's a lot of surprise here in parts of the country that we weren't really expecting to see.