White Americans’ mortality gap more than substance abuse and suicide
Don’t blame suicide and substance abuse entirely for rising death rates among middle-aged white Americans, asserts a new study out Friday.
They’re both factors, but the bigger culprit is almost two decades of stalled progress in fighting leading causes of death — such as heart disease, diabetes and respiratory disease — according to a Commonwealth Fund analysis of data from the federal Centers for Disease Control and Prevention. The fund studied actual and expected death rates, and causes of death, for working-age adults from 1968 through 2014.
Its analysis follows a much-discussed study circulated late last year that found death rates had been rising for non-Hispanic, white Americans between ages 45 and 54 since 1999, following several decades of decline. The two Princeton economists who authored that study — one was Angus Deaton, last year’s winner of the Nobel Memorial Prize in economic science — attributed the turnabout to rising rates of drug abuse, suicides and alcohol-related liver disease.
Don’t blame suicide and substance abuse entirely for rising death rates among middle-aged white Americans, asserts a new study out Friday.
They’re both factors, but the bigger culprit is almost two decades of stalled progress in fighting leading causes of death — such as heart disease, diabetes and respiratory disease — according to a Commonwealth Fund analysis of data from the federal Centers for Disease Control and Prevention. The fund studied actual and expected death rates, and causes of death, for working-age adults from 1968 through 2014.
Its analysis follows a much-discussed study circulated late last year that found death rates had been rising for non-Hispanic, white Americans between ages 45 and 54 since 1999, following several decades of decline. The two Princeton economists who authored that study — one was Angus Deaton, last year’s winner of the Nobel Memorial Prize in economic science — attributed the turnabout to rising rates of drug abuse, suicides and alcohol-related liver disease.
Commonwealth said the “death gap” was most pronounced in seven states: West Virginia, Mississippi, Oklahoma, Tennessee, Kentucky, Alabama and Arkansas. The difference between observed and expected rates was narrowest in New York, New Jersey, California, Connecticut, Minnesota, Massachusetts and Illinois, the study found.
Deaths from suicide and substance abuse explain about 40 percent of the “mortality gap,” while 60 percent is tied to death rates failing to drop as expected for nearly all of the top-ranked causes of death of middle-aged whites, Commonwealth said.
Commonwealth suggested the root causes might be tied to that population’s decline in social and economic status.
“For working-age whites — especially 45-to-54-year-olds — we are witnessing regression that has little precedent in the industrialized world over the past half century,” the report said.
For example, they have lower incomes, fewer are employed and fewer are married, it said. Research published last year found that the higher death rate for the group was concentrated among whites without four-year college degrees.
Commonwealth said its findings increase concerns about continuing lack of health insurance — some states with the highest mortality rates did not expand their Medicaid programs to low-income adults. But insurance expansion alone won’t close the mortality gap, it said.