That may be especially true of middle-aged Caucasians with limited educations. Their plight deserves social and political attention, because they are dying at an accelerated clip. So says a new paper published by the National Academy of Sciences from Princeton economists Ann Case and recent Nobel laureate Angus Deaton.
Let’s start by defining terms. The “mortality rate” is the number of people who die in a given time interval (usually a year), per 100,000 population. Those are “absolute rates,” which can be subdivided and compared relatively among ages and ethnicities, and traced across time to reveal trends. And the trend here is alarming.
Mortality rates in general are declining across the globe, especially in relatively peaceful nations. You’ll see in this graph that the US rate for Non-Hispanic Whites, ages 45-54, has bucked that trend by rising slightly, going from 401 in 1990 to about 412 now. When the numbers are controlled by limited education, they jump by fully 20%. Denominated in lives, that’s almost half-a-million lost early this century, versus a steady decline seen in prior years.
Contrast the rates for several similar countries, including the UK (400 to 270), France (455 to 320), neighboring Canada (360 to 249) and everybody’s favorite socialist example Sweden (340 to 204). Note, too, that the Hispanic White rate in the US fell from 380 to 262 (all values eye-balled). The similar African American mortality rate (not shown) is higher than 412, but it, too, has fallen significantly since 1990.
What’s going on here?
Case and Deaton suspect that several factors may be at-play. They do not relate primarily to traditional scourges like cancer (lung cancer is a big cause, but on the decline) or heart disease.
Looking at this next graph, poisonings, suicides and liver disease and way up, and they now account for a much larger share of deaths than they did in 1990, with diabetes up enough to worry about, but a lesser factor in the increase. Poisoning is a proxy for drug abuse.
Because those are self-destructive “lifestyle” behaviors rather than, say, infectious diseases or calamities, this phenomenon begs the question of why they occur with greater recent frequency. Case and Deaton point to two possibilities: drug abuse via now-more-available opioids, alcohol abuse and ultimately despair born of a segment of the population that has particularly “lost control of the narratives of their lives.”
As an 'aside,' part of the natural process of aging is a passing of the cultural narrative to another generation, in both conscious indignities and unconscious changes. Thus, we boomers are having to cope with a city we didn’t build on rock-n-roll -- and that we barely recognize anymore, movies, music and pop culture references meant for somebody else, and, of course, that point when you let those newest, coolest, next tech innovations pass you by. It’s a slow-creeping, incremental loss that is basically expected, and to which we grudgingly surrender, bit-by-bit.
This is that process on steroids, way faster and with a much earlier onset – and greater impact. It is a despair that arises out of the economic insecurity of lost jobs and absent prospects, a perception of loss of control, and a world of deteriorating “compositional amenities” that were the stuff of another recent tome in this series. It’s easy to suspect that it also finds political expression in the under-focused rage embodied in those anti-immigrant/when-I’m-President-we’ll-all-say-Merry-Christmas-again ravings of a certain presidential contender.
All that despondency has fueled an epidemic of self-medication, leading to severe health effects and suicides, posit Case and Deaton. They further surmise that African Americans and Hispanic Whites do not share the same mortality increase because their prospects were never as high, and they may perceive themselves as collectively making some progress. If they’re right, this is ultimately an artifact of the demographic changing-of-the-guard that proceeds apace in these environs – dare I say the lingering, gradual demise of so-called white privilege?
It should be noted that the study’s conclusions have been challenged by other academics and the punditocracy. Columbia statistician Andrew Gelman questions up to half of the increase for reasons beyond my undergraduate mastery of his craft, but even so, he writes “the change compared to other countries and groups is [still huge.” Tim Worstall writing in Forbes would also like to minimize the impact, but he appears to be motivated more by wishing away the policy implications than by satisfaction with his reasoning.
Others on The Right have surmised, of course, that it’s all Obama’s fault. As Paul Krugman notes, they suggest that “generous social programs have created a culture of dependency and despair, while secular humanists have undermined traditional values.” The evidence is contrary, however, as “life expectancy is high and rising in the Northeast and California, where social benefits are highest and traditional values weakest. Meanwhile, low and stagnant or declining life expectancy is concentrated in the Bible Belt.”
What-to-do-about-it is an even thornier issue, which has a great deal to do with public policies to counteract job-loss and the general hollowing-out of the middle class. The Right will trot-out (usually unspecified) commerce-killing regulations (and maybe even further tax cuts to promote widely discredited tricklage*), while The Left will argue for publically funded education, training, infra-structure programs and taxes-on-the-wealthy to fund them.
Either way, as we all listen to campaign proposals and promises over the coming year, it’s vitally important to recognize that success or failure Matters. It will be denominated in Lives.
* One memorable commenter varied an old saying and wrote “don’t trickle on my head and tell me it’s raining money.”