Despite decades of improvement, mortality rates among white, middle-aged Americans are on the rise, and the opioid epidemic has accelerated the incline.
In their recently released report, Anne Case, Ph.D., and Sir Angus Deaton, Ph.D., professors at Princeton University, examined trends that contributed to the increase in mortality rates for white, middle-aged, non-Hispanic Americans who lacked education beyond a high school degree. This rise in the mortality rate has occurred despite a marked decline in the two biggest causes of death in middle age: heart disease and cancer.
While it’s difficult to pinpoint any singular or fundamental cause for the alarming trend, a contributing factor is a rise in “deaths of despair,” which includes suicide, accidental drug overdoses, and alcohol-related liver mortality.
“Deaths of despair have been rising in America’s white working class since at least 1990, but the introduction of, and easy access to, strong prescription opioids has been a real accelerant,” Case said.
Making these deaths of despair even more concerning is the fact that they have crossed unexpected boundaries and spread to every corner of the country. The rising death rates caused by drugs, alcohol and suicide began as an epidemic centered in the southwestern region of the U.S. at the outset of the 21st century. However, by the mid-2000s, the epidemic had spread to Florida, Appalachia, and the West Coast. Today, deaths of despair are on the rise regardless of gender, and it encompasses the entirety of the United States. It isn’t merely a problem for city dwellers or rural citizens, it affects every level of urbanization.
While simple economic factors contribute to the rise in deaths of despair, income alone cannot explain the entirety of the phenomena. The examined data reveals that non-white Americans, as well as foreign citizens, have not experienced the same rise in the rates of deaths of despair despite similar economic challenges. However, when considered against additional factors, such as falling rates of marriage and a decline in the ratio of population to employment, some patterns begin to appear.
Case and Deaton identify trends that suggest a process of systematic cumulative disadvantage founded upon the long and steady decay of employment opportunities for Americans with an education that does not exceed a high school diploma.
Some, such as the scholar Charles Murray, believe this is because of the loss of American virtues. As he argued in his 2012 book, Coming Apart, working-class whites in America no longer hold traditional virtues in high regard, especially industriousness. Murray believes that this lack of industriousness has led to… (continue reading)
