During an era of headline-grabbing advances in medicine, the United States is experiencing a health cataclysm.
The latest straw in the wind is last week’s report from the Centers for Disease Control and Prevention showing that life expectancy for white women declined slightly from 2013 to 2014.
Other studies indicate rising death rates for a white working class that is in a slow-motion economic and social meltdown. Self-destructive behaviors are outpacing medical advances against killers like heart disease and cancer. Hopelessness may not be a condition studied by epidemiologists, but it is cutting a swath through a segment of white America.
A paper in Proceedings of the National Academy of Sciences late last year highlighted the bleak American exceptionalism of this crisis. It focused on middle-aged whites. In the 20 years prior to 1998, their mortality rate fell about 2 percent a year, in keeping with the trend toward lower mortality in other advanced countries. Then the rates diverged. Rates kept declining in countries like France and Britain. They begin increasing for middle-aged whites in the United States.
The slide in the wrong direction was driven by drug and alcohol poisoning, chronic liver diseases and suicide. In 1999, middle-aged blacks had higher rates of poisoning than whites; by 2013, rates were higher for whites. Overall, mortality rates for middle-aged blacks and Hispanics have declined since 1999, as they have increased for whites.
The trend among whites breaks down neatly by levels of education. The mortality rate for middle-aged whites with a high-school degree or less has jumped since 1999; the rate for middle-aged whites with some college but not a degree stayed roughly flat; the rate for middle-aged whites with a college degree or more dropped. If there is such a thing as white privilege, no one has told less-educated whites.
The most direct indicator of rising distress is that the suicide rate in the United States is at a roughly 30-year high, according to new figures from the National Center for Health Statistics. The rate increased for white middle-aged women by 80 percent from 1999-2014. Although the data wasn’t analyzed by education level, researchers believe it tracks with other findings about increased working-class mortality.
It is not just the middle-aged. The New York Times analyzed death certificates earlier this year. The good news is that the gap in death rates between young-adult blacks and whites is closing fast; the bad news is that soaring death rates for whites account for much of the change.
The Times found that the cohort of whites aged 25-34 is the first to have higher death rates than the generation before it since the Vietnam War, and the trend is particularly pronounced among the less-educated. The rate of drug overdoses among young whites quintupled from 1999-2014.
The white working class is dying from the effects of a long-running alienation from the mainstream of American life. As one researcher told the Times, “they are not in stable relationships, they don’t have jobs, they have children they can’t feed and clothe, and they have no support network.” It is a formula for loneliness, stress and despair.
The Washington Post recently wrote a compelling portrait of a woman in rural Oklahoma who died at age 54 of cirrhosis of the liver. It was a tale of joblessness, of martial breakdown, of alcohol abuse, of repeated heartbreak, until she was “sick and tired of being sick and tired.” She drank herself to death. At her funeral, the Post reporter noted the plots of friends and relatives who had died at ages 46, 52 and 37.
The authors of the Proceedings of the National Academy of Sciences paper say middle-aged whites may be a “lost generation.” That is depressing enough, but there is no guarantee only one generation will be lost.
Rich Lowry can be reached via e-mail: firstname.lastname@example.org.