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Wednesday, November 4, 2015

Trying to Explain the Rise in Death Rates Among Middle-Aged Whites in the US

In a comment on my blog post yesterday about the rise in death rates among middle-aged non-Hispanic whites in the US, Dr. Pete Pollock points out that the answer is STRESS (his emphasis). I think that he is probably right, but this isn't easy to prove. Exactly what kinds of stress and why does stress erupt in these ways? The authors of the study--Anne Case and Angus Deaton--had an email exchange about the paper with Christina Cauterucci of Slate and, despite encouragement, didn't go beyond the idea that this cohort of people has been experiencing "pain" and have been killing themselves in the process of killing the pain. But this explanation, even if correct, doesn't get at the source of the pain. Interestingly enough, a side-note of the Washington Post article on this issue yesterday noted that the paper was published in the Proceedings of the National Academy of Science rather than in a medical journal like the Journal of the American Medical Association precisely because the authors could not identify the cause of the trend. No cause, no publication, was the attitude. Angus Deaton noted that this attitude was a bit bizarre:
He compared the response to calling the fire department to report that your house is on fire: “And they say, 'Well, what caused the fire?' and you say, 'I don’t know,' and they say, 'Well, we can’t send the fire brigade until you tell us what caused the fire.' ”
Even if STRESS is the source of pain, where does it come from? We (by which I mean a lot of as yet unnamed people) need to come up with reasonable hypotheses. We could start, for example, with the issue that a lot of presidential candidates, especially on the Republican side, are talking about--the loss of union-based manufacturing jobs in the US. These are the kinds of jobs that young whites without a college education twenty years ago (when today's middle agers were heading into the labor force) might well have used as a ticket to a better-than-average income if population growth in places like China had not come along and sucked the jobs overseas. But, the problem with that explanation is that it doesn't explain the trends among women (who are less likely to be union workers) and among the better educated, for whom the trend is in the same direction, but just not as severe. I don't pretend to have the answer, but we need to give this issue a lot more serious thought.


  1. Hilary Clinton mentioned this study / trend in her discussion with Rachael Maddow last Friday. I am glad it got her attention; she said the statistic was higher in Southern states. I have not fact checked this. Jen

    1. Yes, here's what Case and Deaton say: "Death rates from these causes in- creased in parallel in all four regions between 1999 and 2013. Suicide rates were higher in the South (marked in black) and the West (green) than in the Midwest (red) or Northeast (blue) at the beginning of this period, but in each region, an increase in suicide mortality of 1 per 100,000 was matched by a 2 per 100,000 increase in poisoning mortality."