From today’s NYT Health section:
… middle-aged white Americans. Unlike every other age group, unlike every other racial and ethnic group, unlike their counterparts in other rich countries, death rates in this group have been rising, not falling…
… two Princeton economists, Angus Deaton… and Anne Case. Analyzing health and mortality data from the Centers for Disease Control and Prevention and from other sources, they concluded that rising annual death rates among this group are being driven … by an epidemic of suicides and afflictions stemming from substance abuse: alcoholic liver disease and overdoses of heroin and prescription opioids…
… the declining health and fortunes of poorly educated American whites. In middle age, they are dying at such a high rate that they are increasing the death rate for the entire group of middle-aged white Americans…
… The mortality rate for whites 45 to 54 years old with no more than a high school education increased by 134 deaths per 100,000 people from 1999 to 2014.
The article falls apart a bit here. What we want to know is how the absolute death rate for non-college middle-aged white Americans in 2013 and in 1999. We want to know how the Long Stagnation has changed vulnerable Americans, but Kolata’s article mixes all white Americans with the no-college cohort.
Fortunately the PNAS article PDF is freely available, but unfortunately it explains Kolata’s problem — the data we want seems to be buried in an unlabeled parenthesis in Table 1. From that I think I can reconstruct the key information: .
|Year||White no college||Black (all)||White some college||White BA+||White All|
For the no-college White American 1999 was a pretty good year; probably the best ever. That was the era of NASCAR America and the candidacy of GWB, champion of the “regular” white guy. Employment demand was high and wages were rising. Yes, as a white guy without any college you had a shorter lifespan than the minority of white (Americans) with a college degree, but at least black Americans were even worse off. It’s always comforting to have someone to look down on.
After 16 years of the Great Stagnation though, things are different. Suicide and substance abuse have pushed no-college white mortality to the level of 1999 black Americans, yet during the same period black American middle-aged mortality has fallen substantially. White no-college Americans are now at the bottom of the heap .
This is why we have the inchoate white rage that thunders through the GOP. This is why we have Donald Trump.
A large and culturally powerful part of America is in crisis. A cohort with lots of guns and a history of violence. Maybe we should pay attention. Trump is a signal.
- fn -
 There was no breakdown of black death rates by education; a 2012 census report said 29% of whites and 18% of blacks had a BA or higher. Since 80%+ of black Americans have no BA it’s likely no-college whites now have higher middle-aged mortality than no-college blacks.
There’s been considerable coverage of this story, but it’s been disappointing. Both DeLong and Krugman missed the college vs. no-college white middle-age cohort, and I think that’s the important story. There’s also been some discussion of anger as a defining trait of the GOP base, but no connection to the extreme distress of their core voter.
I’ve seen speculation that this is all about narcotic overuse. I find that very hard to believe, but I admit the use of narcotics for pain relief in America has exceeded my expectations. I remember in the 90s when “pain is the new vital sign” and family docs were berated for inadequate use of narcotics. I guess my peers responded well to that feedback.
It has occurred to me that there’s a potential bias we’re missing. Over the past 40 years colleges have gone from predominantly male to predominantly female. The big story here is increasing mortality in the no-college white cohort. But if there’s been a gender shift in that cohort, say from 55% female in 1999 to 45% female in 2013, that will make the no-college numbers even more dramatic. Since mortality has increased even when college grads are included this isn’t the entire story, but it will make the no-college effect more dramatic.