It wasn’t supposed to end this way. But this week America learned that the folks everyone thought had it better than most are suffering a fate just as bad as the rest of us, and by some measures, even worse.
A demographic analysis of public health trends in recent years shows that middle-aged whites are living more miserable and sicker lives—and also appear to be dying at a higher rate. From 1999 to 2013, Princeton University researchers observed a disturbing jump in deaths among whites aged 45 to 54. For other groups, including seniors and middle-aged blacks and Latinos, mortality fell, continuing positive health and demographic trends of the past few decades.
Overall, non-Latino white midlife mortality ticked up by 34 deaths per 100,000. It’s not quite an epidemic, but the cumulative death toll suggests a slow-burning affliction that affirms a cultural sense of decline: Across the 15-year period, the researchers calculated, “If the white mortality rate for ages 45–54 had held at their 1998 value…half a million deaths would have been avoided in the period 1999–2013, comparable to lives lost in the US AIDS epidemic through mid-2015.” Driving factors reflected social and public health patterns: suicide, disease (particularly liver problems) and “drug and alcohol poisoning.”
The rising mortality rate, according to the study, paralleled “self-reported declines in health, mental health, and ability to conduct activities of daily living, and increases in chronic pain and inability to work.” But the trends differed by education level, as those with a high school–level education or less experienced worse outcomes than the college-educated.
This twist in America’s demography of death speaks to a societal malaise: The economic decline began well before the latest recession, but coincides with the economic dislocation that accompanied corporate globalization and “free trade” policies. Then the late 1990s brought a withering of the welfare system, leaving many older Americans facing an economic cliff after the financial collapse and debt crisis.
Nonetheless, the narrative of rising death rates among middle-aged whites should be viewed in a context of racial differences across many health measures; blacks in general still suffer higher mortality rates and poorer health outcomes than whites, for example. So this is racial inequality emerging in the negative direction. “The narrowing of the black white mortality gap could be thought of as leveling down,” says researcher Angus Deaton via e-mail. The study isn’t meant to suggest “tension or competition,” he stresses, but to show a more nuanced view of how economic insecurity and social distress interact.