This paper documents a marked increase in the all-cause mortality of middle-aged white non-Hispanic men and women in the United States between 1999 and 2013. This change reversed decades of progress in mortality and was unique to the United States; no other rich country saw a similar turnaround. The midlife mortality reversal was confined to white non-Hispanics; black non-Hispanics and Hispanics at midlife, and those aged 65 and above in every racial and ethnic group, continued to see mortality rates fall. This increase for whites was largely accounted for by increasing death rates from drug and alcohol poisonings, suicide, and chronic liver diseases and cirrhosis. Although all education groups saw increases in mortality from suicide and poisonings, and an overall increase in external cause mortality, those with less education saw the most marked increases. Rising midlife mortality rates of white non-Hispanics were paralleled by increases in midlife morbidity. Self-reported declines in health, mental health, and ability to conduct activities of daily living, and increases in chronic pain and inability to work, as well as clinically measured deteriorations in liver function, all point to growing distress in this population. We comment on potential economic causes and consequences of this deterioration.
In a box labeled “Significance”:
Midlife increases in suicides and drug poisonings have been previously noted. However, that these upward trends were persistent and large enough to drive up all-cause midlife mortality has, to our knowledge, been overlooked. If the white mortality rate for ages 45−54 had held at their 1998 value, 96,000 deaths would have been avoided from 1999–2013, 7,000 in 2013 alone. If it had continued to decline at its previous (1979‒1998) rate, 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. Concurrent declines in self-reported health, mental health, and ability to work, increased reports of pain, and deteriorating measures of liver function all point to increasing midlife distress.
Those boys we went to high school with who didn’t go to college and couldn’t find jobs and joined the Army to have something to do. Paroled from broken homes, lackluster high schools and a shrinking military (after all, there were NO manufacturing jobs), they roamed aimless through an endless array of side gigs. They lived off women — their mothers and lovers and sisters and friends.
They died, America, because THEY DID NOT HAVE JOBS. They died because they’d lost all hope.
Yes, the plane has crashed. It was crashing back in 1977 when their parents divorced and they basically became FATHERLESS. It’s tragic and they never got over it. Jobless and hopeless, they turned to drugs and alcohol to anesthetize the pain. One epidemic wrought another and so it goes on down the line.
Hmmm. My mother died in 1977. (Dad remarried and hung around until 2006.) I have difficulty believing that this is why I’m still around and the number of “in memoriam” entries on the blogroll continues to increase.
Or maybe it’s just that I never had all that much hope to begin with, and therefore losing some of it wasn’t that much of a change.