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Betsy McKay
The Wall Street Journal

In 2015, two Princeton University economists published a landmark paper showing that mortality was rising for white middle-aged Americans after decades of decline, a startling development for an economically advanced nation.

Now a new analysis from the same pair, released Thursday by the Brookings Institution, paints an even bleaker picture of the nation’s largest-population group.

Mortality has been rising since the turn of this century for an even broader swath of white adults, starting at age 25, the researchers found, driven by troubles in a hard-hit working class. Death rates for white non-Hispanics with a high-school education or less now exceed those of blacks overall, the pair said—and they’re 30% higher for whites age 50 to 54 than for blacks overall of that age.

A Rising Toll

New research shows the increasing mortality rate among white Americans spans age groups and is most acute among the less-educated.

White deaths are rising…

Mortality rate by race, ages 50-54

…among all age groups of less-educated whites…

Mortality rate for whites with high school education or less, by age

…in contrast to elsewhere…

Mortality rate for all causes, ages 45-54

…due in part to increases in ‘deaths of despair’.

Mortality rate due to alcohol, drugs and suicide, ages 50-54

 
Mortality rate=deaths per 100,000
Anne Case and Angus Deaton of Princeton University

Blacks have long had a much higher death rate than whites, but that rate has dropped steeply since the beginning of this century, while the rate for whites has crept up.

Driving the uptick are increases in “deaths of despair”—from drugs, alcohol-related liver diseases and suicide, as well as a slowdown in progress against death in middle age from heart disease and cancer, the nation’s biggest killers, wrote Anne Case and Nobel Prize-winning economist Angus Deaton, her husband. The pair examined more than 15 data sets, including government health statistics, death certificates and various economic indicators.

The analysis paints a portrait of a gradual “collapse of the white, high-school-educated working class after its heyday in the early 1970s,” whose health, mental well-being, and attachment to the labor force have become successively worse for people born after 1945, they said.

The opioid epidemic has only heightened a trend that was already under way before those drugs hit the market, they said.

By contrast, Ms. Case and Mr. Deaton noted, the mortality rate has continued to decline this century for whites with a college degree, albeit more slowly than before.

The increase in mortality rate for working-class whites can’t be explained by declining income prospects alone. Blacks and Hispanics face many of the same income struggles but have experienced declines in mortality over the same period, the two economists argued, though their findings reveal more recent troubles for blacks, with gains stagnating the past couple of years amid an increase in drug overdoses and stalling progress against heart disease.

“This doesn’t seem to be about current income,” Ms. Case said in a call with reporters. “It seems to be about accumulating despair.”

The rising mortality of working-class white adults appears to be rooted both in worse job opportunities and increasing social dysfunction, following generations of relatively stable lives that involved job advancement and an expectation of living better than one’s parents, the researchers said.

Wages aren’t rising with age now as much as they once did for high-school-educated white men, Ms. Case said, suggesting that the composition of jobs available to them has changed and that there is less upward mobility.

“The company man job has gone away for working-class people,” Mr. Deaton said.

Those changes have come along with trends such as a decline in marriage, more temporary relationships and children out of wedlock, and a rise in social isolation that have made life less stable, they said. Taken together, these changes in life may be leading to physical and mental-health problems, they said, calling their hypothesis “preliminary but plausible” with more research needed on several fronts.

The work deepens a growing body of academic and government research into the possible causes of rising mortality rates among whites, whose ills among the working class are reshaping the nation’s social, political and economic landscape. Non-Hispanic whites make up 62% of the U.S. population, and their rising mortality rates helped to push overall U.S. life expectancy down slightly in 2015, to 78.8 years.

“For many Americans, America is starting to fail as a country,” said James Smith, chair in labor markets and demographic research at the Rand Corp., who wasn’t involved in the paper and said he was struck that mortality rates are rising for young working-class adults. “The bad things that are going on in America do not appear to be going on in Western European countries, and that’s a big deal.”

The phenomenon is occurring all across the country, both in urban and rural areas, Ms. Case and Mr. Deaton wrote. And the ills are so deep and complex that it could take many years and many changes in policy to reverse.

“As these people move into old age, they’re going to be sick, and that has disastrous consequences for Medicare and Social Security policy,” Mr. Deaton said.

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