Mortality rates for poorly educated US whites are growing

Howard R. Gold | May 31, 2017

Sections Economics

Collections Inequality

For years, income inequality in the United States has been an increasingly popular topic in political and sociological discussion. But research suggests that there’s another growing divide that is perhaps more difficult to address: mortality inequality.

In 2015, Princeton economists Anne Case and Angus Deaton, a Nobel laureate, documented a “marked increase” in the death rates of middle-aged non-Hispanic whites in the US between 1999 and 2013. Not only was the trend unique to the US, it “reversed decades of progress in mortality,” they wrote.

The two researchers found that the jump in mortality for whites—especially those who had less education—was “largely accounted for” by higher death rates from drug and alcohol poisonings, suicide, and chronic liver diseases.

In a follow-up to that research, Case and Deaton now find that increases in all-cause mortality continued unabated through 2015, the latest period for which data are available.

Their new research also indicates that conditions have worsened for non-Hispanic white people without college degrees across a broad range of ages, men and women alike. “Not only are educational differences in mortality among whites increasing, but mortality is rising for those without, and falling for those with, a college degree,” Case and Deaton write.

By contrast, mortality rates in Europe for those with less education continue to fall, and at a more rapid pace than for those with higher levels of education. (The United Kingdom, Ireland, Australia, and Canada also had “substantial” increases in mortality from drugs, alcohol, and suicide during this time, but “their increases are dwarfed by the increase among US whites,” Case and Deaton write.)

Meanwhile, mortality rates continue to fall for US blacks and Hispanics, whose disadvantage relative to whites in this area has completely reversed, the researchers find. “In 1999, the mortality rate of white non-Hispanics aged 50-54 with only a high school degree was 30 percent lower than the mortality rate of blacks in the same age group; by 2015, it was 30 percent higher,” they write.

The trend is not confined to any one region and is “neither an urban nor rural epidemic, rather both,” the researchers conclude.

Case and Deaton trace its cause to a “cumulative deprivation, rooted in the steady deterioration of job opportunities for people with low education.” The conditions of working-class white men in particular have worsened since manufacturing’s peak in the 1970s.

“No longer was it possible for a man to follow his father into a manufacturing job, or to join a union,” they write. As the manufacturing-based economy broke down, so did other traditional social structures and support systems, such as marriage, religious institutions, labor unions, and multigenerational families. At worst, the authors write, “this is a Durkheim-like recipe for suicide.” (Émile Durkheim was a pioneering French sociologist whose 1897 book, Suicide, found that alienation and detachment from society increased the suicide rate.)

Case and Deaton do not attribute this rising mortality rate to widespread prescription of opioid painkillers, although that “added fuel to the flames, making the epidemic much worse.” Controlling opioid prescriptions would help, they write, but “deaths of despair come from a long-standing process of cumulative disadvantage” for the less educated. “The epidemic will not be easily or quickly reversed by policy.”