On the Collapsing Health and Premature Deaths of Poorly Educated American Whites

This article has the most stunning health statistics I’ve seen in years. The documentation appears irrefutable; the research bears the signature the most recent Nobel economics laureate.

The author of this American Prospect article is Paul Starr, author of the classic book, The Social Transformation of American Medicine. Starr is a professor of sociology and public affairs at Princeton University and Stuart Professor of communications and public affairs at Princeton’s Woodrow Wilson School. He’s a writer whose insightful work I have admired for decades. One of Starr’s great strengths is his ability to contextualize the socio-political implications of data.

To wit:

In a reversal of earlier trends, death rates among white non-Hispanic Americans in midlife increased sharply between 1999 and 2013, according to a new study by economists Anne Case and Angus Deaton, winner last month of the Nobel Prize for economics. The increased deaths were concentrated among those with the least education and resulted largely from drug and alcohol “poisonings,” suicide, and chronic liver diseases and cirrhosis. This midlife mortality reversal had no parallel in any other industrialized society or in other demographic groups in the United States.

Case and Deaton’s analysis, published today in the Proceedings of the National Academy of Sciences, also shows increased rates of illness, chronic pain, and disability among middle-aged whites. The findings have important implications for American politics and public policy, particularly for debates about economic inequality, public health, drug policy, disability insurance, and retirement income. The data also suggest why much of American politics may be taking on an increasingly harsh and desperate quality.

The recent divergence in death rates between the United States and other rich countries is striking. Between 1979 and 1999, Case and Deaton show, mortality for white Americans ages 45 to 54 had declined at nearly 2 percent per year. That was about the same as the average rate of decline in mortality for all people the same age in such countries as France, Germany, the United Kingdom, and Sweden. (See figure below.) After 1999, the 2 percent annual decline continued in other industrialized countries and for Hispanics in the United States, but the death rate for middle-aged white non-Hispanic Americans turned around and began rising half a percent a year.

This, as yesterday’s gubernatorial election results in Kentucky have set the stage for the Governor-elect Bevin’s promised elimination of Medicaid expansion in that heart-of-Appalachia state. 400,000 stand to lose their insurance coverage.

Read it and weep …