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Opioid Crisis

Dying white Americans

A new study documents why mortality is higher among poorly educated whites

Tabitha Palmer and Anthony Palmer are Trump voters from Johnstown, Pennsylvania.
Tabitha Palmer and Anthony Palmer are Trump voters from Johnstown, Pennsylvania.

In the United States, middle-aged white men with less education are dying at an unusual rate. In fact, their mortality rate is higher than that of Hispanics or blacks of the same age and of the same educational level. The mortality of the less-educated whites is also much higher now than it was at the beginning of this century. This is an exclusively American phenomenon. In other developed countries it just doesn’t happen.

This is one of the conclusions of an important new study that was just presented in Washington by Angus Deaton and his wife Anne Case. Deaton is the winner of the Nobel Prize in Economics (2015), and Case is a prominent economics professor at Princeton University.

Worldwide mortality has been falling by 2% every year in every country, but uneducated white Americans are the exception

In 2015, these two economists had already caused a stir with a study that, for the first time, documented the tragic rise in deaths among white Americans with no college education. While in 1999 the group’s mortality rate was 30% lower than that of blacks with the same characteristics, by the year 2015 the mortality rate of these whites was 30% higher than African Americans. These changes have erased decades of progress. Over the last century, and continuing today, worldwide mortality has been falling by 2% every year in every country and in every demographic category. But white Americans without much academic preparation are the exception.

What happened? In this group suicides and deaths from drug overdose and alcoholism increased dramatically. Cancer and heart disease also became more acute, as did obesity. Since 2000, deaths from these causes among non-Hispanic whites ages 50-54 have doubled. And by 2015 they were dying at twice the rate of white women with the same characteristics (and four times more than white men who managed to go to college).

Curiously, Hispanics and African Americans, who also lost their jobs and income, are experiencing increasing longevity

A common explanation for this tragedy is the unemployment that struck this group of workers, both because of the financial crisis and globalization as well as the automation of production, circumstances that are making low-skilled jobs disappear.

Deaton and Case do not doubt that unemployment and the consequent fall in income are important factors. But according to them these explanations are insufficient and they maintain that the higher mortality of whites has “deeper causes.” How do you explain, for example, that Hispanics and blacks, who also lost their jobs and income, are experiencing increasing longevity? And why is it that among European workers, who were also victims of the 2008 global recession and the ensuing austerity policies, we don’t see the same lethal trends that affect white workers in the United States? Moreover, in Europe the longevity of those with fewer years of education (and less income) has continued to rise – and rise faster – than those of Europeans with higher educational levels.

According to the two economists, the deeper causes of this phenomenon have to do with what they call “cumulative disadvantages.” These are debilitating conditions and dysfunctional habits that this group has accumulated throughout their life as a reaction to deep economic and social transformations. It typically began with dropping out of high school and an early entry into the labor market in times of plentiful employment and attractive salaries. But this initial “work bonanza” gradually vanished and other changes in society – the role of women, increased divorce rates and family fragmentation, and geographic mobility – made life more difficult for white men and made them more vulnerable to what Deaton and Case describe as “deaths of despair.” They are men who do not see a better future for themselves or for their families.

White men are more vulnerable to what Deaton and Case describe as “deaths of despair”

This hopelessness causes great suffering. In the US, half of unemployed men take pain mediation and two-thirds consume opioids. The abuse of these drugs has become a very serious epidemic. In 2015, more Americans died of drug overdose than by firearms and traffic accidents. The overwhelming majority of victims? White men.

Two final questions: First: Why do white men of Hispanic origin, with little formal education and bad economic situations, die less? Because they have more hope in what the future holds. They are not longing for the better economic situation they had in the past. They never had it. For them the future can only be better. And even more so for their children.

Second: What is the political reaction of white Americans with high mortality rates? To vote for Donald Trump. More than 60% of them did so.

Follow me on Twitter @moisesnaim.

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