Clinton will burn in hell for NAFTA and similar policies
Bush Obama will burn in hell for continuing these policies.
They should emigrate to Iraq to be beheaded.
Idiot professors finally figure out some problems decades after the fact.
Persons living near Mexican border knew problems of such policies decades before they were implemented.
Persons naive about race and culture should not go to college in the social sciences.
Colleges need to tighten admission standards to stop funneling idiots into jobs in high places.
Governments should not fund institutions that are so slow in learning or hide facts.
The love of money is the root of all evil.
Clawback all money wasted on research into already known facts and return that money to tax payers.
Clawback all money wasted on educating students who lack the right qualifications for study.
Old news disguised as new news functions as fake news disinformation.
Rising morbidity and mortality in midlife among white non-Hispanic Americans in the 21st century
Sir Angus Deaton
in Proceedings of the National Academy of the Sciences of the United States of America
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.
Quiet ‘Epidemic’ Has Killed Half a Million Middle-Aged White Americans
Despite advances in health care and quality of life, white middle-aged Americans have seen overall mortality rates increase over the past 15 years, representing an overlooked “epidemic” with deaths comparable to the number of Americans who have died of AIDS, according to new Princeton University research.
The results are published in a new paper in the Proceedings of the National Academy of Sciences from
Anne Case, the Alexander Stewart 1886 Professor of Economics and Public Affairs, and
Angus Deaton, the 2015 Nobel laureate in economics and the Dwight D. Eisenhower Professor of International Affairs and professor of economics and international affairs.
With data from a variety of surveys and reports, the paper reports a sharp increase in the death rate for middle-aged whites after 1998, which the researchers tie to drugs and alcohol, suicide, chronic liver disease and cirrhosis.
This turnaround in mortality reverses decades of progress, the researchers write, and the same pattern is not seen in other rich countries,
nor is it seen among African Americans or Hispanics in the United States.
Although death rates related to drugs, alcohol and suicides have risen for middle-aged whites at all education levels, the largest increases are seen among those with the least education, the researchers found.
For those with a high school degree or less, deaths caused by drug and alcohol poisoning rose fourfold; suicides rose by 81 percent; and deaths caused by liver disease and cirrhosis rose by 50 percent.
All-cause mortality rose by 22 percent for this least-educated group.
Those with some college education saw little change in overall death rates, and those with a bachelor’s degree or higher actually saw death rates decline.
In terms of lives lost, had the white mortality rate held at its 1998 value, 96,000 lives would have been saved between 1998 and 2013.
If it had continued to fall at the rate of decline seen from 1978-1998, 488,500 deaths would have been avoided between 1999 and 2013.
This figure is comparable to the number of deaths caused by the AIDS epidemic in America.
While this turnaround in mortality is only partly understood, the research team cites the increased availability of opioids in the late ’90s as a potential cause, with some substitution toward heroin as opioid prescription became more carefully monitored and the quality and availability of heroin rose.
The authors note that financial stress may also play a role.
Median household incomes of white non-Hispanics began falling in the late 1990s, and the wage stagnation that began with the economic slowdown of the 1970s continues to
hit especially hard those with a high school or less education.
Coupled with the changing nature of the financial risk Americans face when saving for retirement as well as the recent financial crisis, economic insecurity may weigh heavily on U.S. workers, and take a toll on their health and health-related behaviors.
The high death rates also coincide with self-reported declines in health, mental health and the ability to cope with daily living among middle-aged whites over this same period
More middle-aged whites in 2013 reported chronic pain and displayed poorer liver function than those of the same age in 1999.
The fraction in the same age group who reported being unable to work doubled over this period.
In the paper, the authors write that “a serious concern is that those currently in midlife will age into Medicare in worse health than the elderly of today,” but that “this is not automatic;
if the epidemic is brought under control, its survivors may have a healthy old age. Yet addictions are hard to treat and pain is hard to control, so those currently in midlife may be a
‘lost generation’ whose future is less bright than those who preceded them.”
Rising Mortality Rates
Between 1978 and 1998, the mortality rate for white, middle-aged (ages 45 to 54) Americans declined by 2 percent a year on average, which matched the mortality declines observed in other rich countries, including France, Germany, the United Kingdom and Sweden.
After 1998, things changed.
Death rates among middle-aged white Americans began to rise at a steady clip of half a percent per year.
This turnaround was specific to whites, the researchers found. For non-Hispanic African-Americans and Hispanics in the U.S., mortality rates declined at 2.6 and 1.8 percent per year respectively.
Likewise, other rich countries maintained their yearly 2 percent decline.
When looking at the causes of death, the researchers found they were primarily
drug and alcohol poisoning (both accidental and intent undetermined), and
chronic liver disease and cirrhosis, which all increased yearly between 1999 and 2013.
Obesity also increased for middle-aged Americans
While the underlying causes are hypothetical at this point, the researchers point toward the increased availability of
opioid prescriptions that began in the mid-1990s. Tighter restrictions on opioids brought some substitution to heroin, even in regions where heroin had been little seen. At the same time, there has been a substantial increase in reports of pain and suicides.
Pain as well as drug and alcohol use are all established risk factors for suicide
“The epidemic of pain, which the opioids were designed to treat, is real
cannot establish which came first — pain or painkillers.
“Pain prevalence might have been even higher without the drugs, although
long-term opioid use may exacerbate pain for some
effectiveness and risks of long-term opioid use has been hampered by a lack of research evidence
Regionally, the rise in mortality occurred in all regions of the U.S., though
suicide rates were marginally higher in the South and West than the Midwest and Northeast. In each region,
death by way of accidental drug and alcohol poisoning rose at twice the rate of suicide.
In all five-year age groups that the authors looked at between 30 to 34 and 60 to 64, there were marked increases in deaths related to
drug and alcohol poisoning,
chronic liver disease and cirrhosis.
The midlife group differed only in that the number of deaths was so large that it changed the direction of overall mortality.
Increasing Reports of Pain
For middle-aged Americans, increasing mortality ran alongside increasing reports of pain.
One in three white middle-aged Americans reported chronic joint pain, taking the years 2011, 2012 and 2013 together, and one in seven reported sciatica.
All types of pain increased significantly from 1997 to 2013.
“The strongest morbidity effects are seen among those with the least education,”
Psychological distress also shot up in middle-aged whites
The fraction of people showing serious mental illness, rose from 3.9 percent to 4.8 percent between 1997-1999 and 2011-2013, while
the fraction of people who said they had difficulty socializing — a risk factor for suicide — rose from 6.3 to 8.7 percent.
A larger number of middle-aged Americans reported being unable to work or having difficulty with activities of daily living.
explain the increase in Americans on disability, the researchers write, and indeed the
Social Security Administration records also show increased disability associated with musculoskeletal problems and mental health issues.
“With regards to the increase in mental illness, I think it is part and parcel of all of this bad stuff going on,”
“But if people are drinking and drugging too much, or thinking about killing themselves, it is not so surprising they will report rising mental illness.”
In terms of policy, the researchers look toward tighter restrictions on prescription painkillers, but note that
broader social and economic issues are almost certainly involved.
“We need to think hard about controlling the prescriptions of opioid painkillers. The Federal Drug Administration recently approved Oxycontin for kids,” Deaton said.
“While some kids are in awful, terminal pain, and can clearly benefit from it, the scope for abuse is there, especially if pharmaceutical companies misbehave, as they have done in the past.
But if what is happening is an epidemic of despair, that people on the bottom of the economic heap are being increasingly left out as inequality expands, then what we are seeing is just one more terrible consequence of slow growth and growing inequality.”
Case acknowledges support from the National Institute on Aging (Grant P30 AG024361), and
Deaton acknowledges support from the National Institute on Aging through the National Bureau of Economic Research (Grants 5R01AG040629-02 and P01 AG05842-14) and through
Princeton’s Roybal Center for Translational Research on Aging (Grant P30 AG024928).
The paper, “Rising Morbidity and Mortality in Midlife Among White non-Hispanic Americans in the 21st Century,” was published in PNAS on Nov. 2.
The Forces Driving Middle-Aged White People’s ‘Deaths Of Despair’
In 2015, when researchers Ann Case and Angus Deaton discovered that death rates had been rising dramatically since 1999 among middle-aged white Americans, they weren’t sure why people were dying younger, reversing decades of longer life expectancy.
Now the husband-and-wife economists say they have a better understanding of what’s causing these “deaths of despair” by suicide, drugs and alcohol.
In a follow-up to their groundbreaking 2015 work, they say that a
lack of steady, well-paying jobs for whites without college degrees has caused pain, distress and social dysfunction to build up over time.
The mortality rate for that group, ages 45 to 54, increased by a half-percent each year from 1999 to 2013.
But whites with college degrees haven’t suffered the same lack of economic opportunity, and haven’t seen the same loss of life expectancy.
The study was published Thursday in Brookings Papers on Economic Activity.
Case and Deaton, who are both at Princeton University, spoke with NPR’s David Greene about what’s driving these trends. The interview has been edited for brevity and clarity.
On the original discovery of rising mortality rates for middle-aged whites
Deaton: Mortality rates have been going down forever. There’s been a huge increase in life expectancy and reduction in mortality over 100 years or more, and then
for all of this to suddenly go into reverse [for whites aged 45 to 54], we thought it must be wrong.
We spent weeks checking out numbers because we just couldn’t believe that this could have happened, or that if it had, someone else must have already noticed.
It seems like we were right and that no one else had picked it up.
We knew the proximate causes — we know what they were dying from.
We knew suicides were going up rapidly, and that
overdoses mostly from prescription drugs were going up, and that
alcoholic liver disease was going up.
The deeper questions were why those were happening — there’s obviously some underlying malaise, reasons for which we [didn’t] know.
On what’s driving these early deaths
Case: These deaths of despair have been accompanied by
reduced labor force participation,
reduced marriage rates,
increases in reports of poor health and
poor mental health.
So we are beginning to thread a story in that it’s possible that [the trend is] consistent with the
labor market collapsing for people with
less than a college degree.
In turn, those people are being less able to form stable marriages,
and in turn that has effects on the kind of economic and social supports that people need in order to thrive.
In general, the longer you’re in the labor force, the more you earn — in part because you understand your job better and you’re more efficient at your job, you’ve had on-the-job training, you belong to a union, and so your wages go up with age. That’s happened less and less the later and later you’ve been born and the later you enter this labor market.
Deaton: We’re thinking of this in terms of something that’s been going on for a long time, something that’s emerged as the iceberg has risen out of the water.
We think of this as part of the decline of the white working class.
If you go back to the early ’70s when you had the so-called blue-collar aristocrats, those jobs have slowly crumbled away and many more men are finding themselves in a much more hostile labor market with lower wages, lower quality and less permanent jobs. That’s made it harder for them to get married. They don’t get to know their own kids. There’s a lot of social dysfunction building up over time. There’s a sense that these people have lost this sense of status and belonging. And these are classic preconditions for suicide.
The rates of suicide are much higher among men [than women].
And drug overdoses and alcohol-related liver death are higher among men, too.
But the [mortality] trends are identical for men and women with a high school degree or less. So we think of this as
people, either quickly with a gun or slowly with drugs and alcohol, are killing themselves.
Under that body count there’s a lot of social dysfunction that we think ultimately we may be able to pin to poor job prospects over the life course.
On how mortality rates differ among races
Hispanics [have always had lower mortality rates] than whites. It’s a bit of a puzzle that’s not fully resolved, to put it mildly.
Black/White It’s always been true that mortality rates have been higher and life expectancy shorter for African Americans than for whites.
What is happening now is that gap is closing and, for some groups, it’s actually crossed.
What we see in the new work is if you compare
whites with a high school degree or less, at least their mortality rates are now higher than mortality rates for African Americans as a whole.
If you compare whites with a high school degree or less with blacks with a high school degree or less, their mortality rates have converged.
It’s as if poorly educated whites have now taken over from blacks as the lowest rung of society in terms of mortality rates.
On the geography of mortality rates
Case: There’s not a part of the country that has not been touched by this.
We like to make the comparison between Nevada and Utah to look at the extent to which good health behaviors lead to longer life.
Two thirds of Utahans are Mormons. They don’t drink, they don’t smoke, and they don’t drink tea or coffee.
Two thirds of Nevadans live in Las Vegas paradise, where there is a little more of everything,
so the heart disease mortality rates are twice as high in Nevada as they are in Utah.
But both states are [in the] top 10 for deaths of despair.
Utah has had a terrifically hard time dealing with the opioid crisis, and suicide rates [are] going up as well.
There’s a lot of surprise here in parts of the country that we weren’t really expecting to see.