Why Are Middle Age White People Dying at Greater Rates Than Others?

Consider Some Sociological Theories

Two men carry a casket from a church. Rates of mortality among middle aged white Americans have spiked in recent years.
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In September 2015 The National Academy of Sciences published the results of a startling study that show that middle age white Americans are dying at rates far greater than any other group in the nation. Even more shocking are the predominant causes: drug and alcohol overdose, liver disease related to alcohol consumption, and suicide.

The research, conducted by Princeton professors Anne Case and Angus Deaton, is based on mortality rates recorded from 1999 to 2013. Overall in the U.S., as in most Western nations, mortality rates have been on the decline in recent decades. However when analyzed by age and race, Drs. Case and Deaton found that, unlike the rest of the population, the mortality rate for middle age white people--those 45 to 54 years old--has skyrocketed over the last 15 years, though it too had previously been on the decline.

The increasing death rate among this group is so large that, as the authors point out, it is on par with deaths attributed to the AIDS epidemic. If the death rate had continued to decline as it had been through 1998, half a million lives would have been spared.

Most of these deaths are attributed to sharp increases in drug and alcohol-related deaths, and suicide, with the largest increase attributed to overdoses, which climbed from almost nothing in 1999 to a rate of 30 per 100,000 in 2013. For comparison, the rate of drug and alcohol overdose per 100,000 people is just 3.7 among Blacks, and 4.3 among Hispanics. The researchers also observed that those with less education experienced higher mortality rates than those with more. Meanwhile, deaths from lung cancer declined, and those related to diabetes increased only slightly, so it is clear what is driving this troubling trend.

So, why is this happening? The authors point out that this group also reported worsening physical and mental health during the timeframe studied, and reported a decreased ability to work, increasing experience of pain, and deteriorating liver function. They suggest that the growing availability of opioid pain medication, like oxycodone, during this time period could have spurred addiction among this population, which would have subsequently been satisfied with heroin after stricter controls on prescription opioids were introduced.

Drs. Case and Eaton also note that the Great Recession, which saw lots of jobs and homes lost, and which significantly lowered the wealth of many Americans, could be a contributing factor to worsened physical and mental health, as illnesses could go untreated for lack of income or health insurance. But the effects of the Great Recession were experienced by all Americans, not just those who are middle-aged, and in fact, economically speaking, were experienced the worse by Blacks and Latinos.

Insights from sociological research and theory suggest that there may be other social factors at play in this crisis. Loneliness is likely one of them. In a 2013 article for The Atlantic, University of Virginia sociologist W. Bradford Wilcox pointed to the rising disconnect between middle-aged American men and social institutions like family and religion, and increasing rates of un- and under-employment as reasons for a sharp increase in suicide among this population. Wilcox emphasized that when one becomes disconnected from what typically holds people together in a society and gives them a positive sense of self and purpose, one is more likely to commit suicide. And, it's men without college degrees who are most disconnected from these institutions, and who have the highest rate of suicide.

The theory behind Wilcox's argument comes from Émile Durkheim, one of the founders of sociology. In Suicide, one of his most widely read and taught works, Durkheim observed that suicide can be linked to periods of rapid or vast change in society -- when people might feel as if their values no longer match that of society, or that their identity is no longer respected or valued. Durkheim referred to this phenomenon -- the breakdown of connections between an individual and society -- as "anomie."

Taking this into consideration, another possible social cause of the increase in mortality among white middle age Americans could be the changing racial makeup and politics of the U.S. Today, the U.S. is far less white, demographically speaking, than it was when middle age Americans were born. And since that time, and over the last decade especially, public and political attention to the problems of systemic racism, and to the related problems of white supremacy and white privilege, have greatly changed the racial politics of the nation. While racism remains a serious problem, its hold on the social order is increasingly challenged. So from a sociological standpoint, it's possible these changes have presented identity crises, and a related experience of anomie, to middle age white Americans who came of age during the reign of white privilege.

This is just a theory, and it's likely a pretty uncomfortable one to consider, but it is based in sound sociology