High mortality rates for middle-aged whites in Georgia, the South

The prognosis is not good for middle-aged whites, particularly those who live in the South.

In addition to suicide, alcohol and drug abuse, middle-aged whites between 45-54, are dying at even higher rates from heart disease, diabetes and respiratory illnesses, a new Commonwealth Fund study has found. This is in stark contrast for death rates among other racial groups, where the numbers are falling

“We are accustomed to making progress against diseases,” David Blumenthal, co-author of the study and Commonwealth Fund president said in a statement. “For middle-aged whites, that progress has stalled and even reversed for some conditions. We need to find out why this is happening.”

Last year, a study by two Princeton University researchers, Angus Deaton and Anne Case, found mortality rates for less-educated, middle-aged whites had increased by 22 percent between 1999 and 2013. Case and Deaton’s research showed that the surge in deaths among this demographic group was driven by conditions associated with drug abuse; overdoses, liver disease. The Princeton researchers weren’t certain what was causing the increase. They were clear, however, that those with only a high school education or less were more likely to die early, leading some to speculate that diminished economic opportunities for that group contributed to greater instances of substance abuse.

The Commonwealth study found that between 1999 and 2014, other health problems that for decades had been in decline such as heart disease, were on the increase among middle-aged whites causing their mortality rates to stall and rise.

Across most age groups, races and ethnicities, death rates began declining in 1968 by about 2 percent a year. But by 2014, instead of declining an expected 1.8 percent annually, there were more than 100 extra deaths for every 100,000 middle-aged whites, the study found.

“[Substance] abuse, suicides, and liver disease do not fully explain why mortality rates for middle-aged white adults have failed to decline as expected,” Blumenthal and co-researcher David Squires wrote in the study. “Upon further digging, we find a multifaceted phenomenon, where mortality rates for middle-aged whites have stopped declining — or actually increased — across a broad range of health conditions, including most of the leading causes of death for this group.”

By contrast, between 1999 and 2014, mortality rates for non-Hispanic blacks fell by 2.1 percent and for Hispanics, 1.5 percent.

Death rates for non-Hispanic whites were worst in a host of Southern states, including Alabama, Mississippi, and Tennessee. Each had between 152 and 116 extra deaths for every 100,000. Georgia, however, fared a bit better with 49 extra deaths per 100,000, according to Commonwealth researchers. Only Texas, Virginia, Florida and Maryland had lower rates among the Southern states.

As for the causes, Squires, co-author of the new study said, there aren’t any studies yet that identify concrete causes but the common narrative points to diminished economic opportunities.

“Rising income inequality, wage stagnation, loss of manufacturing jobs,” said Squires. “There’s evidence that it’s related to economic and cultural changes that have affected less educated, low income workers. It’s all over the country, though concentrated in certain areas.”

The Commonwealth Fund is a non-profit foundation focused on health care policy and health care systems.

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