Angus Deaton, left, with his wife, Anne Case, after a news conference about his win of the 2015 Nobel Memorial Prize in Economic Science at Princeton University in Princeton, N.J., Oct. 12, 2015. A finding reported Monday by Deaton and Case stated that increases in mortality rates of middle-aged white Americans due to suicide and substance abuse rose in parallel with increasing reports of pain, poor health and distress. (Ben Solomon/The New York Times)

A silent epidemic is killing middle-aged white folks in Georgia

In the past week, news outlets have described a “stunning” and “alarming” study showing an epidemic that grew unnoticed for 15 years: more middle-aged white folks dying.

Suicides, alcohol and drug use were blamed for a 22 percent increase in the mortality rate of white people age 45-54 who have a high school education or less. The strange and troublesome statistical trend flew in the face of accepted wisdom in America — that the population would get healthier as time progressed. Or at least stop dying early.

And now we know, with a little compiling of some numbers, that the same trend that the Princeton University authors found has also occurred in Georgia. In fact, it might be even be worse here.

The death rate for white Georgians, age 45-49 increased 18 percent between 1999 and 2013, according to Georgia Department of Public Health mortality tables. The death rate for those 50-54 rose 21 percent in that same period.

And these rates were for all white Georgians. Take out those with some college and those numbers will assuredly jump.

Gordon Freymann, director of the Georgia Public Health Office of Health Indicators for Planning, crunches numbers for a living and said the suicide rate has not necessarily increased, but a rise in opiate abuse certainly has.

Also, according to Georgia stats, nearly half the increase in the death rate for 45-54 year-old whites comes from a sub group called “external causes” that includes motor vehicle crashes, accidental gun deaths and falls. Other categories like cardiovascular disease and cancer have stayed constant for white Georgians that age but have continued to fall for blacks.

The exact reason for this sea change in mortality rates is not known, although a common theme revolves around the dying of the middle-class, the feeling that the new normal of American life — sketchy work arrangements, smaller wages, increased debt, reduced life expectations and a frayed safety net — will kill you.

Alan Powell, a state representative for 26 years, has watched steady manufacturing jobs evaporate from his hometown in Hartwell in northeast Georgia. He hadn’t heard about the study “but I’m not surprised given the generational changes we have seen,” he said.

“That age group you’re talking about has seen massive changes in the workplace, in medical care, in the cost of medical care, the cost of living overall. You’re talking about the erosion of the middle class.

“They were always raised on the American dream, that you own your house, that your kids will do better,” Powell said, echoing what the study’s authors surmised. “They can’t afford to send their kids to college. The level of stress is astounding.”

Greater distance between the two Georgias

Michael Wald is a retired Bureau of Labor Statistics economist who spent three decades charting the ebbs and flows of employment in Georgia.

“Thirty years ago, we talked about the two Georgias,” he said, referring to the Georgia that is metro Atlanta and the other that isn’t. “It’s the same as it was, although the gulf has widened.”

Shuttered manufacturing plants, closed rural hospitals and failing schools are a tick tock of grim desperation across the state. And people’s strong bonds with co-workers have frayed, leading to isolation.

But if that’s the case, then why are the mortality rates for black people of that same age range — 45-54 — continuing to improve? To be sure, black people in those age groups are still more likely to need funeral directors than white people, but the death gap isn’t nearly what it was a generation ago.

Twenty years ago, black men age 45-49 were twice as likely to die than similarly aged white men — 775 per 100,000 to 307. In 2013, it had fallen to 430 per 100,000 for blacks and crept up to 365 for whites.

Black men age 45-49 have seen a 30 percent improvement in mortality rates since 1999 and those aged 50-54 are now a quarter less likely to die.

Part of the gap closing is because black people were sicker 30 years ago and had more room for improvement than whites. It’s kind of like it’s easier to lose the first 20 pounds on a diet than the last 10.

‘People are frustrated with their future’

And there’s a sense of expectations, the mental health part of it all.

“A number of middle-aged white people feel they fell short of where they should have,” Wald said. “It’s all what you achieve and hope to achieve.”

Black people, because of a history of discrimination and less opportunity, have perhaps a lessened sense of expectations, he said. Or maybe just more realistic.

“People are not just frustrated where they are, they’re frustrated with their future,” he said. Being frustrated with your current state of being can even be motivating. But feeling that the future is lacking for you and, worse, your kids, well, that can be crippling.

And there’s a difference if you blame yourself or others for your lot in life. If you internalize, you drink and become depressed; if it’s other people’s fault, you vote for Trump.

The professionals from the Public Health Department and Emory University’s Rollins School of Public Health were less willing to attribute reasons for the strange shift in death rates.

Jean O’Connor, director of Public Health’s Chronic Disease Prevention Program, said black males are now less likely to smoke than white males. “That’s a huge shift,” she said.

‘That’s a pretty notable change’

But that is a recent phenomenon and the death rate statistics are a rolling total through time, said Michael Kramer, an Emory epidemiologist.

“We have seen persistent improvement in mortality for everyone through the years and to see increases like this raises eyebrows,” he said. “Forty-five to fifty four-year-old black and whites are almost the same (in death rates). That’s a pretty notable change. But it’s getting smaller because whites are not improving. And that’s concerning.”

Alan Powell, the state rep, remarked that the trends in health, once terribly lopsided have evened.

“Does that mean we have become race-neutral as far as health goes in America?” he asked, pausing. “Well, there you go, it’s a balancing act.”

Although, he added, not the balance anyone had ever hoped for.