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A group of middle-aged whites in the U.S. is dying at a startling rate
- lujim 11y agoSo from 1979 - 1999 mortality rates fell an average of 2% but have risen half a percent per year since then. If I had to guess it could be that the pressures of stagnant incomes, skyrocketing higher health care costs, and more volatile economic conditions could be a bit of a pressure cooker for stress, poor diets, and increased alcohol/drug use.
- _sword 11y agoAdding to that, the authors of the article and the paper are constructing an argument that over-prescription of opiod painkillers is a significant component of the problem.
- JoeAltmaier 11y agoHow about: they got more affluent, ate too much red meat and died of strokes?
- sithadmin 11y agoWhat are you trying to get at here? If this is supposed to be sarcasm, I'm missing it.
- lujim 11y agoYeah could be that, but think stress. We started the millennium with a stock market crash, 9/11, the Concord crashed, the Space Shuttle broke up on reentry, two wars kicked off and just when things started calming down... the Great Recession. If you weren't laid off then you probably knew a few people that were. It seemed like everything we had built over the past two decades was failing us all at once. The 90's seemed like a time when you just watched Seinfeld on Thursday nights and watched your stocks go up in value. The 2000's and on have been a bit more stressful.
- maxerickson 11y agoThe morbidity statistics they are using would break out strokes as a category. The abstract for the paper says This increase for whites was largely accounted for by increasing death rates from drug and alcohol poisonings, suicide, and chronic liver diseases and cirrhosis. ( http://www.pnas.org/content/early/2015/10/29/1518393112.abstract http://www.pnas.org/content/early/2015/10/29/1518393112.abst... ) So strokes probably don't explain it. In a previous discussion I speculated that military service (and thus combat) could be a contributing factor. It would be interesting to see how many of the suicides and overdoses were people who had experienced combat.
- programmernews3 11y agoComplete straw man argument but not surprising from a self-hating liberal. The article details the increasing causes of mortality in this group.
- lujim 11y agoNo doubt there. Over prescribing them leads to dependency, then the DEA terrifies doctors into abruptly cutting the doses for those already on them and those patients turn to more sinister alternatives like heroin.
- GoodOldNe 11y agoER doc here. I think that this is absolutely a large contributor of these mortality trends. There are so many more factors than just users turning to IV drugs / overdosing on rx meds though, and I think that's what we're just now finding out -- things like anhedonia that occurs because of neural-level changes in brain wiring due to long-term use of opioids, hyperalgesia (increased sensing of pain) from the same thing, and more and more people developing an illness script around chronic pain that they see themselves as victims of, necesitating ever-escalating doses of analgesia (whether that's in the form of opiates, opioids, alcohol, other substances) to deal with. Really, really big problem that I think we're just waking up to deal with.
- pnathan 11y ago> ...more and more people developing an illness script around chronic pain that they see themselves as victims of... Can you talk about this more? Some family members have routine complaints of chronic pain without a concrete physiological root cause, and I'd like to understand your comment further.
- simonh 11y agoMaybe, but the years from 79-99 were hardly stress free and actual standards of living and health care are still well above what they were in the late 70s. Or maybe the rate of improvement in living standards actually contributes more to life expectancy that the absolute level? That seems hard to believe though.
- sremani 11y agoSince the 80s whites as a group have diverged into blue-collar and white-collar groups. The socio-economic index of the blue-collar has been falling, and mortality has thus followed. My assumption the blue-collar group in bigger than the white-collar one, and hence the overall as a group is down. Charles Murray has some literature on this issue. I understand he is hated in Leftist circles, but the general observations have some merit.
- 6stringmerc 11y agoNot contradicting, actually I think supporting your point - check out this graphic noting the prescription demographics of painkillers: http://cbsnews1.cbsistatic.com/hub/i/2014/07/01/98ca03d6-2e25-4a6c-9957-63d75ac3ecbc/e34f4d33dd4f691d6faffc79f5ba05fd/cdc-painkiller-map620px.jpg http://cbsnews1.cbsistatic.com/hub/i/2014/07/01/98ca03d6-2e2... Source: http://www.cbsnews.com/news/the-states-with-the-worst-prescription-painkiller-problem/ http://www.cbsnews.com/news/the-states-with-the-worst-prescr...
- tlack 11y agoA friend illustrated an interesting correlation: http://www.modernmethod.com/send/files/military-vs-pain.png http://www.modernmethod.com/send/files/military-vs-pain.png
- scarmig 11y agoTaking issue with a book he wrote two decades ago doesn't mean hating him. He's one of my favorite thinkers.
- deleted 11y ago[deleted]
- sithadmin 11y agoThough I'm still on the fence about the validity of the comparison, an argument that I've seen online regarding these stats is that it echoes similar trends in addiction and suicide that manifested in post-USSR Russia, which were arguably driven by an increase in general despair and decline in quality of life. Here's an interesting qualitative description of the phenomenon: http://www.nybooks.com/blogs/nyrblog/2014/sep/02/dying-russians/ http://www.nybooks.com/blogs/nyrblog/2014/sep/02/dying-russi... Now, back to the contemporary statistics: the correlation between increased mortality and socioeconomic groups 'hardest-hit' by recent economic concerns (globalization, the recession, and income inequality) seems quite clear, but I'm wondering if the correlation with mortality associated with drug poisoning would hold true if the same information were collected about a country with a less dysfunctional approach to narcotics and addiction management. I have a hunch that it wouldn't.
- mbrutsch 11y ago> an increase in general despair and decline in quality of life. Yet in our own country, suicide is treated as a "mental illness", and rarely does anyone acknowledge the circumstances which make suicide the rational option.
- humanrebar 11y agoPlease don't call suicide a rational option. One can argue that oppression and malaise are driving people to despair. It's another argument entirely to say that wasting a life makes sense.
- JoeAltmaier 11y agoAssisted suicide is regarded as a human right by some. There are good rational arguments for that. Lets not be too PC to have the conversation.
- skwirl 11y agoI didn't get the impression that mbrutsch was referring to assisted suicide. Check out the quoted line. He/she was referring to suicide as the rational option for "an increase in general despair and decline in quality of life."
- deleted 11y ago[deleted]
- roymurdock 11y agoThe mortality rate for white men and women ages 45-54 with less than a college education increased markedly between 1999 and 2013, most likely because of problems with legal and illegal drugs, alcohol and suicide, the researchers concluded. Before then, death rates for that group dropped steadily, and at a faster pace. A graph in the article [0] shows a large spike in deaths by poisoning, a modest increase in suicides and chronic liver disease, no change in diabetes, and a decrease in lung cancer. So the authors quasi-conclude that the increase in this demographic is due to underlying psychic pain (tough times post-recession?) that causes people to overdose/die from alcohol poisoning. There is a weird stat at the bottom of the article - according to the "National Heroin Task Force" (who knew there was such a thing) 110 people overdose on legal/illegal drugs every day. The CDC says that only 6 people die from alcohol poisoning every day. So if we take those stats at face value, which we probably shouldn't because the National Heroin Task Force has an incentive to overblow the problem, then we would conclude that heroin is a much larger problem than alcoholism across this demographic. One other discrepancy was the author throwing in this strange citation that (supposedly) bemoans the future of Medicare: "This is the first indicator that the plane has crashed," said Jonathan Skinner, a professor of economics at Dartmouth College, who reviewed the study and co-authored a commentary that appears with it. "I don’t know what’s going on, but the plane has definitely crashed." It's not often that you see this level of insightful journalism and deep analysis, so I took a moment to savor that nugget of knowledge. Then I wondered - isn't it a "good" thing for the Medicare system if the working class is dying off after contributing to the pot but before taking anything out? [0] https://img.washingtonpost.com/rf/image_1484w/2010-2019/WashingtonPost/2015/11/02/Health-Environment-Science/Images/Whitedeath2.jpg?uuid=rEBj4IF6EeWnymq27CD4OQ https://img.washingtonpost.com/rf/image_1484w/2010-2019/Wash...
- cubano 11y agoFrom experience, not every heroin overdose ends in death, so perhaps that explains it.
- 6stringmerc 11y agoThough it's not a concern within my inner circle, I've studied the War on Drugs and to claim the "National Heroin Task Force" should be baseline accused of "overblowing" the problem shows, well, straight up ignorance. Currently, yes, it's a much more fatal problem than alcoholism. The toxicity of opiate addiction - and the unregulated black market for which to get heroin - is a deadly mixture of factors. So as painkiller overdoses leveled off at about 16,000 in recent years, heroin deaths skyrocketed from just over 3,000 in 2010 to more than 8,200 in 2013, according to CDC data. Though all heroin users didn't necessarily start with painkillers, it's the transition from painkillers to heroin, Humphreys and other experts say, that led to the recent dramatic spike in heroin abuse. Below is a link to a Vox article that presents evidence regarding the above quote, and the reason there's a heroin epidemic in the US is because of the overly aggressive (lobbied, and punished for dishonesty in marketing) pharmaceutical industry pushing opiate drugs. Now, with the crackdown on pills, there are wide, wide swaths of the US population who've gone from pills to the horse: http://www.vox.com/2015/10/1/9433099/opioid-painkiller-heroin-epidemic http://www.vox.com/2015/10/1/9433099/opioid-painkiller-heroi...
- timmaah 11y agoNYTimes take on it from yesterday: https://news.ycombinator.com/item?id=10495758 https://news.ycombinator.com/item?id=10495758
- cryoshon 11y agoYeah, I can imagine how it would be extremely stressful and life-shortening to be perpetually worried about money. Wealth inequality has been rising for a very long time, with all but the highest income brackets stagnating. This isn't sustainable, it's literally causing the serfs to be so stressed that they die or kill themselves because of how few resources they get. We need at least some of these people alive and functioning if our society is to continue.
- jazzyk 11y agoThe two - very telling - numbers to explain worries about money: - 62.4% Civilian Labor Force Participation Rate - the lowest in 38 years! (http://data.bls.gov/timeseries/LNS11300000 http://data.bls.gov/timeseries/LNS11300000) - 9M people on Disability Insurance, double the number in 1995 and six times the number in 1970 (http://fortune.com/2015/10/08/disability-insurance-unemployment-great-recession http://fortune.com/2015/10/08/disability-insurance-unemploym...)
- jazzyk 11y agoForgot to say that these numbers are rarely ever mentioned by the mainstream media (MSM), not to spoil the back-slapping narrative of politicians and their sycophants "See? We stabilized the economy and saved you from a depression" (at the cost of $1T new debt/year).
- cryoshon 11y agoNot sure why you got downvoted for this, you are entirely right regarding the shyness of the MSM to discuss the actual state of the economy. Part of it is due to the perception of the economy creating the reality of the economy, but it's also much more in line with the government to say that things are rosy.
- morgante 11y ago> Forgot to say that these numbers are rarely ever mentioned by the mainstream media (MSM) I see despairing articles about the state of the American middle class in the media all the time. In fact, this very article is from the mainstream media.
- cubano 11y agoI can totally understand why individuals with substance abuse problems give up in their early 50's and commit suicide, as I personally have felt this tug at times. It is very difficult, both emotionally and financially, to look back at a life of wrecked relationships and blown opportunities and not feel an intense disgust with yourself and a deep fear about the future. Also, there is simply no place for you in society anymore. In your 50's, you are almost completely judged by your status in life; your house, your cars, your relationships...someone fighting addiction for 30 years will have little to none of this. Even super close old friends eventually give up on you and stop returning calls. I often say these days the only real regrets I have in life is hurting those who loved me due to my substance abuse lifestyle.
- yeahrite 11y agoI think that you are doing great.
- lujim 11y agoPainful to read. Addiction lives in a gray area of free will. Although people make bad decisions and we all need to own our mistakes, there is a good chance that most of the time you were just along for the same crappy ride as your family and friends. You are in the unfortunate position of having to bear the brunt of the guilt.
- drzaiusapelord 11y agoThis is why I'm largely against drug liberalization. Pot and maybe MDMA sure, but everything else, probably best left illegal. I could see exceptions for psychedlics for medical use, but not the kind of thing you would buy at the corner store, but administered by a doctor. The hysterical "legalize everything" crowd has probably set back sane drug reform for decades. I don't think these people remotely understand how addiction ruins lives and families and how hard it is to get out of it.
- jacquesm 11y agoThere are two things that I see often confused: legalization vs decriminalization and to me they mean different things. The problem is the users and the traders are often lumped together (and sure there are users that trade too). Tackle the traders but leave the users alone. This will still drive up prices and will still force some people into crime (but other crimes than mere possession) but it would be a good first step towards treating substance abuse (and that includes alcohol by the way) as a personal problem rather than a crime. That does not automatically translate into 'crack and heroin should be available at the corner store'. Nor does it translate into a free pass for traders or producers.
- alvern 11y agoMy wife's parents both passed in this group. Her father died of heart attack in 2001, but was heavy into cocaine and speed-drinking. Her mother recently passed last year of a heart attack, but was on methadone for opiate addiction and had sclerosis of the liver. Both of their death certificates list heart attack as the cause of death. I have to wonder how many of these opiate and poison related deaths are being cherry picked to hide other more common cause of deaths like heart disease.
- at-fates-hands 11y agoInteresting there is no mention of obesity and the correlated diseases which are associated with being overweight. The US has an obesity epidemic right now and it has huge risks for some of these health issues: 1. high blood pressure 2. diabetes 3. heart disease 4. cancer 5. ulcers Yet absolutely no mention of this in any of the stats or the issues which may be contributing to early deaths of this segment of the population.
- strictnein 11y agoBut aren't all other segments of the population experiencing that as well?
- ben010783 11y agoThey do mention it. They suggest that those types of ailments are increasing, but not at a pace that would explain these deaths. "...the study clearly shows they are not the result of diseases such as lung cancer or diabetes, which are declining and increasing slowly, respectively."
- maxerickson 11y agoThey are examining trends in morbidity data. Presumably, those causes of death did not show the same rise that is shown in the causes of death that they are calling attention to. That is, the paper would mention it if the population in question had seen an unusual rise in deaths from cardiovascular diseases and cancers.
- daxfohl 11y agoI wonder if the next generation will sneer when watching circa 2015 clips of people boozing at virtually every social outing, like we do when we see old clips of people smoking everywhere.
- mikeash 11y agoI'm doubtful. Smoking is a fairly recent phenomenon for the most part, while drinking long predates written history.
- rustynails 11y agoSmoking has been around for about 5000 years, https://en.m.wikipedia.org/wiki/History_of_smoking https://en.m.wikipedia.org/wiki/History_of_smoking It may be the impact to others that gave smoking it's stigma compared to alcohol. Smoke drifts through the air and leaves a pungent smell in clothing. For non-smokers, this can be far more impacting than alcohol when both substances are consumed in moderation.
- mikeash 11y agoRight, but it wasn't the modern form of smoking a lot every day as a habit, as far as I can tell, but more of an occasional thing. That's what I tried to cover, vaguely, with "for the most part." Smoking a little bit isn't too bad, it's when you're inhaling multiple cigarettes every day that you really have trouble.
- JoeAltmaier 11y ago500 years in the 'western' world. Imagine the first Europeans to encounter it. "What is this?" "Tobacco, sir" "What do you do with it?" "Why, roll it up, stick it in your face, and light it on fire"
- laboo 11y agoFox News Channel, founded 1996.
- pnathan 11y agoBlue collar white Americans haven't exactly been celebrated in the past 30 years. One might suspect that there is a connection.
- rdtsc 11y agoThey have become this mythical creature in political rhetoric along with "small business owners". A lot of stuff is done and claimed in their name. Little of it becomes true, but the rhetoric of appealing to "hard working men and women" never fails.
- pnathan 11y agoI am related several different ways to blue collar people: they see the sham.
- MisterBastahrd 11y agoNone of my relatives do. They eat that stuff up, because the alternative is to admit that they're a mediocre bunch that hasn't risen one iota above the wealth or social status of their predecessors, despite their derision for poor people of color for not climbing that same social ladder.
- programmernews3 11y agoBlue collar white Americans are being replaced by cheaper, less demanding migrant labour. It is a bad time for those that are not academically gifted.
- josefresco 11y agoYou need to be a lot more than "academically gifted" to make it in today's America. In fact, "academically gifted" probably means you have crushing student debt.
- adventured 11y ago
- annacollins 11y agoThe Reagan Democrats--white, lightly educated, profoundly homophobic-slit their own throats, but they still have their gods and their guns.
- deleted 11y ago[deleted]
- cryoshon 11y ago"We need better antidepressants. We need antidepressants that create reliable, stable euphoria, not just an absence of debilitating depression that struggles to beat placebo. But we need more than that. We need positive eugenics. We need to raise the IQ of the average human at least one standard deviation. But the hedonic treadmill will grind on, and sustainable euphoric antidepressants might be impossible. And that will still leave 50% of the population miserable that they are in the bottom half." And here you have made the case for a dystopia by suggesting that the human condition can and should be medicated away for the purposes of compliance. We already have a population that is heavily psychotropic drug-reliant in order to function, and the results aren't great. Stable euphoria is possible, just take up heroin injection. The argument for eugenics is also problematic/impossible. The low IQ people are just as human as the high IQ people, and they can't simply be bred out peacefully because, surprise, the smarter people get the fewer children they have. To offer a bit of perspective, I'd consider looking at societies that are less status-driven than the US as proof that blasting the public with medication isn't necessary with the economic/political tools of today. There are plenty of other places (Denmark or Nepal being good examples) where happiness is quite high, inequality is quite low, and the pyramid of status is much shorter and wider. People frequently want a sensation of fairness more than relative status; this is good especially because relative status is amorphously framed by the individual. EDIT: I have read some of the literature at the website cited, and find it to be largely philosophically spurious techno-fantasy. On a very long view, we may need to address the question of abolishing human suffering entirely (an extremely optimistic speculation), but it's a premature conversation to have because the road between here and there will change the nature of the problem.
- deleted 11y ago[deleted]
- JoeAltmaier 11y agoMaybe we need a way of life that doesn't drive us all to depression in the first place. Get out of the house, into the wild once in a while. Move, play, exercise with a purpose instead of those dreadful torture chambers of stationary bikes and mills. They used to put criminals on treadmills as punishment! And increase socialization to a daily activity. No more trudging to a faceless cubicle, then trudging home to an empty flat for some TV time. Then drugs to sleep, and drugs to wake up again. We need no antidepressants; we need to stop actively inducing depression!
- CPLX 11y agoI was surprised to read through all this and not see a more direct mention of the likely triad of causes for this phenomenon: debt, divorce, and dependents. Especially divorce.
- stillsut 11y agoBut isn't divorce down (or at least flat) since 1980? However % of out-of-wedlock births have continued to rise. Anecdotally and statistically, it seems like 'Family Court' findings are the major cause for a precarious-to-struggling decade long stretch of life.
- PsychopompPoet 11y agoelephant in the room - our culture is broken
- bcabs 11y agopmuch. https://www.youtube.com/watch?v=ao8L-0nSYzg https://www.youtube.com/watch?v=ao8L-0nSYzg
- Estragon 11y agoThanks for linking that, it's wonderful.
- runarb 11y agoI really wish that the whole Rat Park experiment this video relies on had been true, and a cure for addiction was that easy, but as I understand it the scientist behind the Rat Park experiment falsified the data to spark a public debate. The idea was great, but further studies failed to reproduce the original results and all major science journals rejected the paper. We are not making it easier to handle this big issue of addiction by relying on fals or unreproducible data.
- rustynails 11y agoIt's not all doom and gloom, there's still confirmation that environment and drug addiction are linked. Here's a link to the rat park experiment that touches on this topic, https://en.m.wikipedia.org/wiki/Rat_Park https://en.m.wikipedia.org/wiki/Rat_Park
- eric_h 11y agoDo you have a source that thoroughly supports the debunking of the Rat Park experiment? This is the first I'd heard that it was unreproducible and the result of falsified data.
- jgalt212 11y agoIn short, poor white folks struggle mightily just like poor black folks (or folks of any color) do.
- MadManE 11y agoIt's a little terrifying that this needs to be said. We are now operating under the assumption that if you are white, then your life can't be bad in any way and you have money to burn. I guess the propaganda has worked.
- learning_still 11y ago"This is the first indicator that the plane has crashed,” said Jonathan Skinner, a professor of economics at Dartmouth College, who reviewed the study and co-authored a commentary that appears with it. “I don’t know what’s going on, but the plane has definitely crashed." This basically sums up my fears. Whatever is going on, economics is at the root of it.
- jimrandomh 11y agoThe study itself: http://www.pnas.org/content/early/2015/10/29/1518393112.full.pdf http://www.pnas.org/content/early/2015/10/29/1518393112.full... Kudos to the authors and journal for providing a full PDF immediately. Boo to the Washington Post for not linking.
- hownottowrite 11y agoYay! GenX makes the news at at last! [Spoiler: I'm 45 and white. This isn't sarcasm. It's just how we are.]
- JustSomeNobody 11y agoHow much of this is due to the economy? The people in this group, surely, are finding it harder to get well paying jobs. It is much harder to find a middle income job working with your hands now than it was 20, 30 years ago. What did this group's wages do during this same time period? Something had to push them to this. I am guessing this is it.
- adventured 11y agoPeople with no college experience, are basically the only group not participating in the rebounded economy. In fact the only demographics that are actually losing jobs to immigrants in net, are lower class whites and blacks. Their job opportunities have been seriously harmed by the immigration influx. It makes perfect sense you would see a decline in their well being accordingly (especially considering the US has a weaker welfare state in sheer benefits volume, including for mental health, versus much of western Europe).
- kriro 11y agoVaguely reminds me of the chapter on suicides in Tipping Point (iirc). I wonder if this can be explained in a similar fashion instead of by macro trends?
- shawnee_ 11y agoThe findings discussed in this study make an interesting side note to this (older HN) discussion: https://news.ycombinator.com/item?id=5424241 https://news.ycombinator.com/item?id=5424241 The generation of "middle-aged whites" (which the article describes as being aged 45-54 between 1999 and 2013) probably doesn't get enough credit. So... lack of college education is a common denominator in many of their deaths. But people keep forgetting the information economy came after we had our hefty physical infrastructure. Alcohol and drug abuse are how people self-medicate when they can't afford expensive / professional medical care. We're only barely starting to scratch the surface of this problem with AHA; but for many of the "uneducated" people in this generation who were/are employed in construction / physical labor... it probably seems like too little too late.
- panglott 11y ago"While the death rate for African Americans is still greater than the rate for whites, the turnaround among whites is shocking because of the advantages they enjoy, said David Weir..." Is this just reversion to the mean? That is, is the death rate for working-class white people simply converging to to the death rate for African Americans? If so, that's the most horrible way to end white privilege :(
- adventured 11y agoNo, because we have explanations for what's causing it: suicides, drinking, drugs. It likely includes the large increase in pill overdoses by that white demographic since the mid to late 1990s. It's something that whites in the US seem to abuse more than any other group of people in any other country. Doctors in the US have become drug addiction facilitators. Further, historically American whites had among the highest life expectancy, between 1800-1970 - right until the obesity explosion left Americans trailing behind. So what reversion to the mean? Reversion would be that American whites drop the obesity, go back to 1970 weight levels, and live five years longer.
- ajross 11y agoNo, a "reversion to the mean" is a statistical error caused by small sample sizes. For obvious reasons, you're not likely to see it when looking at death statistics for a population in the tens of millions. There's a clear hypothesis here for a real effect.
- astine 11y agoUnless you are using a different meaning of 'reversion to the mean' than I am familiar with, it's not a statistical error and has nothing to do with the size of the sample. 'Regression to the mean' happens when you have an imperfect correlation between two data fields.
- intrasight 11y agoWhy just non-college considered in study? Seems to be an example of selection bias.
- ChuckMcM 11y agoMy concern is that this only gets worse going forward. We have so many people raised to "hit the milestone, get the prize" sort of life strategies that when you run out of milestones to hit it will greatly depress them.
- GPGPU 11y agoI would have liked to see them account for obesity, too. With more than 2/3 of our population overweight or obese this may have an effect. Sadly, our current education system cares more about "anorexia" and "body image" issues (that maybe kill 1,000 people/year) than obesity which directly kills 300,000 Americans a year.