Alarming trend among less-educated 45- to 54-year-olds largely thought to be a result of more suicides and the misuse of drugs and alcohol
Monday 2 November 2015
A sharp rise in death rates among white middle-aged Americans has claimed nearly as many lives in the past 15 years as the spread of Aids in the US, researchers have said.
The alarming trend, overlooked until now, has hit less-educated 45- to 54-year-olds the hardest, with no other groups in the US as affected and no similar declines seen in other rich countries.
Though not fully understood, the increased deaths are largely thought to be a result of more suicides and the misuse of drugs and alcohol, driven by easier access to powerful prescription painkillers, cheaper high quality heroin and greater financial stresses.
The turnaround reverses decades of falling mortality rates achieved through better medical care and lifestyle choices that continue to improve public health in other groups in the US and in other nations around the world.
“This was absolutely a surprise to us. It knocked us off our chairs,” said Anne Case, an economics professor at Princeton University who worked on the study. Since discovering the trend, Case and her colleague Angus Deaton, also an economics professor at Princeton, have shared the findings with healthcare professionals. “We wanted to make sure we weren’t missing something,” Case said. “Everyone’s been stunned.”
The findings emerged from a review of national surveys in the US and six other rich industrialised countries, namely the UK, Australia, France, Germany, Sweden and Canada.
They showed that from 1978 to 1998, the mortality rate for US whites aged 45 to 54 fell by 2% a year, a figure very much in line with the celebrated improvements in health seen in the other countries.
But after 1998, the death rates of US whites began to buck the trend. While other countries saw their mortality rates continue to fall, they began to rise among middle-aged white non-Hispanic Americans by 0.5% a year. The effect was not confined to the 45- to 54-year-olds. In the 35- to 44-year-old bracket, the mortality rate stopped falling in 2000. For 55- to 59-year-olds, the fall slowed to 0.5% a year.