More on the White Death:

Drug Overdoses Propel Rise in Mortality Rates of Young Whites

NYT

By GINA KOLATA and SARAH COHEN JAN. 16, 2016 538 COMMENTS

Drug overdoses are driving up the death rate of young white adults in the United States to levels not seen since the end of the AIDS epidemic more than two decades ago — a turn of fortune that stands in sharp contrast to falling death rates for young blacks, a New York Times analysis of death certificates has found.

The rising death rates for those young white adults, ages 25 to 34, make them the first generation since the Vietnam War years of the mid-1960s to experience higher death rates in early adulthood than the generation that preceded it.

The Times analyzed nearly 60 million death certificates collected by the Centers for Disease Control and Prevention from 1990 to 2014. It found death rates for non-Hispanic whites either rising or flattening for all the adult age groups under 65 — a trend that was particularly pronounced in women — even as medical advances sharply reduce deaths from traditional killers like heart disease. Death rates for blacks and most Hispanic groups continued to fall.

The analysis shows that the rise in white mortality extends well beyond the 45- to 54-year-old age group documented by a pair of Princeton economists in a research paper that startled policy makers and politicians two months ago.

While the death rate among young whites rose for every age group over the five years before 2014, it rose faster by any measure for the less educated, by 23 percent for those without a high school education, compared with only 4 percent for those with a college degree or more.

The drug overdose numbers were stark. In 2014, the overdose death rate for whites ages 25 to 34 was five times its level in 1999, and the rate for 35- to 44-year-old whites tripled during that period. The numbers cover both illegal and prescription drugs. …

There is a reason that blacks appear to have been spared the worst of the narcotic epidemic, said Dr. Andrew Kolodny, a drug abuse expert. Studies have found that doctors are much more reluctant to prescribe painkillers to minority patients, worrying that they might sell them or become addicted.

“The answer is that racial stereotypes are protecting these patients from the addiction epidemic,” said Dr. Kolodny, a senior scientist at the Heller School for Social Policy and Management at Brandeis University and chief medical officer for Phoenix House Foundation, a national drug and alcohol treatment company. …

Researchers are struggling to come up with an answer to the question of why whites in particular are doing so poorly. No one has a clear answer, but researchers repeatedly speculate that the nation is seeing a cohort of whites who are isolated and left out of the economy and society and who have gotten ready access to cheap heroin and to prescription narcotic drugs.

“There are large numbers of people who never get established in the economy, who live outside family relationships and are on the edge of poverty,” Dr. Hayward said. Many end up taking prescription narcotics, he added.

“Poverty and stress, for example, are risk factors for misuse of prescription narcotics,” Dr. Hayward said.

Eileen Crimmins, a professor of gerontology at the University of Southern California, said the causes of death in these younger people were largely social — “violence and drinking and taking drugs.” Her research shows that social problems are concentrated in the lower education group.

“For too many, and especially for too many women,” she said, “they are not in stable relationships, they don’t have jobs, they have children they can’t feed and clothe, and they have no support network.”