The death rate among white middle-aged Americans is rising at an alarming rate, even as death rates for all other Americans are falling. The increase is concentrated among whites with meager educations and is “largely accounted for by increasing death rates from drug and alcohol poisonings, suicide and chronic liver diseases and cirrhosis,” according to two Princeton University scholars, one of whom was just awarded the Nobel in economics. Their findings should awaken Americans to the price we pay for pursuing economic policies that enrich the few at the expense of the many. Drug and alcohol use that results in death from either poisoning or chronic disease, as well as increased self-extermination, point to social pathologies fostered by government policies that favor moving jobs offshore, reducing wages, restricting access to health care and enabling age discrimination in hiring.

Macabre data

There is good reason to think worsening economic conditions are at the heart of what the Princeton economists — Anne Case and Angus Deaton, the new Nobel laureate — found by simply analyzing published mortality data. Case and Deaton, who are married, found “declines in self-reported health, mental health and ability to work, increased reports of pain, and deteriorating measures of liver function all point to increasing midlife distress,” according to their paper published in The Proceedings of the National Academy of Sciences. We’ll return to that in a moment, but first, let’s get a handle on the enormity of this macabre trend among middle-aged white Americans. Every 75 minutes, a white middle-aged American dies who would be alive had the United States simply maintained the mortality level of that group in 1998. That’s about 7,000 unnecessary deaths per year. Worse, every 16 minutes, a white middle-aged American dies who would be alive had the trend of falling death rates from 1979 through 1998 continued its downward trajectory for the next 15 years. That comes to a half million extra deaths among middle-aged white Americans from 1999 to 2013. Many of these added deaths stem from drug and alcohol poisoning and diseases from chronic use, the data show. The use of prescription painkillers, as well as illegal drugs such as heroin that tamp down emotional pain, is on the rise, especially in states where limited educations are common. In Alabama, among the poorest states, doctors wrote 143 prescriptions for opioids such as Oxycontin for every 100 residents in 2012 — the highest rate in the nation. Tennessee doctors write such prescriptions at more than 21 times the rate of Minnesota doctors.

Social pathologies

That the death rate for middle-aged American whites, especially those with meager educations, started rising at the turn of the century fits the economic data that I have been analyzing for years. The harsh reality is that our economy is in many ways stuck in 1998 and that for poorly educated Americans, the economy has become a living nightmare with no expectation of a brighter tomorrow.

The rise in drug and alcohol poisonings as well as the rising tide of suicides should not surprise. But these trends should disturb.

In a society based on paid work, long-term unemployment can be devastating to self-esteem, social attachment and life planning. Joblessness and uncertain work promote despair and alcohol abuse. Alcohol dependence is worst among the unemployed and is higher among those with a high school education or less than among those with a college degree or more, the federal Centers for Disease Control and Prevention reports. Suicide is the 10th-leading cause of death in America and accounts for a large portion of the rising death toll among middle-aged whites. In 2013, CDC data show, more than 41,000 people took their own lives, more than 32,000 of them men. Suicide is far more common among white men than black men. While people commit suicide for many reasons, suicides are a canary-in-the-mineshaft indicator of societal pathologies. Economic shocks, especially the loss of reliable income, can result in a significant increase in suicides, as Russian society experienced soon after the collapse of the Soviet empire.

The wages of inequality