Death is the Ultimate Statistic

Two and a half years ago, a study reported that the death rate among non-Hispanic White women age 18 to 54 who were not high school graduates had spiked.

At the time I speculated that this might be the canary in the coalmine, the first indicator of the negative implications of the diminished economic standing, increasing social isolation, and public policy disadvantages of the generations that followed Generation Greed. But others noted that since fewer and fewer women have become high school dropouts over time, the dropout population is now probably more troubled than in the past, and this could explain the higher death rate.

Last week, however, a new study showed the death rate has increased for ALL white women age 18 to 54. So much for the shifting cohort composition objection.

“We don’t have enough evidence to tell whether the increase is a temporary one linked to painkiller abuse or if it’s a long-term shift,” Bloomberg News reported. “The authors cite examples of other short-term spikes in mortality.” However, the increased death rate may reflect “’a systematic reversal in the long-term trend of mortality decline’ for white women, according to the Urban Institute paper. Such a shift could be linked to social and economic circumstances. Poorer people generally have poorer health for a variety of reasons, and growing inequality could be weighing on death rates.” If so, life expectancy may start to fall, and not just for white women. “America isn’t really used to the idea of declining life expectancy. The next few decades might change that.”

Vital statistics, such as birth and death, are the ultimate statistics. They are the most venerable, the easiest to measure, and the least subject to interpretation. Since they correlate with health, and (health aside) individual happiness may be more a result of personal circumstances than social arrangements, one could argue that vital statistics are the best measures of social well being. Everything else – education, income, poverty, household type, housing – could be considered as a mere cause or explanation of what really matters in the end.

So if, as I have shown in other posts, younger generations have been disadvantaged economically,

and in public policy,

and in family life,

and if that disadvantage is meaningful, as opposed to being insignificant and/or offset by other factors, it ought to eventually show up in the death rate. Particularly as the disadvantaged population faces the vulnerabilities and diminished health of old age.

As I’ve noted, since the 1960s the suicide rate among senior citizens has plunged, as social benefits have reduced the anxieties and infirmaries of old age. The very social benefits that have been and will continue to be diminished for younger generations, as the government goes broke as a result of the unwillingness of the generations that benefitted to pay for those benefits. At the same time, with family dissolution and rising drug abuse the suicide rate among teens and young adults has increased. But according to the study the largest factor in the rising death rate for white women isn’t suicide.

“Death rates from accidental poisoning increased more than all other causes combined, zooming from 3.3 to 15.9 deaths per 100,000 women, an increase of 12.6. This large increase is generally attributed to accidental poisonings from prescription opioids (Paulozzi and Annest 2007). The Centers for Disease Control and Prevention (2013) reports, for example, that more than 6,600 women (of all races) died from prescription painkiller overdoses in 2010, more than five times as many women as in 1999.”

Suicide, smoking and obesity related causes of death also increased, but not the same extent.

“The recent spike in white women’s mortality may be analogous, in part, to the spike in black mortality—including adult women’s mortality—that accompanied the rise of the crack epidemic in the late 1980s and early 1990s. If so, one might predict that this mortality epidemic will ebb in the same way that several causes of death associated with the crack epidemic subsequently ebbed (Fryer et al. 2013). Another parallel might be the apparently subsiding high death rates among Russian men from the alcohol epidemic (Pridemore et al. 2014). In both these examples, increases in death rates were associated with particular behaviors (drug and alcohol use). The appropriate public health responses to such spikes are targeted interventions for the affected groups.”

“Similarly, the findings on the causes of death among adult non-Hispanic white women point to the need for a strong public health focus on the misuse of prescription opioid drugs, as well as continued attention to reducing smoking and obesity. All three of these behavioral factors are directly implicated in the rise of this group’s mortality from 1999 to 2011.”

The more troubling possibility is that the change isn’t temporary, but rather a fundamental and broader shift that is showing up among White women first.

Structural change in society is difficult to forecast, because forecasting models are based on the structure of society as it already exists. To try to anticipate such shifts, one can only note a change in one place, or among one group, and speculate as to whether it is an early indicator of a broader change among the entire population.

In addition to the rising death rate for White women, Bloomberg News cites the “Hispanic Paradox,”

As noted by NPR,

“For the first time, the statisticians over at the Centers for Disease Control and Prevention figured out how to estimate the life expectancy of Hispanics in this country. And, it turns out, Hispanics born recently can expect to live longer than either whites or blacks. How much longer? Well, a Hispanic person born in 2006 can expect to live to the ripe old age of about 80 years. More than 2 years longer than non-Hispanic whites who’re looking at about 78 years. And for non-Hispanic blacks, the expected lifespan is nearly 8 years shorter at 73 years. The Associated Press reports it’s the latest evidence for an apparent Hispanic paradox: the group is living longer than others in this country despite less fortunate socioeconomic circumstances. Nineteen percent live below the poverty line.”

The selective nature of immigration as cited as a reason. “Moving from one country to another takes some effort and fitness. So the United States may be attracting relatively healthier people from Mexico, the largest source of Hispanic immigrants, and other countries.”

But Cubans and Puerto Ricans (in Puerto Rico) pretty much outlive Americans too.

A check of who is washing the dishes in any restaurant will tell you that Latinos do most of the physical work in America today. Perhaps this spares them the growing infirmaries as a result of physical inactivity. However, I would speculate that Latinos have been less affected by the growing social isolation of life in the U.S., at least so far, and that is why they are living longer despite economic disadvantage.

As for Black women age 18 to 54 their death rate may not be rising, but it is already high to begin with, the report shows. Their lives may not be getting worse, and may even be getting a little better, but they weren’t that good to start with.

I raise social isolation and family dissolution as a cause of rising death rates because family is about women and children. One might say it is something that women and children, and men who cared about them, came up with to keep the other men in line. Or something that spontaneously emerged in disconnected human societies across the globe by natural selection, because it made one’s offspring more likely to survive to a healthy adulthood and reproduce themselves.

Opiate overdoses? Perhaps those are related to an increase in depression.

Those who grow up in severely disadvantaged circumstances, whether in poverty or in troubled families, seldom reach adulthood articulate enough and connected enough to broadly publicize what that was like. That’s why Angela’s Ashes was such an amazing book: a man survived desperate poverty and was articulate enough to describe what that life was like. So what could I point to as a first person account of what might be driving the rise in the death rate among White women age 18 to 54? How about this song, which the artist wrote about life in the wake of her parents’ divorce at age five?

Multiply that by a few tens of million people somewhere out there in America.

If economic and public policy disadvantage, and social isolation, are greater among the generations that followed Generation Greed, do not expect rising death rates and falling life expectancy to remain limited to the White woman age 18 to 54 sub-population over time. After all, there is other evidence that recent economic and social changes have actually been more detrimental to many men and boys. And in the end, with consequences perhaps showing up in their 60s (a decade or so from now), social isolation isn’t great for men either.