The Worrying Rise of the Mortality Rate in the United States
Published in Les Échos
(France) on 16 November 2017
by François Bourguignon (link to original)
(France) on 16 November 2017
by François Bourguignon (link to original)
Translated from
by Tristan Harper.
Edited by Tiana Robles.
Since the turn of the millennium, life expectancy has declined in the United States. This phenomenon is particularly observable among white men with little education. We look at the reasons for this drift.
Among developed countries, the United States stands out for a surprising reason. Since the turn of the millennium, the mortality rate of the middle-aged has been rising, an increase sufficiently significant to negatively affect life expectancy. With the United States also conspicuous for its high – and rising – level of income inequality, it’s tempting to link the two, and to see in the rising mortality rate an unexpected and dramatic consequence of renewed inequality. Several analysts have made this connection.
A recent article by Case and Deaton, who brought the recent rise in mortality rate to light, suggests the connection to be more complex than it seems, though it’s equally concerning with regard to the evolution of post-industrial societies. According to them, it isn’t the growing inequality of incomes measured at each point in time that is the cause of the rising mortality rate, but more likely a change in the way professional and social attitudes are handed down from one generation to the next, itself possibly the result of globalization and technological change.
Deaths of Despair
Their argument rests on three main points. The first is that the increased mortality rate only concerns the white population whose education ends after high school. At every stage of life, mortality continues its age-old decrease for African-American and Hispanic populations and for those with a higher level of education. It’s therefore not a question of income having a direct effect, as black and Hispanic populations have experienced the same economic hardships as less educated white people.
Secondly, the increased mortality rate of the latter is due mainly to a rise in deaths described as “deaths of despair.” These include suicide, death from alcoholism or drug dependency, including addiction to opioids, which are intended to ease chronic pain, often of a depressive origin. It’s also due, to a lesser extent, to a slowing down in the same population of the fall in mortality rate for those with heart conditions. However, other causes of death have evolved in a similar fashion to that observed in other population groups.
Thirdly, the increased mortality rate includes a strong generational component. At any given age, the mortality rate increases systematically from one demographic group to the next. In other words, the mortality rate for those aged between 30 years old and 35 years old in the group born in 1980 is higher than that of the groups born in 1970 and 1960 at the same age, this being equally true for the 40-year-olds to 45-year-olds born in 1970 compared to those born in 1960, etc.
Disintegration of the Working Class
In this intergenerational context, statistical analysis reveals an evolutionary factor common to the increase in suicide, alcoholism, certain physical conditions (notably arthritic and sciatic pain), depression, social isolation, but also – and above all – to withdrawal from the labor market and the fall in wages for unskilled labor.
If this type of analysis doesn’t allow one to conclude a causal relationship between these diverse economic and social dysfunctions, it nevertheless suggests that the labor market and the major traumas it has been subjected to in recent decades (globalization, technological change) may have played a decisive role. Ultimately, Case and Deaton view this set of phenomena as an expression of the disintegration of the working class in America at the beginning of the 1970s, then at its peak.
They are probably right and one can’t help but be drawn to the populist conclusion of Donald Trump when he proclaims his desire to bring American industry and its lost “jobs” back home. He’s succeeded in convincing a large part of the working class with this kind of talk. But, of course, these jobs won’t come back.
Among developed countries, the United States stands out for a surprising reason. Since the turn of the millennium, the mortality rate of the middle-aged has been rising, an increase sufficiently significant to negatively affect life expectancy. With the United States also conspicuous for its high – and rising – level of income inequality, it’s tempting to link the two, and to see in the rising mortality rate an unexpected and dramatic consequence of renewed inequality. Several analysts have made this connection.
A recent article by Case and Deaton, who brought the recent rise in mortality rate to light, suggests the connection to be more complex than it seems, though it’s equally concerning with regard to the evolution of post-industrial societies. According to them, it isn’t the growing inequality of incomes measured at each point in time that is the cause of the rising mortality rate, but more likely a change in the way professional and social attitudes are handed down from one generation to the next, itself possibly the result of globalization and technological change.
Deaths of Despair
Their argument rests on three main points. The first is that the increased mortality rate only concerns the white population whose education ends after high school. At every stage of life, mortality continues its age-old decrease for African-American and Hispanic populations and for those with a higher level of education. It’s therefore not a question of income having a direct effect, as black and Hispanic populations have experienced the same economic hardships as less educated white people.
Secondly, the increased mortality rate of the latter is due mainly to a rise in deaths described as “deaths of despair.” These include suicide, death from alcoholism or drug dependency, including addiction to opioids, which are intended to ease chronic pain, often of a depressive origin. It’s also due, to a lesser extent, to a slowing down in the same population of the fall in mortality rate for those with heart conditions. However, other causes of death have evolved in a similar fashion to that observed in other population groups.
Thirdly, the increased mortality rate includes a strong generational component. At any given age, the mortality rate increases systematically from one demographic group to the next. In other words, the mortality rate for those aged between 30 years old and 35 years old in the group born in 1980 is higher than that of the groups born in 1970 and 1960 at the same age, this being equally true for the 40-year-olds to 45-year-olds born in 1970 compared to those born in 1960, etc.
Disintegration of the Working Class
In this intergenerational context, statistical analysis reveals an evolutionary factor common to the increase in suicide, alcoholism, certain physical conditions (notably arthritic and sciatic pain), depression, social isolation, but also – and above all – to withdrawal from the labor market and the fall in wages for unskilled labor.
If this type of analysis doesn’t allow one to conclude a causal relationship between these diverse economic and social dysfunctions, it nevertheless suggests that the labor market and the major traumas it has been subjected to in recent decades (globalization, technological change) may have played a decisive role. Ultimately, Case and Deaton view this set of phenomena as an expression of the disintegration of the working class in America at the beginning of the 1970s, then at its peak.
They are probably right and one can’t help but be drawn to the populist conclusion of Donald Trump when he proclaims his desire to bring American industry and its lost “jobs” back home. He’s succeeded in convincing a large part of the working class with this kind of talk. But, of course, these jobs won’t come back.
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