The death rate for middle-aged white Americans, particularly those who are undereducated, is on the rise. This peculiar health crisis cannot be boiled down to one simple cause or solution, but in a new report published Friday, experts say that the opioid epidemic has "added fuel to the flames."
As first highlighted by Princeton economists in 2015, the death rate for non-Hispanic, white Americans has been climbing since the late 90s. For decades, death rates (the number of deaths in a given population) have dropped for Americans overall, and middle-aged whites were no exception. Each year, on average, the death rate dropped by 2 percent.
But in 1998, something flipped, and while the death rates for everyone else—including black, Hispanic, and Asian Americans—continued to steadily drop, the death rates for middle-aged white Americans start to creep up: 0.5 percent a year, every year:
They've been dubbed "deaths of despair," due to the high number of overdose and suicide deaths. Those same economists, Anne Case and Angus Deaton, have now published a follow-up report where they've attempted to untangle the cause of this epidemic. While many experts supposed it's linked to a worsening economy and lower incomes, Case and Deaton say their analysis shows it's not so simple.
"The story is rooted in the labor market, but involves many aspects of life, including health in childhood, marriage, child rearing, and religion," the researchers wrote. "Although we do not see the supply of opioids as the fundamental factor, the prescription of opioids for chronic pain added fuel to the flames, making the epidemic much worse than it otherwise would have been."
Opioid overprescription and addiction has been an increasing scourge in the US, killing 91 Americans every day, especially low-income white Americans, according to the Centers of Disease Control. During President Donald Trump's election campaign, he regularly pledged to crack down on this epidemic, which disproportionately impacts many of his biggest supporters. Trump performed best in the counties hardest hit by the opioid epidemic.
Though focusing on the opioid epidemic won't solve the issue of rising death rates for middle-aged white Americans, Case and Deaton argue that it's certainly not a bad place to start. They two problems are intimately linked: another economist found last year that nearly half of all men who are currently outside the labor force are taking pain medication, two thirds of which are prescription painkillers, like opioids.
"None of this implies that there are no policy levers to be pulled; preventing the over-prescription of opioids is an obvious target that would clearly be helpful," Case and Deaton wrote.
But despite pledging to eradicate the opioid epidemic, Trump's proposed budget fails to address the primary factors impacting opioid addiction, focusing on law enforcement over treatment services. If Trump wants to serve his most enthusiastic voters, and stop them from dying in heightened numbers, he needs to listen to the experts in the field making it clear that more needs to be done.