Posts Tagged ‘Case-Deaton Study’

American optimism and deaths of despair

June 12, 2017

I always thought that optimism was a basic and unchanging part of the American national character.

My belief is shaken by the rise in “deaths of despair”—first among middle-aged (45-to 54) white Americans, more recently among prime working aged (25 to 44) Americans of all races.

“Deaths of despair” are suicide, drug overdoses and alcohol-related liver disease.  The rise is thought to be caused by the hopeless economic situation of many Americans and by the ready availability of addictive drugs.

But this can’t the whole story.   In earlier eras of American history, such as the 1890s, poverty was greater, inequality was more extreme and addictive drugs were more freely available than they are now.

Pioneer families struggling to survive in sod houses on the prairie, immigrants in ragged clothes getting off the boat on Ellis Island, let alone African-Americans and native Americans—they all were in more desperate situations than any American today.

The USA was in the midst of a depression, comparable to the Great Depression of the 1930s.  There was no social safety net.   It was possible to starve to death in New York City or any major city in the Western world.  If you couldn’t pay a doctor bill, you relied on charity or, more commonly, did without.

Opiates were sold legally.  Opium dens were found in every major city.  Heroin was a patented brand-name drug sold legally by the Bayer company.   Drunkenness was a serious social problem.

But this was an era of hope, not despair.  Workers formed labor unions and fought armed company police.   Farmers started organized the Populist movement.   Middle-class reformers started the Progressive movement.   They enacted reforms and social changes from which we Americans still benefit.

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The spread of deaths of despair in the USA

June 12, 2017

Americans in the prime years of life—aged 25 to 44—are dying at an increasing rate, and the increase is mainly due to “deaths of despair”—drug overdoses and alcohol-related disease.

I recently wrote a post about the Case-Deaton study, which shows a rise in “deaths of despair” among white Americans, especially those age 45 to 54, since 1999.

Now reporters for the Washington Post have done their own study which shows a rise in the death rate since 2010 among Americans of all races in the prime of life—age 25 to 44.

As in the Case-Deaton study, the increase is due to “deaths of despair”—drug overdoses and alcohol-related diseases.

Since 2010, death rates have risen

  • 16 percent for young white American adults.
  • 18 percent for young native American adults
  • 7 percent for young Hispanic American adults
  • 4 percent for young African-American adults
  • 3 percent for young Asian American adults.

Why is this happening?

The majority of Americans are doing badly economically.  Wages are stagnant.  Good jobs are scarce.  Many have educational, medical or other debts they never will be able to pay.

Except for the professional classes and the ultra-rich, few expect to do better economically than their parents, and few expect their children to do better than themselves.

In the past generation, some of us have been sold in the idea that medications, such as Prozac, are the solution to our psychological and personal problems.   A journalist named Robert Whitaker did a good job of documenting this in his book, Anatomy of an Epidemic, and his book and website, Mad in America.

This new respectable drug culture made it easy for Purdue Pharmaceuticals to market Oxycontin, an addictive pain killing prescription drug, and widespread use of Oxycontin made it easy for illegal drug traffickers to sell heroin as a cheap substitute.  For some, drugs provided an easier escape from dead-end lives than individual initiative or political struggle.

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Why is the Hispanic death rate lower?

June 6, 2017

Click to enlarge

Compared to non-Hispanic whites and blacks, Hispanic Americans are survivors.

Why?

The Case-Deaton study and its new update showed that the death rate is rising among non-Hispanic white Americans while it is falling among citizens of every other important industrial nation.   Anne Case and Angus Deaton attribute this to the rise “deaths of despair”—from alcohol, drugs and suicide.

The study showed something else that I think is equally interesting.  The death rate among Hispanic Americans has always been lower than among non-Hispanic whites, and it continues to fall, in line with trends in other industrial nations.

In the chart above, the bright red line is the death rate among non-Hispanic white Americans and the bright blue line is the death rate among Hispanic Americans.

The death rate among non-Hispanic American blacks is higher than among whites, but it is falling, not rising.

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Opioid abuse and the white American death rate

July 12, 2016

I wrote blog posts some time back about the Case-Deaton study of the rising death rate in the 21st century among middle-aged white people without college educations—a strange trend because the death rate continues to fall for all other demographic groups and also for Europeans.

OXYCONTINI also reviewed a book, Dreamland, about over-prescription of optoid drugs and how this has led to a heroin epidemic specifically among white people.  I didn’t make the obvious connection with the Case-Deaton study.

A blogger who calls himself Lambert Strether pointed out that the body count from opioid overdoses approaches the number deaths from AIDS.  If you think of opioid overdose as a disease, the vector of the spread is not a microbe and not unsafe sex, but the marketing strategies of certain drug companies—especially Purdue Pharma, manufacturer of OxyContin.

I accept that there are deeper reasons for the rise in drug abuse than the unethical marketing of one drug by one company.  Purdue Pharma would not have been so successful if there hadn’t been a big potential demand for its product.  I still think drug prohibition hasn’t worked, just as alcohol prohibition didn’t work and gun prohibition wouldn’t work.

This is another question for which I don’t have good answers.  What do you think?

LINKS

Genocide by Prescription: The ‘Natural History’ of the Declining White Working Class in America by James Petras and Robin Eastman Abaya [added 7/14/2016]

Credentialism and Corruption: The Opioid Epidemic and the Looting Professional Class by Lambert Strether for naked capitalism.  Very much worth reading.

Poison Pill by Mike Mariani for Pacific Standard.

Drug abuse and suicide: Why death rates have spiked among middle-aged white Americans, an interview of Angus Deaton, one of the authors of the study, by Christina Cauterucci for Slate.

Opioid Addiction 2016 Facts & Figures by the American Society of Addiction Medicine.