Not Only the Good Die Young

Life expectancy is not supposed to decline in wealthy First World countries. As I wrote two years ago reporting that 2015 saw the first decrease since 1993 at the height of the AIDS epidemic (“American Life Expectancy Unexpectedly Declines”, Jan 11, 2017), “Life expectancy is a measurement that summarizes almost everything about quality of life in a society, and therefore even tiny increases or decreases are indications of profound changes with deep consequences.” Life expectancy has now declined for three consecutive years, according to the 2017 figures recently released, turning a statistical blip into a catastrophe.

Why? A complicated confluence of factors, but it’s racial: In a decade-long trend reported in the now-famous Deaton-Case study in 2015, non-Hispanic white men and women are dying younger than they used to, the only groups to do so other than black women. Increased suicide (up 33% since 1999) and drug overdose (up 255% since 1999, up 9.6% since 2016) are big factors, and the suicide rate is now almost double in the most rural counties what it is in the most urban. (See Amadeus Finlay, “The Last Unspoken Taboo: Unraveling the relationship between privilege and white male suicide”, Jan 16, 2019, page XX.) Was this a warning sign about economic despair and income inequality felt by the people who in 2016 would elect Donald Trump?

The death rate from cancer, still the second most common cause of death after heart disease, decreased by 2.1% – as cancer, surprisingly, starts to become a condition associated with lower socio-economic status. (See

Video (3m47s): Anne Case and Angus Deaton of Princeton University discuss their research into “deaths of despair.” (Courtesy: Brookings Institution)

The original 2015 Deaton-Case study: “Rising morbidity and mortality in midlife among white non-Hispanic Americans in the 21st century.” Proc Natl Acad Sci U S A. 2015; 112(49):15078-83 Their 2017 follow-up: “Mortality and morbidity in the 21st century.” Brookings Papers on Economic Activity, Spring 2017; Thursday, March 23, 2017

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