Rising morbidity and mortality in midlife among white non-Hispanic Americans in the 21st century. By Anne Case and Angus Deaton. PNAS, published online November 2, 2015.
Death Rates Rising for Middle-Aged White Americans, Study Finds. By Gina Kolata. New York Times, November 2, 2015.
Middle-Aged White Americans Are Dying of Despair. By Olga Khazan. The Atlantic, November 4, 2015.
The Crisis of the American Working Class. By Ben Domenech. The Federalist, November 4, 2015.
Now White People Are Dying From Our Terrible Economic Policies, Too. By Michelle Chen. The Nation, November 6, 2015.
The Dying of the Whites. By Ross Douthat. New York Times, November 7, 2015.
Study: Deaths rates rising in middle-aged whites. By Mike Stobbe. AP. AOL, November 3, 2015.
Bill Maher and Anthony Weiner Suggest Reagan Economic Policies and Conservatives Are to Blame for Increase in Suicides. By Ian Hanchett. Breitbart, November 6, 2015. YouTube.
Beyond Blue: The Twenty-first Century Retirement Model Is Coming into Focus. By Walter Russell Mead. The American Interest, October 16, 2015.
Via Meadia Staff:
The economists Anne Case and Angus Deaton—authors of a groundbreaking new study showing that middle aged whites without college degrees are dying at far faster rates in America than in other developed countries—were generally cautious about attributing causality to their widely discussed findings. However, as the Atlantic’s write-up highlights, they did speculate about whether America’s ongoing shift from defined-benefit pensions to a defined-contribution retirement model has something to do with the apparent agony of the white working class:
We don’t claim to know what did or didn’t cause the shocking uptick in mortality that Case and Deaton demonstrate, but we think it would be a grave mistake to read the paper and conclude that a return to the defined-benefit pension model is the answer to America’s social ills. This system was sustainable in midcentury “blue model” America, but it is not suited to the realities of the American economy today, for two reasons that Walter Russell Mead articulated in an essay last month.The United States has moved primarily to defined-contribution pension plans with associated stock market risk, whereas, in Europe, defined-benefit pensions are still the norm. Future financial insecurity may weigh more heavily on US workers, if they perceive stock market risk harder to manage than earnings risk, or if they have contributed inadequately to defined-contribution plans.
First,
defined-benefit pension programs strongly favor long-term workers. In the
heyday of this retirement model, a worker’s pension size was determined by the
number of years he spent at a company, and he needed to stay for a certain
number of years to be eligible for any retirement benefits at all. The reality
of the 21st-century American economy, where even the most established companies
are under intense pressure from globalization and technological innovation, is
that workers need to have the flexibility to move from one job to another. This
is much more difficult under a defined-benefit system.
Second,
defined-benefit pension plans are only as strong as the companies that
guarantee them. This might have been tolerable in blue model America, where a
handful of giant, stable companies dominated each industry, and it might still
be tolerable in European countries, which a gigantic regulatory state blocks or
slows American-style creative destruction. But in a post-blue American economy
at the forefront of global innovation where companies rise and fall at the
blink of an eye, a defined-benefit pension system is a risky bet, and could
cause many people to lose everything.
None of
this means that the shift away from defined-benefit pensions has not been
painful for many workers—it has. And as the post-blue economy takes shape,
companies and policymakers must think about ways to make the transition easier.
Among the changes that should be considered: auto-enroll programs, where
companies automatically deduct from employees’ paychecks and place money in
401(k)s; an increased focus on financial education in public education, so that
workers can invest retirement plans more effectively; and more intelligent
regulation of the part of the financial service industry that deals with 401(k)
plans.
The
decline of the post-blue economy has created its share of challenges, including
greater financial insecurity among less-skilled workers. But the right answer
is not to double down on a system that is on its way out, but to develop new
institutions and policies that will allow Americans to thrive in the
twenty-first century.
Chen:
The rising mortality rate, according to the study, paralleled “self-reported declines in health, mental health, and ability to conduct activities of daily living, and increases in chronic pain and inability to work.” But the trends differed by education level, as those with a high school–level education or less experienced worse outcomes than the college-educated.
Khazan:
The reasons for the increased death rate are not the usual things that kill Americans, like diabetes and heart disease. Rather, it’s suicide, alcohol and drug poisonings, and alcohol-related liver disease.
Chen:
The rising mortality rate, according to the study, paralleled “self-reported declines in health, mental health, and ability to conduct activities of daily living, and increases in chronic pain and inability to work.” But the trends differed by education level, as those with a high school–level education or less experienced worse outcomes than the college-educated.
This
twist in America’s demography of death speaks to a societal malaise: The
economic decline began well before the latest recession, but coincides with the
economic dislocation that accompanied corporate globalization and “free trade”
policies. Then the late 1990s brought a withering of the welfare system,
leaving many older Americans facing an economic cliff after the financial
collapse and debt crisis.
Nonetheless,
the narrative of rising death rates among middle-aged whites should be viewed
in a context of racial differences across many health measures; blacks in
general still suffer higher mortality rates and poorer health outcomes than
whites, for example. So this is racial inequality emerging in the negative
direction. “The narrowing of the black white mortality gap could be thought of
as leveling down,” says researcher Angus Deaton via e-mail. The study isn’t
meant to suggest “tension or competition,” he stresses, but to show a more
nuanced view of how economic insecurity and social distress interact.
These
socioeconomic factors converge against the backdrop of a shattered American
Dream: In their analysis of the results, Deaton and co-author Anne Case write
that since economic growth has sputtered since the 1970s, “with widening income
inequality, many of the baby-boom generation are the first to find, in midlife,
that they will not be better off than were their parents.”
How
does this figure into the public discourse on race and health? Rising white
midlife death isn’t so much a counterpoint to the narrative of racial
segregation as it is a revelation about the long-term costs of structural
inequality. As the “middle class” hollows out, whites who started life under
more promising circumstances—when a high-school graduate could land a job for
life on the assembly line—are finally seeing the floor fall out under them too.
Arguably, they may have had a harder landing than the groups always stuck at
the bottom; could drugs be a distressed response to that collective class
trauma? Many have dropped out of the workforce. Displaced middle-aged
manufacturing workers have watched old factories shutter and neighborhoods subsequently deteriorate in the aftermath of mass foreclosures.
Economic
hardship among whites is most acutely reflected in rural regions where
joblessness and social distress run rampant, youth flee to seek better
prospects elsewhere, and poverty has risen faster than in cities.
. . . .
But
heroin overdoses may be a symptom of another social pathology. The 15-year
death spike among middle-aged whites tracks the slow bleed of neoliberalism:
the massive offshoring of manufacturing jobs, financial booms and busts,
corporate deregulation. All these statistics suggest the need for government-sponsored social
supports is growing just as the government is rolling back welfare (Bill
Clinton’s neoliberal welfare reform agenda was imposed shortly before the white
midlife death patterns appeared), healthcare, and education resources
(including workforce investment programs that were designed to aid dislocated
older workers). The same generation has suffered from the collapse of
institutions that once helped anchor the working class: active unions or just
common workplaces in factory towns.
This
aspect of public health may get lost in the statistics: the community cohesion
that gives life meaning. Before these people lost their health or succumbed to
despair, many may have lost something more vital: a sense of connection to the
wider world. The downward leveling of society, with health crises penetrating a
relatively privileged group, reveals a different kind of connection: the
interwoven hardships in the fraying social fabric—a shared fate we only see
when the seams come undone.
Khazan:
The reasons for the increased death rate are not the usual things that kill Americans, like diabetes and heart disease. Rather, it’s suicide, alcohol and drug poisonings, and alcohol-related liver disease.
The
least-educated are worst off: All-cause mortality among middle-aged Americans
with a high-school degree or less increased by 134 deaths per 100,000 people
between 1999 and 2013, but there was little change in mortality for people with
some college. The death rate for the college-educated fell slightly.
. . . .
Obviously,
no one can be blamed for his own addiction or depression. But the causes of
death this study highlights are the kinds of things—drinking, doping,
suicide—that people who feel good about their lives don’t tend to do.
So,
what’s eating less-educated Boomers?
One
persuasive explanation, and one the researchers put forth, is financial strain.
Jobs in fields like manufacturing and construction, which were historically
filled by people without college degrees, have been evaporating quickly over
the past 15 years. As I’ve written previously, less-educated people are more likely to be unemployed and to make less, so they struggle to afford things
like therapy, gym memberships, and recreation that isn’t drugs. Without jobs,
they may lack the social networks and sense of purpose that have shown to
reduce mortality.
Nearly
half of Americans in their 40s and 50s don’t have enough money saved for
retirement to live as they’re accustomed to, even if they work until they’re 65. All of this is crashing down on Boomers, who were raised on the promise of
the American Dream.
As
Deaton and his co-author, his wife and fellow Princeton economist Anne Case,
put it, “After the productivity slowdown in the early 1970s, and with widening
income inequality, many of the baby-boom generation are the first to find, in
midlife, that they will not be better off than were their parents.”
Deaton
and Case note that middle-aged people in other countries also faced dire
financial straits, especially during the 2009 recession. Yet they’re not dying
like American 50-somethings are. One difference is that in those countries,
comfortable pensions for retirees are guaranteed, so the prospect of an
impoverished retirement might not loom as large in Europe as it does here.
“The
U.S. has moved primarily to defined-contribution pension plans with associated
stock market risk, whereas, in Europe, defined-benefit pensions are still the
norm,” Deaton and Case write. “Future financial insecurity may weigh more
heavily on U.S. workers.”
Tragically,
that weight seems to be crushing these Americans before they can even retire.