Growing mortality among middle-aged Americans


White Americans, middle-aged, with a medium-low level of education: it is the category of people who, surprisingly, instead of benefiting from an increasingly longer and healthier life, get sick and die much more than their peers Industrialized countries. An increase in unexpected and unpredictable mortality, according to data from a study that has just appeared in the journal Pnas, is probably due mainly to the increase in suicides and to alcohol and drug addiction.

Like the AIDS epidemic. It is a turning point that surprised the authors of the study, Angus Deaton, the Princeton economist who had the Nobel prize for economics a month ago (for his studies on consumption, poverty and welfare), and his wife, Anne Case, also an economist in the same university.

The numbers of the phenomenon were obtained almost by chance by the two researchers analyzing the mortality statistics in the United States and in six other industrialized countries (Great Britain, Australia, France, Germany, Sweden and Canada). From 1978 to 1998, the mortality rate for white Americans aged 45 to 54 has decreased by two percent a year, a figure that can be explained by improvements in public health and in line with what happened in other countries.

But between 1999 and 2013, the trend in the United States, instead of continuing as has happened elsewhere, has reversed, with an increase in mortality of 0.5 per cent per year among middle-aged white Americans of non- Hispanic. The two authors of the study calculate that if mortality remained stable at the 1998 level, there would have been 96 thousand fewer deaths. If instead it had continued to fall as expected, the deaths would have been 500 thousand less. Considering that the deaths from AIDS in the United States were 650 thousand, this is a figure comparable to that of an epidemic.

Unexpected causes of death. Going into more detail, the researchers clarify that this is a phenomenon that affects only middle age, in practice the baby-boomers. In fact, among the elderly, between 65 and 74 years, mortality continued to fall according to expectations. The three main causes of death responsible for the increase, however, are not the ones most commonly thought of, cancer and cardiovascular diseases, but suicides, drug and alcohol poisoning, and liver diseases, overhead cirrhosis.

The increase in suicides and drug overdoses in the middle age group had already been noted, but it was also a surprise for the authors of the study to find that it was so consistent as to result in a significant shift in mortality. An important fact is that the increase in deaths involved both men and women in the middle age group, but the greatest weight was observed among people with a lower level of education.

Factor mix. Not everything is clear on what factors drive this specific trend for the United States. The researchers note that the increase in mortality has coincided with the entry into the market of powerful opioid painkillers, which have made it "more within reach" a potential means of suicide. And that often have been the gateway to other forms of addiction, from alcohol and heroin. But to guide people towards these choices are probably social and economic factors, such as the decrease in productivity and income, which however has also affected other countries, and subsequently the economic crisis. In short, it would seem that despair and distrust in the future is undermining the health and life expectancy of an entire generation and social class.

Lost generation? It is a wake-up call for something worrying that is happening in American families, particularly in some sectors of society. The authors conclude: «If this" epidemic "is brought under control, the survivors will be able to live a healthy old age. However, addictions are difficult to treat, and pain difficult to control, so those of middle age may be a "lost generation" whose future is less rosy than those who preceded them. "