This paper documents a marked increase in the all-cause mortality of middle-aged white non-Hispanic men and women in the United States between 1999 and 2013. This change reversed decades of progress in mortality and was unique to the United States; no other rich country saw a similar turnaround. The midlife mortality reversal was confined to white non-Hispanics; black non-Hispanics and Hispanics at midlife, and those aged 65 and above in every racial and ethnic group, continued to see mortality rates fall. This increase for whites was largely accounted for by increasing death rates from drug and alcohol poisonings, suicide, and chronic liver diseases and cirrhosis. Although all education groups saw increases in mortality from suicide and poisonings, and an overall increase in external cause mortality, those with less education saw the most marked increases. Rising midlife mortality rates of white non-Hispanics were paralleled by increases in midlife morbidity. Self-reported declines in health, mental health, and ability to conduct activities of daily living, and increases in chronic pain and inability to work, as well as clinically measured deteriorations in liver function, all point to growing distress in this population. We comment on potential economic causes and consequences of this deterioration.Krugman is right to compare what is going on now in the U.S. for whites to what happened in Russia after collapse of the Soviet Union:
Even more striking are the proximate causes of rising mortality. Basically, white Americans are, in increasing numbers, killing themselves, directly or indirectly. Suicide is way up, and so are deaths from drug poisoning and the chronic liver disease that excessive drinking can cause. We’ve seen this kind of thing in other times and places – for example, in the plunging life expectancy that afflicted Russia after the fall of Communism. But it’s a shock to see it, even in an attenuated form, in America.Sadly, for aging white America, the savior waiting in the wings is no Vladimir Putin; he is, as Douhat remarks, Donald Trump:
Yet here, too, Deaton and Case’s data is somewhat confounding, because if economic stress were all, you would expect the mortality crisis to manifest itself more sharply among black and Hispanic Americans — who have consistently higher unemployment rates than their white neighbors, and lag whites in wealth by far.
But in fact the mortality rate for minorities in the U.S. continued to fall between 1999 and 2013, mirroring the trend in Europe, and the African-American death rate in particular fell hugely. Amid the stresses of the dot-com bust and the Great Recession, it was only white Americans who turned increasingly to drugs, liquor and quietus.
Why only them? One possible solution is suggested by a paper from 2012, whose co-authors include Andrew Cherlin and Brad Wilcox, leading left and right-leaning scholars, respectively, of marriage and family.
Noting that religious practice has fallen faster recently among less-educated whites than among less-educated blacks and Hispanics, their paper argues that white social institutions, blue-collar as well as white-collar, have long reflected a “bourgeois moral logic” that binds employment, churchgoing, the nuclear family and upward mobility.The Walmarting of America, the blasting to smithereens of towns and small cities by big box outlet stores, the offshoring of U.S. industrial capacity, a political class that suckles exclusively on the corporate tit, all this and more explains the rise in morbidity in less-educated whites. If they can put away their Budweiser and OxyContin long enough to make it to the polls, Donald Trump will be the next POTUS.
But in an era of stagnating wages, family breakdown, and social dislocation, this logic no longer seems to make as much sense. The result is a mounting feeling of what the American Conservative’s Rod Dreher calls white “dispossession” — a sense of promises broken, a feeling that what you were supposed to have has been denied to you. (The Donald Trump phenomenon, Dreher notes, feeds off precisely this anxiety.)
Carson's moment in the spotlight is fast fading. And it appears that with the two main contenders for the establishment GOP crown on the threshold of mutually assured destruction, The Donald is once again in the catbird seat.