Ruminations

Blog dedicated primarily to randomly selected news items; comments reflecting personal perceptions

Thursday, November 05, 2015

Mysterious Anomie

"Drugs and alcohol, and suicide ... are clearly the proximate cause. Half a million people are dead who should not be dead."
"About 40 times the Ebola stats. You're getting up there with HIV-AIDS."
"This change reversed decades of progress in mortality and was unique to the United States; no other rich country saw a similar turnaround."
Angus Deaton, economics professor, Princeton University
US Mortality Rates per 100,00 people for 45-54 years of age by race
"This is the first indicator that the plane has crashed. I don't know what's going on, but the plane has definitely crashed."
"High school graduates [and] high school dropouts [are] 40 percent of the population. It's not just the ten percent who didn't finish high school. It's a much bigger group."
Jonathan Skinner, professor of economics, Dartmouth College

"[Typically, socioeconomic circumstances] gang up on African Americans, who have lower education, lower incomes and race all working against them."
"In this case, that's not happening."
David Weir, director, health and retirement study, Institute for Social Research, University of Michigan
Suicide rates are higher in the Western and Southern regions of the US
Suicide rates are higher in the Western and Southern regions of the US -- Getty images

So then, what is happening to cause a relatively sudden rise in the death rate that just should not be happening when medical science has made such whopping great advances to extend people's lives, and modern technology helps people to live better lives. With so much working to extend and to improve the quality of life what could possibly be driving segments of the American population to relinquish their lives as though they are disposable?

Despite what the most ardent believers in religion's assurances that the faithful will continue to live after death, simply on another plane, perhaps in another form, the fact is that we have one life to live and it should be viewed as an absolute value to be treasured, nurtured and made the most of. Are we so resistant to using our cerebral functions to ensure that the excitement of learning and personal progress never end, that we fall instead into the trap of ennui, and nothing has value?

Responding instead to the siren song [for some] of drug and alcohol addiction, courting ill health and a miserable existence that begs to be ended? According to statistics garnered from a new study it would seem that a large segment of white, middle-aged Americans is at the vanguard of an unexpected rise in its death rate, an accelerated episode that began in 1999. Decades of progress appear to have been reversed.

Men and women between the ages of 45 and 54 who haven't attained a college education have seen their mortality rate rise by a half percent each year, between 1999 and 2013. The intelligent hypothesis has it that the causes can be related to legal and illegal drugs, alcohol and suicide, according to study results published in the Proceedings of the National Academy of Sciences. Previously that group's death rates had been diminishing at an average of 2 percent annually.

A parallel increase in the rate of illness has accompanied the rising death rate. Angus Deaton, the 2015 Nobel laureate in economics co-authored the paper with his wife, Anne Case, both professors of economics at Princeton University. Since the 1970s citizens of wealthy countries like the United States have been the recipients of opportunities to enjoy longer and healthier lives with the decline of tobacco use, improved medical treatments and the development of preventive health measures, all of which have had their impact on mortality rates.

As the Baby Boom generation continues to move to retirement a sicker population appears to have emerged, unprepared for the costs associated with old age, which will result in a notable burden on federal welfare programs and society in general, according to the paper, one that has been peer reviewed before publication, by other experts in the field. And the general view that living rurally is better for one's health, doesn't appear to hold water, according to their survey.

Other developed nations were examined for their death rates as well by the two researchers, along with rates for American blacks and Hispanics validating their continuing decline in death rates. White populations in age groups between 30 and 64 and more highly educated whites reflected lower death rates, even while the other age groups experienced higher death rates from drug and alcohol overdoses, suicide, chronic liver disease and cirrhosis of the liver.

From, in other words, choices in lifestyle that serve to produce poor health and life outcomes. The only other recent comparison that can be made is with Russian men after the collapse of the Soviet Union, and that country's serious problem with alcohol abuse. Whites, who traditionally enjoyed advantages denied African-Americans, have been outdistancing the latter in death rates.

As far as Dr. Weir is concerned, economic insecurity, the breakdown of families, the weakening of community support undeniably have some impact on illness and death rates. The opioid epidemic as well as other factors identified by the paper's authors are all implicated. Yet diseases such as lung cancer or diabetes, on the decline, are now once again gradually increasing; dire diseases often related to lifestyle and as such, avoidable.
"It has to do with a mix of risk factors. This is not an urban, African-American issue as much as it is a poor, rural, white male issue... Culture comes to play, a culture of not necessarily treating depression. The rural culture - if it's not broken, don't fix it."
"There are no single reasons for this, but the typical cascade is - an individual will obtain a narcotic through a prescription, transition to lower cost drugs like heroin, then eventually have health problems, then have an early death."
"Forty-five to 54 is an age range where people can struggle. They may be in mid-life, they may not have the means, or health insurance or access to primary care."
"With the culture in rural communities, when economic conditions [worsen] during recessions, we see almost like clockwork, rates of suicide and self-destructive behaviours going up." 
Pat Remington, professor of population health sciences, University of Wisconsin
Death rate for U.S. non-Hispanic whites (USW), U.S. Hispanics and six comparison countries, aged 45-54. (Source: Proceedings of the National Academy of Sciences.)

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