Mortality and morbidity in the 21^st century

Area of Science:

• Public Health
• Sociology
• Epidemiology

Background:

• Increases in midlife mortality and morbidity among white non-Hispanic Americans since 2000, building on Case and Deaton (2015).
• Rising rates of drug overdoses, suicides, and alcohol-related liver mortality disproportionately affect those with lower educational attainment.

Purpose of the Study:

• To analyze trends in all-cause mortality and identify contributing factors among different demographic groups in the US.
• To compare US mortality trends with those in comparable rich countries, particularly in Europe.
• To investigate the role of economic resources versus cumulative disadvantage in explaining observed mortality patterns.

Main Methods:

• Analysis of mortality data from 1998-2015, disaggregated by race, ethnicity, education level, and age group.
• Comparison of US mortality trends with international data from comparable high-income countries.
• Evaluation of economic factors (income, labor market opportunities) and their correlation with mortality trends.

Main Results:

• All-cause mortality continued to rise for white non-Hispanic Americans, driven by heart disease, drug overdoses, suicides, and alcohol-related liver mortality.
• Mortality rates increased for white individuals without a college degree while decreasing for those with a college degree.
• Mortality rates for Black and Hispanic Americans continued to decline, with significant crossover points where white non-Hispanic mortality surpassed other groups.
• European countries showed falling mortality rates across educational attainment levels, contrasting sharply with US trends.

Conclusions:

• Cumulative disadvantage, triggered by worsening labor market entry conditions for less educated white individuals, offers a plausible explanation for rising midlife mortality.
• Current policies focused solely on improving earnings or redistributing income may take many years to reverse these negative mortality trends.
• Preventing issues like the over-prescription of opioids is a critical, actionable policy lever to address the ongoing mortality crisis.