In 2015, when researchers Anne Case and Angus Deaton discovered that death rates had been rising dramatically since 1999 among middle-aged white Americans, they weren't sure why people were dying younger, reversing decades of longer life expectancy.
Now the husband-and-wife economists say they have a better understanding of what's causing these "deaths of despair" by suicide, drugs and alcohol.
In a follow-up to their groundbreaking 2015 work, they say that a lack of steady, well-paying jobs for whites without college degrees has caused pain, distress and social dysfunction to build up over time. The mortality rate for that group, ages 45 to 54, increased by a half percent each year from 1999 to 2013.
But whites with college degrees haven't suffered the same lack of economic opportunity and haven't seen the same loss of life expectancy. The study was published Thursday in Brookings Papers on Economic Activity.
Case and Deaton, who are both at Princeton University, spoke with NPR's David Greene about what's driving these trends. The interview has been edited for brevity and clarity.
Interview Highlights
On the original discovery of rising mortality rates for middle-aged whites
Angus Deaton: Mortality rates have been going down forever. There's been a huge increase in life expectancy and reduction in mortality over 100 years or more, and then for all of this to suddenly go into reverse [for whites ages 45 to 54], we thought it must be wrong. We spent weeks checking out numbers because we just couldn't believe that this could have happened, or that if it had, someone else must have already noticed. It seems like we were right and that no one else had picked it up.
We knew the proximate causes — we know what they were dying from. We knew suicides were going up rapidly, and that overdoses mostly from prescription drugs were going up, and that alcoholic liver disease was going up. The deeper questions were why those were happening — there's obviously some underlying malaise, reasons for which we [didn't] know.
On what's driving these early deaths
Anne Case: These deaths of despair have been accompanied by reduced labor force participation, reduced marriage rates, increases in reports of poor health and poor mental health. So we are beginning to thread a story in that it's possible that [the trend is] consistent with the labor market collapsing for people with less than a college degree. In turn, those people are being less able to form stable marriages, and in turn that has effects on the kind of economic and social supports that people need in order to thrive.
In general, the longer you're in the labor force, the more you earn — in part because you understand your job better and you're more efficient at your job, you've had on-the-job training, you belong to a union, and so your wages go up with age. That's happened less and less the later and later you've been born and the later you enter this labor market.
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