“Deaths of Despair” Reveals America’s Troubled Soul A “White Death” Takes the Lives of 45-54 Year-Olds

By Nick Gier
Reader Columnist

The workman is not in harmony with his social
position if he is not convinced that he has his deserts.

—Emile Durkheim

These people kill themselves slowly with
alcohol or drugs, or quickly with a gun.

—Anne Case, Princeton economist

During the early Vladimir Putin years (1999-2009), Russia experienced unprecedented economic growth, but the nation’s oligarchs captured most of the wealth. According to a feature article in The New Republic (8/2017), some of them moved into Trump Tower and laundered billions of dollars by buying high end real estate. The authors argue that Trump’s deals with these Russians saved him from financial ruin after his Atlantic City casinos went bankrupt.

Russia’s transition from communism to capitalism, however, has come at high social costs. From 1992-2009 Russia lost seven million people, primarily because of unusually high mortality rates. Ten years after the fall of the Soviet Union in 1989, males in Moscow were living eight fewer years than before. By 2006, according to a Russian demographer, “overall life expectancy at age fifteen in the Russian Federation is lower than some of the countries the UN designates to be least developed.”

The reasons for this social disaster are many, and they include economic dislocation, accidents, and a high incidence of circulatory disease. Mortality from the latter is 30 percent higher than Western Europe, and deaths from injury and poisoning are five times greater than other Europeans. Excessive drinking, sometimes leading to alcohol poisoning, is the main cause of this epidemic of accidents and heart disease.

America’s “Deaths of Despair” Increasing

Many Americans are also experiencing an increase in mortality and morbidity, which means higher rates of diseases. Starting in 1998, white Americans aged 45-54 began dying earlier than a century-long, world-wide (except for Russia) trend of higher life expectancy. Princeton economists Anne Case and Angus Deaton, who have now published two studies on these trends, have called them “deaths of despair.” Some writers have called it “The White Death.”

Most dramatic is the fact that while black Americans previously had a higher mortality rate than middle-age white Americans without a college degree, the latter’s rate is now 30 percent higher. Despite many difficulties for some, Hispanics have joined their black brother and sisters in living longer. Their work force participation rate is also higher than their white counterparts.

Having a college education is indeed a key factor. According to the Center for Disease Control and Prevention, Americans with a bachelor’s degree live nine years longer on average. With the decline of good paying blue collar jobs and the union security previously associated with them, more jobs require post-secondary training and degrees. Those with a college degree have more successful marriages, better health, and they have more stable lives in general.

More Women than Men in College

Among college graduates there are significant gender differences. In 2012, 76 percent of female high school graduates were enrolled in college while only 66 percent were men. Significantly, this is an average across white, black, Hispanic, and Asian populations with more women than men in each demographic. Not surprising, the largest percentages and smallest gap was among Asians (86%-83%).

Even women without college degrees are coping better in this new economy. They are more engaged in their community and churches, while many similarly educated, unemployed men stay at home, watching TV/videos, surfing the internet, and self-medicating with alcohol and opioids. Here is where a great many of premature deaths occur.

Suicides Rates Nearly Eight Times National Average

Suicide rates are also much higher in the 45-54-year demographic. As Anne Case says: “These people kill themselves slowly with alcohol or drugs, or quickly with a gun. For people aged 50-55, for example, those rates went from 40 per 100,000 to 80 per 100,000 since the turn of the century.” The national rate for all ages is 12.6 with men killing themselves at a rate of 19.5 vs. women at 5.8 per 100,000 (2015 data).

No “Deaths of Despair” in Europe or Canada

These premature deaths are unnecessary, because they were for the most part preventable. The Great Recession, caused primarily by corrupt American and British bankers, hit Europe just as hard as it did the U.S. In a number of countries unemployment was higher, and in Spain and Greece it was double the U.S. rate.

Millions of Europeans are heavy drinkers and they also have access to heroin and other hard drugs, but deaths due these substances are much fewer than in the U.S. Overall, Europeans continue to live longer and report high levels of happiness and well-being. I believe that difference with the U.S. lies in better educational systems, effective job training programs, universal health care, and a comprehensive social safety net.

European vs. American Co-Habitation

European co-habitation rates are the highest in the world, especially in the Nordic countries. Case and Deaton have also found co-habitation rising among those in the 45-54 demographic. The differences between Europeans in general and Americans in this age group are striking.

Most of the cohabitating Europeans never married and are raising families that are thriving, primarily because of generous paternity/maternity leave, monthly child support checks, and subsidized day care. The divorce rate for Americans ages 45-54 is very high, and co-habitation for them, considering their economic and health conditions, has not at all been a successful experiment.

Opioid Overdose Killing 142 Americans Each Day

Opioid addiction and deaths due to overdose have made the U.S. situation far worse. According to the CDC, the rate of death from prescription opioid overdoses more than quadrupled between 1999 and 2015, leading to the deaths of 183,000 people during that period. Now these deaths are happening at a rate of 142 per day. More Americans die from overdoses than car accidents and most of those dying are white. In Pennsylvania it causes the most accidental deaths—3,264 in 2015, a 20 percent increase over the previous year.

According to a CNBC report, 80 percent of the world’s opioids are consumed by Americans, and, incredibly enough, they pop 99 percent of the hydrocodone pills. Canadians consume another 20 percent of the opioid supply, so that leaves only 5 percent for the rest of the world.

Canada’s Opioid Problem Contained by Social Safety Net

Primarily because of industrial decline in its Rust Belt just above the border, Canada has joined the U.S. in having a serious opioid problem among its low-income men. In 2015 Canadian pharmacists issued 534 opioid prescriptions per 1,000 population, while their American counterparts filled 775. Mortality rates among these men, however, are much lower their American counterparts—a significant 7.4-year difference. Again, the difference is due to Canada’s universal health care and social safety net.

Those Without College Drawn to Evangelicals

Case and Deaton also discovered that those without a college education were drawn to evangelical churches, which emphasize an individualism that make “people feel increased responsibility for their own successes or failures.” Many of these churches preach a Prosperity Gospel, which obviously increases the desperation of those who have experienced nothing but failure.

Many of these people, who do not kill themselves slowly with drugs or shoot themselves, may see their options as either winning the lottery or electing as president a “successful” businessman who promises to bring back jobs, which they don’t realize are mostly lost forever.

High Correlation between Trump Support and Premature Deaths

Shannon Monnat, a rural sociologist at Penn State, has found that counties that have high rates of premature voted overwhelmingly for Trump. As Monnat observes: “Some people turn to self-medicating, and some people turn to another kind of fix, which may be voting for a candidate that is proposing some radical change: burning the place down.”

These Trump voters have had their wish fulfilled. Trump has burned bridges internationally as well as domestically. Business leaders have left his advisory boards (both have now disbanded), his own Republicans bristle at his insults, and the GOP Congress has accomplished very little.

Trump supported a health care bill which would have gutted programs that help those who are most prone to premature deaths. These people should be grateful to former President Obama for the extended Medicaid coverage that is still available in 32 states.

Recently, Trump declared that “we will fight this deadly epidemic and the United States will win,” but it will take far more government intervention than Congress is willing to support. It doesn’t help at all that Trump has called New Hampshire a “drug-infested den,” nor does it do any good to blame Mexico. The opioids are produced in the U.S., and Mexican heroin comes across the border only because of high demand from American users.

While president, Obama proposed legislation that would have provided $54 billion for retraining workers for the new economy, the same sort of programs that have succeeded in Canada and Europe. Republicans of course could never support something as reasonable as that.

Europe or America: Where are the Lost Souls?

American conservatives say that European welfare states infantilize their citizens and make them completely dependent on the state. They claim that Europeans have lost their souls because of “statist” policies, but the evidence clearly shows otherwise. These critics should realize that it is their legislators who have lost their way, and that the troubled souls are right here in America.

Vladimir Putin’s approval ratings remain very high, even though his policies have ruined the lives of millions of Russians. Trump’s approval ratings are dropping, but his core supporters are still with him. Incredibly enough, they still believe that only he can save them from the “deaths of despair” in their midst.

Nick Gier of Moscow taught philosophy at the University of Idaho for 31 years. There, from 1980-2003, Coordinator of Religious Studies. He is also President of the Idaho Federation of Teachers, AFT/AFL-CIO. Read all his recent columns at www.sandpointreader.com under “Columns.” He can be reached at [email protected].