There continues to be a lot of discussion on the purported increase in mortality rates among middle-aged white people in America.
Actually an increase among women and not much change among men but you don’t hear so much about this as it contradicts the “struggling white men” story that we hear so much about in the news media.
A big fat pile of graphs
To move things along, Jonathan Auerbach and I prepared a massive document (zipped file here; still huge) with 60 pages of graphs, showing raw data and smoothed trends in age-adjusted mortality rate from 1999-2014 for:
– 50 states
– men and women
– non-hispanic whites, blacks, and hispanics
– age categories 0-1, 1-4, 5-14, 15-24, 25-34, 35-44, 45-54, 55-64, 65-74, 75-84.
It’s amazing how much you can learn by staring at these graphs.
For example, these trends are pretty much the same in all 50 states:
But look at these:
Flat in some states, sharp increases in others, and steady decreases in other states.
The patterns are even clearer here:
Different things are happening in different regions—in particular, things have been getting worse for women in the south and midwest, whereas the death rate of men in this age group have been declining during the past few years—but overall there has been little change since 1999. In contrast, as Anne Case and Angus Deaton noticed a bit over a year ago, other countries and U.S. nonwhites have seen large declines in death rates, something like 20%.
Breaking down trends by education: it’s tricky
In a forthcoming paper, “Mortality and morbidity in the 21st century,” Case and Deaton report big differences in trends among whites with high and low levels of education: “mortality is rising for those without, and falling for those with, a college degree.”
But the comparison of death rates by education is tricky because average education levels have been increasing over time. There’s a paper from 2015 on this topic, “Measuring Recent Apparent Declines In Longevity: The Role Of Increasing Educational Attainment,” by John Bound, Arline Geronimus, Javier Rodriguez, and Timothy Waidmann, who write:
Independent researchers have reported an alarming decline in life expectancy after 1990 among US non-Hispanic whites with less than a high school education. However, US educational attainment rose dramatically during the twentieth century; thus, focusing on changes in mortality rates of those not completing high school means looking at a different, shrinking, and increasingly vulnerable segment of the population in each year.
Breaking down trends by state
In my paper with Jonathan Auerbach, we found big differences in different regions of the country. We followed up and estimated mortality rates by state and by age group, and there are tons of interesting patterns. Again, our latest graph dump is here (zipped file here), and you can look through the graphs yourself to see what you see. Next step is to build some sort of open-ended tool to use Stan to do smoothing for arbitrary slices of these data. Also there are selection issues as people move between states, which is similar but not identical to selection issues regarding education.
Message to journalists
Case and Deaton found some interesting patterns. They got the ball rolling. Read their paper, talk with them, get their perspective. Then talk with other experts: demographers, actuaries, public health experts. Talk with John Bound, Arline Geronimus, Javier Rodriguez, and Timothy Waidmann, who specifically raised concerns about comparisons of time series broken down by education. Talk with Chris Schmid, author of the paper, “Increased mortality for white middle-aged Americans not fully explained by causes suggested.” You don’t need to talk with me—I’m just a number cruncher and claim no expertise on causes of death. But click on the link, wait 20 minutes for it to download and take a look at our smoothed mortality rate trends by state. There’s lots and lots there, much more than can be captured in any simple story.