Updates on Mortality Rates and the Impact of Drug Deaths

A couple of years ago now, there was a lot of hubbub around a paper about mortality rates among white Americans. This paper purported to show that mortality for middle aged white people in the US were not decreasing (like other countries/races/ethnicities) were, but was actually increasing.

Andrew Gelman and others challenged this idea, and noted that some of the increase in mortality was actually a cohort effect. In other words, mortality was up, but so was the average age of a “45-54 year old”. After adjusting for this, their work suggested that actually it was white middle aged women in the south who were seeing an increase in mortality:

In this article for Slate, they published the state by state data to make this even clearer:

In other words, there are trends happening, but they’re complicated and not easy to generalize.

One of the big questions that came up when this work was originally discussed was how much “despair deaths” like the opioid overdoses or suicide rates were driving this change.

In 2017, a paper was published that showed that this was likely only partially true. Suicide and alcohol related deaths had remained relatively stable for white people, but drug deaths had risen:

Now, there appears to be a new paper coming out  that shows there may be elevated mortality in even earlier age groups. It appears only the abstract is up at the moment, but the initial reporting shows that there may be some increase in Gen X (current 38-45 year olds) and some Gen Y (27-37 year olds). They have reportedly found elevated mortality patterns among white men and women in that age group, being partially driven by drug overdoses and alcohol poisonings.

From the abstract, the generations with elevated mortality were:

    • Non-Hispanic Blacks and Hispanics: Baby Boomers
    • Non-Hispanic White females: late-Gen Xers and early-Gen Yers
    • Non-Hispanic White males: Baby Boomers, late-Gen Xers, and early-Gen Yers.

Partial drivers for each group:

  • Baby Boomers: drug poisoning, suicide, external causes, chronic obstructive pulmonary disease and HIV/AIDS for all race and gender groups affected.
  • Late-Gen Xers and early-Gen Yers: are at least partially driven by mortality related to drug poisonings and alcohol-related diseases for non-Hispanic Whites.

And finally, one nerve-wracking sentence:

Differential patterns of drug poisoning-related mortality play an important role in the racial/ethnic disparities in these mortality patterns.

It remains to be seen if this paper will have some of the cohort effect problems that have plagued other analyses, but the drug poisoning death issue seems to be a common feature. It remains to be seen what the long term outcomes of this will be, but here’s an interesting visualization from Senator Mike Lee’s website:

Not a pretty picture.

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