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Death rate, poor health rise for middle-aged whites, reversing trend

The death rate among middle-aged, white Americans rose significantly between 1999 and 2013, reversing a decades-long trend of improvement, new research shows. This group also reported worse physical and mental health than other age groups, according to the NIA-funded study, published online Nov. 2, 2015, in the Proceedings of the National Academy of Sciences.

From 1978 to 1998, the death rate for U.S. non-Hispanic whites ages 45 to 54 fell 2 percent per year on average, matching the rate for some wealthy European countries, reported economists Drs. Anne Case and Angus Deaton of Princeton University. But in the following 15 years, the U.S. group’s death rate rose half a percent per year on average, while the death rate for their European peers continued to fall. The experts analyzed federal survey data.

In the U.S., this higher death rate was unique to middle-aged whites. During the same period, the average yearly death rate decreased 1.8 percent for Hispanics and 2.8 percent for non-Hispanic blacks in the same age group. Even older Americans age 65–74 had a lower death rate than 45- to 54-year-old whites.

Drug and alcohol poisoning, suicide, and chronic liver disease and cirrhosis drove up the death rate for white people in this age group, the analysis showed. For those aged 45–54, if the white mortality rate had held at its 1998 value, 96,000 deaths would have been avoided from 1999–2013, the researchers noted. Death rates were highest for people with the least education (a high school degree or less).

There was also a significant rise in the proportion of middle-aged adults reporting fair or poor health in 2011–13, compared with 1997–99. Individuals reported higher rates of chronic pain, psychological distress, and difficulty with daily activities. Risk for heavy drinking also rose significantly.

The authors noted that the increase in midlife mortality is only partly understood. Increased availability of opioid prescription drugs, chronic pain (for which opioids are often prescribed), and the economic crisis which began in 2008 may all have contributed to an increase in overdoses, suicide, and increased liver disease associated with alcohol abuse.

Reference: Case, A., and Deaton, A. Rising morbidity and mortality in midlife among white non-Hispanic Americans in the 21st century. Proceedings of the National Academy of Sciences. doi: 10.1073/pnas.1518393112. Published online Nov. 2, 2015.