News & Commentary

Uneducated Whites’ ‘Deaths of Despair’


There’s an unhealthy dynamic at work for poorer, less educated whites in the United States. The fewer their job prospects, the worse their health, and that worsening health limits job prospects even further. In a follow-up to their ground-breaking 2015 study Mortality and Morbidity in the 21st Century, Princeton professors Anne Case and Angus Deaton argue that the labor-participation rates for this cohort in the U.S. is one of the lowest among the developed countries.

Case and Deaton have traced an increase in midlife mortality for whites with a high school diploma or less to increases in the number of “deaths of despair”—death from drug and alcohol abuse and suicides. The whites with limited education have also not benefited as much from the gains against heart disease and cancer.

In 1999, the mortality rates for whites with no more than a high school degree was about 30% lower than the mortality rates of blacks, in the 50−54 age group. About 15 years later, the relationship reversed: The mortality rate for whites with that level of education was about 30% higher than blacks, according to Case and Deaton’s research.

Whites with a college degree not only tend to live longer than whites without one, but the gap between the two groups is actually widening, states the updated version of the study, which was published by the Brookings Institution in March.

But why?

“We propose a preliminary but plausible story in which cumulative disadvantage over life, in the labor market, in marriage and child outcomes, and in health, is triggered by progressively worsening labor market opportunities at the time of entry for whites with low levels of education,” according to Case and Deaton.

Time is already a critical factor, the study argues. Even public policies that can successfully improve job prospects or redistribute income will “take many years to reverse the mortality and morbidity increase, and that those in midlife now are likely to do much worse in old age than those currently older than 65.”