Suicide, drugs only partly to blame for rising deaths of middle-aged US whites

(HealthDay)—Death rates among middle-aged white Americans were higher than expected in 2014, likely because progress against common killers such as diabetes and heart disease has halted, a new study contends.

Substance abuse and suicide rates among white adults ages 45 to 54 have risen, but not enough to explain why death rates in this group have shifted from their historical decline, according to the Commonwealth Fund report released Jan. 29.

If death rates in this group had followed past patterns, they would have fallen 1.8 percent a year between 1999 and 2014. Instead, they rose, the new study found.

"We are accustomed to making progress against diseases. We learn how to prevent them and how to treat them and, as we do that, fewer people die from them," Commonwealth Fund President Dr. David Blumenthal, a study co-author, said in a news release.

"For middle-aged whites, that progress has stalled and even reversed for some conditions. We need to find out why this is happening," he added. "However, maintaining and improving access to health care remains important, especially for lower-income people in states that have not expanded Medicaid."

The gap between expected and actual death rates occurred in all states, but was largest in Alabama, Arkansas, Kentucky, Mississippi, Oklahoma, Tennessee and West Virginia, the researchers reported. In those states, actual death rates were between 60 percent and 76 percent higher than expected. In West Virginia, the death rate among whites ages 45 to 54 is the highest since 1980.

The gap was smallest in California, Connecticut, Massachusetts, Minnesota, New Jersey, New York and Illinois, where there was a slight decrease in middle-aged white adult death rates between 1999 and 2014.

Deaths from substance abuse and suicide rose among middle-aged whites between 1999 and 2014. But, those two causes accounted for only about 40 percent of the gap between expected and actual death rates, the researchers said.

Sixty percent of the gap was because death rates from nearly all leading causes of death—such as diabetes, heart and lung disease—didn't fall as expected, they noted.

The researchers suggest another contributor to the gap: "The excess deaths among middle-aged whites could be due in large part to the erosion in their socioeconomic standing. On a range of social and economic indicators, middle-aged whites have been falling behind in the 21st century," they wrote.

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