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Increasing mortality rates and whiteness as a marked category

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Gina Kolata and Sarah Cohen have written up a massive study of 60 million American deaths over the last 25 years. Their findings are even more striking than those announced in the startling Case and Deaton paper a few months ago, which found mortality rates rising about middle-aged whites:

While the death rate among young whites rose for every age group over the five years before 2014, it rose faster by any measure for the less educated, by 23 percent for those without a high school education, compared with only 4 percent for those with a college degree or more.

The drug overdose numbers were stark. In 2014, the overdose death rate for whites ages 25 to 34 was five times its level in 1999, and the rate for 35- to 44-year-old whites tripled during that period. The numbers cover both illegal and prescription drugs.

“That is startling,” said Dr. Wilson Compton, the deputy director of the National Institute on Drug Abuse. “Those are tremendous increases.”

Rising rates of overdose deaths and suicide appear to have erased the benefits from advances in medical treatment for most age groups of whites. Death rates for drug overdoses and suicides “are running counter to those of chronic diseases,” like heart disease, said Ian Rockett, an epidemiologist at West Virginia University.

In fact, graphs of the drug overdose deaths look like those of deaths from a new infectious disease, said Jonathan Skinner, a Dartmouth economist. “It is like an infection model, diffusing out and catching more and more people,” he said.

Yet overdose deaths for young adult blacks have edged up only slightly. Over all, the death rate for blacks has been steadily falling, largely driven by a decline in deaths from AIDS. The result is that a once yawning gap between death rates for blacks and whites has shrunk by two-thirds.

A few notes:

*Both the Case and Deaton paper and this new analysis are examples of how whiteness in America is increasingly becoming what sociologists call a “marked category” — that is, a phenomenon or group that stands out in its difference from what is assumed to be the normal, the ordinary, and the therefore largely invisible. In other words, until fairly recently the issue of “white drug abuse” would have been much more difficult to notice or even conceptualize, since drug abuse would be framed as either a society-wide problem, and/or a problem for various others, i.e., racial minorities, the poor, counter-culture types etc.

*We can only hope that the striking spike in drug overdose deaths about young and middle-aged whites (it’s unclear whether the Times article is including alcohol overdoses in its numbers) doesn’t lead to yet another wave of counter-productive drug war initiatives. Increasing substance abuse is usually a symptom of deeper social problems more than it is a cause of those problems — although of course as its prevalence increases, it ends up being the latter thing as well.

*It’s quite possible that one explanation for the spike in white overdose rates is, as the story notes, the reluctance of doctors to prescribe painkillers to minority patients, for reasons that are all too easy to guess. “‘Racial stereotypes are protecting these [minority] patients from the addiction epidemic,’” said Dr. Kolodny, a senior scientist at the Heller School for Social Policy and Management at Brandeis University.” Whether the benefits of that sort of “protection” outweigh the medical and social costs produced by racial discrimination in the prescription of painkillers is another question.

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