{"id":493,"date":"2017-04-05T17:51:46","date_gmt":"2017-04-05T17:51:46","guid":{"rendered":"http:\/\/nortonspeaks.com\/?p=493"},"modified":"2017-04-05T18:02:57","modified_gmt":"2017-04-05T18:02:57","slug":"a-collapse-of-hope","status":"publish","type":"post","link":"http:\/\/nortonspeaks.com\/index.php\/2017\/04\/05\/a-collapse-of-hope\/","title":{"rendered":"A Collapse of Hope"},"content":{"rendered":"

PNAS 2015 Dec 112(49) 15078-83, Fig. 1<\/a><\/strong><\/p>\n

By Susan Grigsby<\/strong><\/a><\/p>\n

Sunday Apr 02, 2017 \u00b7 6:00 PM PDT \u00a0reported \u00a0on \u00a0Daily KOS<\/p>\n

In 1995, at the height of the AIDS epidemic, there were 43,115 deaths from the disease and its complications. Twenty years later, our current opiate epidemic has passed that gruesome marker, racking up 52,404 deaths. Today, opioid-related\u00a0deaths outnumber those resulting from\u00a0car accidents or guns.<\/p>\n

According to Princeton economists\u00a0Anne Case and Angus Deaton, these are \u201cdeaths of despair,\u201d and combined with deaths from\u00a0alcohol\u00a0and suicide they have resulted in an alarming increase in the mortality rate of white, non-Hispanic Americans in mid-life. Their report, titled “Rising morbidity and mortality in midlife among white non-Hispanic Americans in the 21st century<\/a>,\u201d\u00a0was published\u00a0in PNAS (Proceedings of the National Academy of Sciences<\/em>) in September 2015 to widespread headlines. Last week they issued a new paper for the Brookings Panel on Economic Activity, titled “Mortality and morbidity in the 21st century<\/a>.\u201d\u00a0Jared Keller, writing for Pacific Standard<\/em><\/a>, reports that:<\/p>\n

To be more exact, Case and Deaton found that middle-aged, non-Hispanic Americans without a college degree experience a significantly higher mortality rate than those in advanced countries like the United Kingdom or Germany. While everyone else in the United States is getting healthier and living longer, it\u2019s that segment of whites who accounted<\/a> for \u201chalf a million deaths\u201d between 1999 and 2013.<\/p>\n

To scientists, the sudden die-off in middle-of-the-road white Americans constitutes<\/a> a phenomenon \u201cunprecedented in the annals of public health among developed nations\u201d with the exception of the post-U.S.S.R. deaths of Russian males and, in some ways, the first shock waves of the AIDs crisis in the early 1980s.<\/p>\n

The causes of the increase in mortality and morbidity among white, non-Hispanics (WNH) seem to be equal parts economic inequality, with its accompanying\u00a0lack of economic progress among WNH, and the opioid epidemic that has spread across the nation. The increase in mortality among WNH is centered mostly among those lacking higher education and appears to have few\u00a0geographical restrictions. The increase in morbidity has not only increased the number of people on Social Security, but will also impact Medicare as this cohort ages into retirement.<\/p>\n

Joseph Stiglitz\u00a0lays much of the blame<\/a> for the increase in deaths from suicide, drugs,\u00a0and alcoholism\u00a0on our growing economic inequality, and on\u00a0the high price we, as a nation, pay for medical care which, for too long, has put\u00a0it out of the reach of those who need it most. Stiglitz also mentions the increase in mortality that occurred in Russia after the dissolution of the USSR.<\/p>\n

During the early 1990<\/a>s, Russia saw an alarming increase in the mortality of its men as their life expectancy fell by six years,\u00a0while that of women fell by three. By 2006, Russia\u2019s mortality rate, which had been 38 percent higher than that of Western Europe in 1980, increased to a level of\u00a0135\u00a0percent. Granted, they have been dealing with their own AIDS epidemic\u00a0as well as a large jump in tuberculosis infections, many of which appear to be antibiotic resistant. But most of the increase comes from mortalities due to\u00a0cardiovascular diseases (CVD) which are currently 3.8 times greater than the rate of CVD mortality in\u00a0Western Europe. Deaths from external events (injuries, accidents, poisonings) increased from 2.5 times more than Western Europe in 1980 to 5.3 times greater in 2006. From a spring\u00a02009, World Affairs Journal<\/em> article by Nicholas Eberstadt<\/a>:<\/p>\n

Taken together, then, deaths from cardiovascular disease and from injuries and poisoning have evidently been the main drivers of modern Russia\u2019s strange upsurge in premature mortality and its broad, prolonged retrogression in public health conditions. One final factor that is intimately associated with both of these causes of mortality is alcohol abuse.<\/p>\n

The damage done by alcohol\u00a0in Russia\u00a0is much worse than here in the U.S.\u00a0due to the popularity of home brews known as samogon<\/em>. Often filled with impurities, these home brews have contributed to the death rate due to alcohol poisoning. Local studies have shown that alcohol is \u201ca direct factor in premature death,\u201d including one in a city in the Urals that …<\/p>\n

indicated that over 40 percent of the younger male decedents evaluated had probably been alcohol-impaired or severely intoxicated at the time of death\u2014including one quarter of the deaths from heart disease and over half of those from accidents or injuries.<\/p>\n

So, when looking at\u00a0a chart (click on PNAS link at top of article) that was part of the original study done by Case and Denton, \u00a0the other nations all have decent health care available to all citizens. The Russian health care safety net <\/a>is not unlike the one that exists in too many parts of the United States\u00a0today\u2014somewhere between very weak and nonexistent. It would be interesting to see how a chart that included Russia would look.<\/p>\n

All-cause mortality, ages 45\u201354 for US White non-Hispanics (USW), US Hispanics (USH), and six comparison countries: France (FRA), Germany (GER), the United Kingdom (UK), Canada (CAN), Australia (AUS), and Sweden (SWE).<\/p>\n

Michelle A. Parsons published\u00a0Dying Unneeded:\u00a0The Cultural Context of the Russian Mortality Crisis<\/em><\/a>\u00a0<\/em>in 2014. A<\/em>\u00a0sociocultural anthropologist with a background in global health, Parsons interviewed\u00a0Muscovites\u00a0in an attempt to find the cultural causes of the increase in mortality. She found that after the collapse<\/a> of the USSR, middle-aged Russians were faced with an economy that no longer provided\u00a0stable, secure\u00a0employment, and that the retirement system had collapsed, leaving the future uncertain with few prospects for improvement. They no longer felt needed, by their society or by their families. Parsons looks at the involvement of alcohol in the increased mortality rate and:<\/p>\n

\u201ctheorizes that drinking is, for what its worth, an instrument of adapting to the harsh reality and sense of worthlessness that would otherwise make one want to curl up and die.\u201d<\/p>\n

One wonders how much of that attitude is shared by the middle-aged Americans that Case and Deaton have examined.\u00a0In discussing their original paper, Paul Starr\u00a0of the American Prospect<\/em>\u00a0wrote<\/a>:<\/p>\n

The declining health of middle-aged white Americans may also shed light on the intensity of the political reaction taking place on the right today. The role of suicide, drugs, and alcohol in the white midlife mortality reversal is a signal of heightened desperation among a population in measurable decline. We are not talking merely about \u201cstatus anxiety\u201d due to rising immigrant populations and changing racial and gender relations. Nor are we talking only about stagnation in wages as if the problem were merely one of take-home pay. The phenomenon Case and Deaton have identified suggests a dire collapse of hope, and that same collapse may be propelling support for more radical political change. Much of that support is now going to Republican candidates, notably Donald Trump. Whether Democrats can compete effectively for that support on the basis of substantive economic and social policies will crucially affect the country\u2019s political future.<\/p>\n","protected":false},"excerpt":{"rendered":"PNAS 2015 Dec 112(49) 15078-83, Fig. 1 By Susan Grigsby Sunday Apr 02, 2017 \u00b7 6:00 PM PDT \u00a0reported \u00a0on \u00a0Daily KOS In 1995, at the height of the AIDS epidemic, there were 43,115 deaths from the disease and its complications. Twenty years later, our current opiate epidemic has passed that gruesome marker, racking up…","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"om_disable_all_campaigns":false,"_monsterinsights_skip_tracking":false,"_monsterinsights_sitenote_active":false,"_monsterinsights_sitenote_note":"","_monsterinsights_sitenote_category":0,"_uf_show_specific_survey":0,"_uf_disable_surveys":false,"jetpack_post_was_ever_published":false,"_jetpack_newsletter_access":"","_jetpack_dont_email_post_to_subs":false,"_jetpack_newsletter_tier_id":0,"_jetpack_memberships_contains_paywalled_content":false,"_jetpack_memberships_contains_paid_content":false,"footnotes":"","jetpack_publicize_message":"","jetpack_publicize_feature_enabled":true,"jetpack_social_post_already_shared":true,"jetpack_social_options":{"image_generator_settings":{"template":"highway","enabled":false},"version":2}},"categories":[12],"tags":[88,66,86,87,39],"class_list":["entry","author-larrynorton","post-493","post","type-post","status-publish","format-standard","hentry","category-updates","tag-death","tag-health","tag-mortality","tag-opioids","tag-russia","no-post-thumbnail"],"jetpack_publicize_connections":[],"aioseo_notices":[],"jetpack_featured_media_url":"","jetpack_sharing_enabled":true,"jetpack_shortlink":"https:\/\/wp.me\/p8bppg-7X","jetpack_likes_enabled":true,"jetpack-related-posts":[],"_links":{"self":[{"href":"http:\/\/nortonspeaks.com\/index.php\/wp-json\/wp\/v2\/posts\/493","targetHints":{"allow":["GET"]}}],"collection":[{"href":"http:\/\/nortonspeaks.com\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"http:\/\/nortonspeaks.com\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"http:\/\/nortonspeaks.com\/index.php\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"http:\/\/nortonspeaks.com\/index.php\/wp-json\/wp\/v2\/comments?post=493"}],"version-history":[{"count":6,"href":"http:\/\/nortonspeaks.com\/index.php\/wp-json\/wp\/v2\/posts\/493\/revisions"}],"predecessor-version":[{"id":500,"href":"http:\/\/nortonspeaks.com\/index.php\/wp-json\/wp\/v2\/posts\/493\/revisions\/500"}],"wp:attachment":[{"href":"http:\/\/nortonspeaks.com\/index.php\/wp-json\/wp\/v2\/media?parent=493"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"http:\/\/nortonspeaks.com\/index.php\/wp-json\/wp\/v2\/categories?post=493"},{"taxonomy":"post_tag","embeddable":true,"href":"http:\/\/nortonspeaks.com\/index.php\/wp-json\/wp\/v2\/tags?post=493"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}