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STICERD Public Events and Lectures

STICERD Atkinson Lecture- Midlife morbidity and mortality in Europe and America: Why has the US left the herd?

Anne C. Case (Woodrow Wilson School of Public & International Affairs, Princeton University)

Monday 28 November 2016 09:30 - 18:00

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About this event

After a century of nearly uninterrupted progress, all-cause mortality rates among white men and women in middle age stopped falling in the US, in the late 1990s, and began to rise. While midlife mortality continued to fall in other rich countries, and in other racial and ethnic groups in the US, white non-Hispanic mortality rates increased from 1999 through 2014. Mortality from the two biggest killers in middle age – cancer and heart disease – declined between 2000 and 2014, but were offset by marked increases in drug overdoses, suicides, and alcohol-related liver mortality. Increased mortality in midlife, led by these “deaths of despair,” is now large enough to offset mortality gains observed for children and the elderly, leading to the first decline in life expectancy among whites observed in several decades. Mortality increases for whites in midlife are mirrored by reported deterioration in health and mental health, and increased reports of chronic pain. Many theories have been put forward to explain this turnaround, and its roots in deaths of despair. In this paper, we examine economic, cultural and social explanations for this decline, using current and historical data from the US and Europe. We discuss hypotheses that could potentially explain the increased deaths of despair that we observe in the data, and compare outcomes predicted by these hypotheses to the spatial, temporal and demographic characteristics of this quietly unfolding epidemic.

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