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Further criticism of social scientists and journalists jumping to conclusions based on mortality trends

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So. We’ve been having some discussion regarding reports of the purported increase in mortality rates among middle-aged white people in America. The news media have mostly spun a simple narrative of struggling working-class whites, but there’s more to the story.

Some people have pointed me to some contributions from various sources:

In “The Death of the White Working Class Has Been Greatly Exaggerated,” journalist Malcolm Harris looks into some of the selection biases and problems with data presentation that has led people to misunderstand recent trends.

In “Why Are American Non-College Whites Killing Themselves?,” Hugh Whalen goes beyond the mortality trends (which is all that I’ve ever looked at for this problem) and considers social and economic causes. I haven’t looked into Whalen’s analysis in detail but from a quick glance it looks reasonable, and more sophisticated than the basic white-men-are-suffering story. (Yes, white men are suffering; so are a lot of other people. The point of these more careful analyses is not to dismiss the pain of white men but rather to understand the bigger picture.)

In “Deaths of Despair. An Analysis of the Case-Deaton Conference Paper on the Mortality Rates of Middle-Aged Whites,” Echidne (the pseudonym of a thoughtful social-science-and-politics blogger) again recognizes that these comparisons of recent mortality trends are important and newsworthy, while criticizing the over-simplified stories presented in prominent scholarly articles as well as in the press. Echidne also talks about the bait-and-switch, in which the data come from both sexes (indeed, as shown in the graphs below, the much-advertised increase in middle-aged white mortality is among women, not among men) but then the discussion is mostly about men.

I find a lot of this “working class” discussion to be gendered. The phrase “woking class” seems to conjure up an image of a man working at a factory and not a woman cleaning bedpans, for example. I’m sure that middle-aged men have it tough in many ways, but I’ve been hearing the story of the suffering emasculated white male for over 40 years now—ever since the movies “Mean Streets,” “Rocky,” and “Saturday Night Fever”—and every time we hear it again, it’s presented as a new and transgressive idea. Again, I think it’s fine to talk about the troubles of non-upper-class white men, and also to talk about corresponding troubles of non-upper-class white women, and all sorts of other groups. We just have to be careful with the bait-and-switch. The statistics should be relevant to the group being discussed, and terms such as “working class” (or, worse, “blue collar“) have this gendered aspect that can distort the conversation.

Background (for those who haven’t been following the story)

Economists Anne Case and Angus Deaton started the general discussion with two papers, “Rising morbidity and mortality in midlife among white non-Hispanic Americans in the 21st century” and “Mortality and morbidity in the 21st century.”

These articles raised some interesting issues but had some technical problems, as I discussed in various ways here on the blog and with summary articles in Slate in
2015 and 2017.

From my paper with Jonathan Auerbach:

The whole discussion was kinda weird because everybody knows that when you’re analyzing mortality rates you should separate the sexes and you should age adjust. Reporting trends in mortality rates without age adjusting is like reporting trends in nominal prices without adjusting for the consumer price index.

More recently there was some discussion regarding breakdowns by age, education, and ethnicity. I expressed some concern about selection bias from the education breakdown, also some concern about isolating particular ethnicities and particular age groups, and so Jonathan and I prepared a document showing trends for both sexes, lots of age groups, and four different ethnic categories.

P.S. Bottom line is that Case, Deaton, and many others have made valuable contributions in looking at these data in various ways and drawing people’s attention to demographic trends, both expected and unexpected. Let’s not let some relatively minor technical issues distract us from that.


  1. Jon Minton says:

    There’s also my paper, highlighting importance of looking at a broader range of age and ethnic groups to understand additional contemporaneous changes, and suggesting that Lexis surfaces can be an effective way to do this and avoid aspects of the aggregation problems in the first place:

  2. Tom Mulholland says:

    Just some background from someone whose day job has demographer in it. I usually refrain from trying to nail down cause and effect. The reaskn why is probably summed up rather well in an article called “Broken limits to life expectancy.(link at bottom).

    For a number of years there has been a very contested view of mortality. It very much depends on the emphasis and purpose of your forecast (which is really the inference being made). So you have a school that is seeing a stong consistent trend that is not really based on a particular theory. Against this there are theories based on biological ideas that have data syggesting changes we are naking with duet etc that suggest things will change.

    Since the post us really contesting blind use of the former i guess it might help the reader to follow up with some of the work in the latter field that doesn’t use a Lee-Carter methid for forecasting future mortality.

  3. David18 says:

    I was recently asked while discussing healthcare and technology a question about what to do about the rising mortality rate from opioids.

    My answer was that naloxone which is a drug given to some first responders and others which counteracts the effects of opioids and prevents overdoses should be even more readily distributed (with trying) to more people, especially in areas with high incidence of overdosing.

    Also a tighter control over opioid prescriptions would. be helpful, there is a significant variation between different counties in the number of opioid prescriptions. But various opioids are now readily available illegally on the street.

    But I continued that the real issue is that the overdoses and use of opioids is really a symptom for despair and lack of hope because of job loss largely as a result of globalization. Charles Murray in his title, “Coming Apart: The State of White America, 1960-2010” speaks of the problems. Author Frank Thomas (“What’s the Matter with Kansas”, “Listen Liberal”) and Guardian columnist has also spoken of the problem of despair. The political elites of both parties and MSM (e.g., NYTims, WaPo) have largely ignored the problem with the exception of Trump which is a reason that Trump won.

    See, for example, March 2016
    Millions of ordinary Americans support Donald Trump. Here’s why

    Post BrExit:
    The world is taking its revenge against elites. When will America’s wake up?

    The Democratic candidate, who accepted $675,000 from Goldman, the Wall Street Bank that is iconic for the 2008 Financial Crisis, for 3 talks and spoke of those suffering from globalization as “A Basketful of Deplorables.”

    What I find disturbing is that even after the election, MSM seems more obsessed with Russians than it does helping to address the causes of the rising mortality rates and opioid overdoses. By simply focusing on it and keeping it in the news, it will help to “persuade” the political elites to address the problem.

  4. Elin says:

    From the original discussion, one issue I think is that the standard advise in demography is that age adjustment within 10 year intervals is _not_ necessary (and that might have made sense when computation was expensive) but your analysis found that actually that advise is really misguided and out of date.

  5. Hi Andrew,

    Your articles continue to poke holes in studies that clearly represent biases from researchers to drive certain agendas. The issue I see is that the general public, who is untrained in statistical modeling, inference, and gathering, will see studies like these and fuel a potentially incorrect narrative. Keep up the great work.

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