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The epidemic of despair among white americans: Trends in the leading causes of premature death, 1999-2015

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  • Stein, E.M.
  • Gennuso, K.P.
  • Ugboaja, D.C.
  • Remington, P.L.

Abstract

Objectives. To evaluate trends in premature death rates by cause of death, age, race, and urbanization level in the United States. Methods. We calculated cause-specific death rates using the Compressed Mortality File, National Center for Health Statistics data for adults aged 25 to 64 years in 2 time periods: 1999 to 2001 and 2013 to 2015. We defined 48 subpopulations by 10-year age groups, race/ethnicity, and county urbanization level (large urban, suburban, small or medium metropolitan, and rural). Results.The age-adjusted premature death rates for all adults declined by8%between 1999 to 2001 and 2013 to 2015, with decreases in 39 of the 48 subpopulations. Most decreases in death rates were attributable to HIV, cardiovascular disease, and cancer. All 9 subpopulations with increased death rates were non-Hispanic Whites, largely outside large urban areas. Most increases in death rates were attributable to suicide, poisoning, and liver disease. Conclusions. The unfavorable recent trends in premature death rate among non-Hispanic Whites outside large urban areas were primarily caused by self-destructive health behaviors likely related to underlying social and economic factors in these communities.

Suggested Citation

  • Stein, E.M. & Gennuso, K.P. & Ugboaja, D.C. & Remington, P.L., 2017. "The epidemic of despair among white americans: Trends in the leading causes of premature death, 1999-2015," American Journal of Public Health, American Public Health Association, vol. 107(10), pages 1541-1547.
  • Handle: RePEc:aph:ajpbhl:10.2105/ajph.2017.303941_8
    DOI: 10.2105/AJPH.2017.303941
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    Cited by:

    1. David G. Blanchflower & Donn. L. Feir, 2023. "Native Americans’ experience of chronic distress in the USA," Journal of Population Economics, Springer;European Society for Population Economics, vol. 36(2), pages 885-909, April.
    2. Akee, Randall K. Q. & Feir, Donn. L. & Gorzig, Marina Mileo & Myers Jr, Samuel, 2022. "Native American "Deaths of Despair" and Economic Conditions," IZA Discussion Papers 15546, Institute of Labor Economics (IZA).
    3. Seto, Christopher, 2022. "Saving Grace? Religious ecology and deaths of despair," Social Science & Medicine, Elsevier, vol. 293(C).
    4. Pinghui Wu, 2022. "Wage Inequality and the Rise in Labor Force Exit: The Case of US Prime-Age Men," Working Papers 22-16, Federal Reserve Bank of Boston.
    5. Shannon M. Monnat, 2022. "Demographic and Geographic Variation in Fatal Drug Overdoses in the United States, 1999–2020," The ANNALS of the American Academy of Political and Social Science, , vol. 703(1), pages 50-78, September.
    6. Murphy, David M.A., 2023. "Sobriety, social capital, and village network structures," World Development, Elsevier, vol. 166(C).
    7. Glei, Dana A. & Stokes, Andrew & Weinstein, Maxine, 2020. "Changes in mental health, pain, and drug misuse since the mid-1990s: Is there a link?," Social Science & Medicine, Elsevier, vol. 246(C).
    8. Peter Congdon, 2020. "Geographical Aspects of Recent Trends in Drug-Related Deaths, with a Focus on Intra-National Contextual Variation," IJERPH, MDPI, vol. 17(21), pages 1-18, November.
    9. Boslett, Andrew & Hill, Elaine, 2022. "Mortality during resource booms and busts," Journal of Environmental Economics and Management, Elsevier, vol. 115(C).
    10. Efird, Caroline R. & Lightfoot, Alexandra F., 2020. "Missing Mayberry: How whiteness shapes perceptions of health among white Americans in a rural Southern community," Social Science & Medicine, Elsevier, vol. 253(C).
    11. Miller, Charlotte E. & Vasan, Ramachandran S., 2021. "The southern rural health and mortality penalty: A review of regional health inequities in the United States," Social Science & Medicine, Elsevier, vol. 268(C).
    12. Elisabet Beseran & Juan M. Pericàs & Lucinda Cash-Gibson & Meritxell Ventura-Cots & Keshia M. Pollack Porter & Joan Benach, 2022. "Deaths of Despair: A Scoping Review on the Social Determinants of Drug Overdose, Alcohol-Related Liver Disease and Suicide," IJERPH, MDPI, vol. 19(19), pages 1-18, September.
    13. Perry, Seth W & Allison, Stephen & Bastiampillai, Tarun & Wong, Ma-Li & Licinio, Julio & Sharfstein, Steven S. & Wilcox, Holly C., 2019. "Rising US Suicides: Achieving Health Equity," OSF Preprints m5q64, Center for Open Science.
    14. Gianfranco Alicandro & Matteo Malvezzi & Silvano Gallus & Carlo La Vecchia & Eva Negri & Paola Bertuccio, 2019. "Worldwide trends in suicide mortality from 1990 to 2015 with a focus on the global recession time frame," International Journal of Public Health, Springer;Swiss School of Public Health (SSPH+), vol. 64(5), pages 785-795, June.
    15. Snell-Rood, Claire & Carpenter-Song, Elizabeth, 2018. "Depression in a depressed area: Deservingness, mental illness, and treatment in the contemporary rural U.S," Social Science & Medicine, Elsevier, vol. 219(C), pages 78-86.
    16. Shannon M. Monnat, 2020. "Trends in U.S. Working-Age non-Hispanic White Mortality: Rural–Urban and Within-Rural Differences," Population Research and Policy Review, Springer;Southern Demographic Association (SDA), vol. 39(5), pages 805-834, October.
    17. Cotti, Chad D. & Gordanier, John M. & Ozturk, Orgul D., 2020. "The relationship of opioid prescriptions and the educational performance of children," Social Science & Medicine, Elsevier, vol. 265(C).
    18. Mariaelena Gonzalez & Ashley Sanders-Jackson, 2021. "Traditional Cigarette and Poly-Tobacco Use Are Associated with Medical Opioid Use in Rural Areas of the US," IJERPH, MDPI, vol. 18(22), pages 1-7, November.

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