One group of middle-aged whites in the US is dying at a startling rate

WASHINGTON - A large segment of white middle-aged Americans has suffered a startling rise in its death rate since 1999, reversing decades of progress, according to a new review of statistics published Monday.

The mortality rate for white men and women between the ages of 45 and 54 with less than a college education increased by half a percent per year between 1999 and 2013, most likely because of problems with legal and illegal drugs, alcohol, and suicide, according to the study released in the Proceedings of the National Academy of Sciences. Before then, death rates for that group were dropping at an average of 2 percent a year.

The rising death rate was accompanied by a parallel increase in the rate of illness, the authors wrote.

"Drugs and alcohol, and suicide . . . are clearly the proximate cause," said Angus Deaton, the 2015 Nobel laureate in economics, who cowrote the paper with his wife, Anne Case. Both are economics professors at Princeton University.

"Half a million people are dead who should not be dead," he added. "About 40 times the Ebola stats. You're getting up there with HIV-AIDS."

Since at least 1970, Americans and residents of other wealthy countries have generally enjoyed longer and healthier lives, as smoking has declined, better treatments have been developed and preventive measures have had an impact on mortality.

But these bleak findings could have far-reaching implications as the surviving members of this sizable segment of the baby boom continue toward retirement and eligibility for Medicare, according to experts. A sicker population that has been less able to prepare for the costs associated with old age will place an increasing burden on society and federal programs, they said.

"This is the first indicator that the plane has crashed," said Jonathan Skinner, a professor of economics at Dartmouth College, who reviewed the study and cowrote a commentary that appears with it. "I don't know what's going on, but the plane has definitely crashed."

Death rates for other developed nations examined by the two researchers, as well as rates for U.S. blacks and Hispanics, continued the steady decline of recent decades. Whites in other age groups between 30 and 64, and more educated whites also had lower death rates. But the other age groups also experienced substantially higher death rates from drug and alcohol overdoses, suicide, chronic liver disease and cirrhosis of the liver.

An increase in the mortality rate for any large demographic group in an advanced nation is virtually unheard of in recent decades, with the exception of Russian men after the collapse of the Soviet Union.

While the death rate for African Americans is still greater than the rate for whites, the turnaround among whites is shocking because of the advantages they enjoy, said David Weir, director of the health and retirement study at the Institute for Social Research at the University of Michigan.

Weir said economic insecurity, the decay of communities and the breakdown of families probably have had some impact on death and illness rates, in addition to the nation's opioid epidemic and the factors the authors identified.

"I think it has to have something to do [with] the pain underlying it," both physical and psychic, he said. "That is the age when people have their mid-life crisis. . . . I think it has to do with that stage of life, and physical ailments do start to accumulate at that age.

"This paper really is a question, not an answer," he added.