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Report Sheds More Light on 'Despair Deaths' of White, Middle-Aged Americans


  • Ryan Johnson

The kids are alright, but their parents? Not so much.

According to a study published in November 2015 in the Proceedings of the National Academy of Sciences, the mortality rate for middle-aged, white Americans has for years been bucking a general trend toward better health and longevity. While death rates for white Americans aged 45-54 had declined an average of 2 percent per year from 1978 to 1998, between 1998 and 2014 it reversed course, rising an average of 0.5 percent per year.

The study pegged that increase to higher rates of drug and alcohol abuse, chronic liver diseases and cirrhosis, and suicide.

PNAS Study
Now, another study from the Commonwealth Fund has shed more light on what The Atlantic, which first reported on the trend, has dubbed "despair deaths." According to the most recent report, not only are middle-aged whites dying in greater numbers from substance abuse and suicide, but they are increasingly the victims of heart disease, diabetes and respiratory disease. As The Atlantic reported this morning, "more of them are getting sick with the diseases that usually kill older people. And when they get sick, they don't get better."

The so-called "despair death" phenomenon is playing out in Idaho, too, where a number of factors including  low wages, lack of health care access and high incidences of suicide have combined to create what Family Medicine Residency of Idaho Dr. Ted Epperly called a "toxic mix"—especially for white males.

"Males tend to be more stoic," he told Boise Weekly in November. "They much less commonly share those feelings and they keep them bundled up pretty tight, especially in a state that's rural like ours, where there are a lot of farmers and ranchers and individualists. They're a pretty rugged group of people. The way that comes out is with hard drinking and hard living, and if you just get to your rope's end, they aren't going to talk about it. They're just going to take action into their own hands and they're going to finish it."

Idaho ranks eighth in the nation for suicides, and its suicide rate is 44 percent higher than the national average. In Idaho, nearly 80 percent of suicides from 2009 to 2013 were males. What's more, 65 percent of suicides in Idaho in 2013 involved a firearm, according to the Idaho Suicide Prevention Hotline.

When it comes to the latest study and its findings regarding deaths from heart disease, diabetes and respiratory disease, The Atlantic reported seven Southern states were especially hard hit—four of them, the magazine noted, have opted not to expand Medicaid.

Access to Medicaid in Idaho has long been a political football. According to Close the Gap Idaho, which advocates for expanding Medicaid, as many as 78,000 Idahoans lack access to adequate health care because they make too much money to qualify for the Idaho Medicaid and not enough to access the Your Health Idaho insurance exchange. 

That issue is currently playing out in the Idaho Legislature, where three proposals have been fronted—two from Moscow Democratic Sen. Dan Schmidt, and one from Gov. C.L. "Butch" Otter.

In one measure, Schmidt is proposing an expansion of the program to adults earning up to 138 percent of the poverty level. His second proposal would expand Medicaid to the 100 percent federal poverty level.

Meanwhile, Otter is pushing his Primary Care Access Program, unveiled in the 2016 State of the State address. The governor's plan would channel state funds to support a range of health services, including behavioral health crisis centers around the state and health assessments. Opponents of the plan, dubbed "Ottercare," say the governor's proposal doesn't go far enough, omitting hospital care, emergency medical transportation, cancer care and prescriptions.

One or both of Schmidt's proposals is expected to go before the Senate Health and Welfare Committee as early as Tuesday, Feb. 2. Otter's plan may also surface in committee next week.