Some of the blame lies on suicide and substance abuse for the rising mortality rates of middle-aged white Americans. However, a decline in socioeconomic standing and a decades-long stall in progress made in combating common diseases deserve much of the blame, according to a new report from the Commonwealth Fund.
There has been a doubling of the death rates in middle-aged white Americans aged 22 to 56 between 1999 and 2014. To blame, mostly, is a rise in accidental poisoning, suicide and alcohol-related liver disease.
While those three categories have risen, research also shows the rising mortality rates due to diseases such as diabetes and liver disease.
"We are accustomed to making progress against diseases. We learn how to prevent them and how to treat them and, as we do that, fewer people die from them," said Dr. David Blumenthal, study co-author and president of the Commonwealth Fund. The Commonwealth Fund promotes a high-performing health care system to improve access, quality, and efficiency.
However, Blumenthal says that for middle-aged white Americans, that progress in combating diseases has stalled, and even gone backward for some conditions.
"We need to find out why this is happening," he added.
Mortality rates have fallen relatively quickly for many other age groups in both white and minority populations, the report noted.
"But for working-age whites - especially 45-to-54-year-olds - we are witnessing regression that has little precedent in the industrialized world over the past half-century," the report states.
While research into heart and liver disease has virtually stalled over the last couple decades, relative to the speed at which it once moved, there is yet another factor that may explain while middle-aged whites are dying in larger numbers.
"One hypothesis is that the excess deaths among middle-aged whites reflect erosion in their socioeconomic standing," the report says. "On a range of social and economic indicators, middle-aged whites have been falling behind in the 21st century."
This isn't to say that the quality of life of middle-aged white Americans has fallen behind that of other groups. This may be due to under-educated workers leaving the mainstream workforce, lower levels of social interaction, the decline of social institutions and "the splintering of society along class, geographic and cultural lines."
The death gap, the disparity between expected and actual mortality, was in excess of 200 deaths per 100,000 in Alabama, Arkansas, Kentucky, Mississippi, Oklahoma and West Virginia. The death gap was especially pronounced in West Virginia, where mortality rates were at their highest since 1980.
