Drug overdoses propel rise in mortality rates of whites in U.S.

Judy Rummler’s son, who took OxyContin for a back injury, became addicted and later died of a heroin overdose.
Judy Rummler’s son, who took OxyContin for a back injury, became addicted and later died of a heroin overdose.
Published Jan. 17, 2016

Drug overdoses are driving up the death rate of young, white adults in the United States to levels not seen since the end of the AIDS epidemic more than two decades ago — a turn of fortune that stands in sharp contrast to falling death rates for young blacks, a New York Times analysis of death certificates has found.

The rising death rates for those young white adults, ages 25 to 34, make them the first generation since the Vietnam War years of the mid 1960s to have higher death rates in early adulthood than the generation before it.

The New York Times analyzed nearly 60 million death certificates collected by the Centers for Disease Control and Prevention from 1990 to 2014. It found death rates for non-Hispanic whites either rising or flattening for all the adult age groups under 65 — a trend that was particularly pronounced in women — even as medical advances sharply reduce deaths from traditional killers like heart disease. Death rates for blacks and most Hispanic groups continued to fall.

The analysis shows that the rise in white mortality extends well beyond the 45- to 54-year-old age group documented by a pair of Princeton economists, Anne Case and Angus Deaton, in a research paper that startled policymakers and politicians two months ago.

While the death rate among young whites rose for every age group over the five years before 2014, it rose faster by any measure for the less educated, by 23 percent for those without a high school education, compared with only 4 percent for those with a college degree or more.

The drug overdose numbers were stark. In 2014, the overdose death rate for whites ages 25 to 34 was five times its level in 1999, and the rate for 35- to 44-year-old whites tripled during that period. The numbers cover both illegal and prescription drugs.

"That is startling," said Dr. Wilson Compton, the deputy director of the National Institute on Drug Abuse. "Those are tremendous increases."

Rising rates of overdose deaths and suicide appeared to have erased the benefits from advances in medical treatment for most age groups of whites. Death rates for drug overdoses and suicides "are running counter to those of chronic diseases," said Ian Rockett, an epidemiologist at West Virginia University.

In fact, graphs of the drug overdose deaths look like those of deaths from a new infectious disease, said Jonathan Skinner, a Dartmouth economist.

"It is like an infection model, diffusing out and catching more and more people," he said.

Yet overdose deaths for young adult blacks have edged up only slightly. Overall, the death rate for blacks has been steadily falling, largely driven by a decline in deaths from AIDS. The result is that a once yawning gap between death rates for blacks and whites has shrunk by two-thirds.

There is a reason that blacks appear to have been spared the worst of the narcotic epidemic, said Dr. Andrew Kolodny, a drug abuse expert. Studies have found that doctors are much more reluctant to prescribe painkillers to minority patients, worrying that they might sell them or become addicted.

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"The answer is that racial stereotypes are protecting these patients from the addiction epidemic," said Kolodny, a senior scientist at the Heller School for Social Policy and Management at Brandeis University and chief medical officer for Phoenix House Foundation, a national drug and alcohol treatment company.

Not many young people die of any cause. In 2014, there were about 29,000 deaths out of a population of about 25 million whites in the 25-to-34 age group. That number had steadily increased since 2004, rising by about 5,500 — about 24 percent — while the population of the group as a whole rose only 5 percent. In 2004, there were 2,888 deaths from overdoses in that group; in 2014, the number totaled 7,558.

Mark Hayward, a professor of sociology at the University of Texas at Austin, said mortality rates are one of the most sensitive measures of quality of life.

For young, non-Hispanic whites, the death rate from accidental poisoning, which is mostly drug overdoses, rose from 6 to 30 per 100,000 from 1999 to 2014, and the suicide rate rose to 19.5 per 100,000 from 15, the New York Times analysis found.

For non-Hispanic whites ages 35 to 44, the accidental poisoning rate rose to 29.9 from 9.6 in that period. And for non-Hispanic whites 45 to 54, the poisoning rate rose to 29.9 per 100,000 from 6.7, and the suicide rate rose to 26 per 100,000 from 16, the newspaper's analysis found

But deaths from the traditional killers for which treatment has greatly improved over the past decade — heart disease, HIV and cancer — went down.

Abuse of both illegal drugs, like heroin, and prescription painkillers has become a part of the American political discourse as never before, with some presidential candidates, including Jeb Bush and Carly Fiorina, telling stories of addiction in their own families.