The Real Reason Middle-Aged White Men Are Dying

Last week, Dr. Anne Case and Dr. Angus Deaton published a paper analyzing the change in American death rates over the last 15 years. The good news is that, thanks to improvements in the economy and the delivery of health care, the mortality rate has fallen in almost all demographic groups. The bad news is that middle-aged white men have bucked this trend. Among non-hispanic white men ages 45 to 54, the mortality rate has risen from 380 to 415 (per 100,000 Americans in that age group).

Dr. Case and Dr. Deaton were able to identify the direct cause of these additional premature deaths: suicide, drug overdoses, and liver disease (from alcohol abuse). However, they were on shakier ground when trying to explain the root cause of the increase in suicide and substance abuse in this demographic. Dr. Deaton believes that middle-aged white men are dying because they have "lost the narrative of their lives" (whatever the fuck that is supposed to mean). Since then, everyone from Paul Krugman to Mother Jones to the The Daily Caller have chimed in. Krugman goes on for fourteen paragraphs, blaming everything from rising inequality to "traditional religion" and America's relatively weak welfare system. Sweden, for example, has a stronger welfare state and places less emphasis on religion -- and Sweden's middle-aged mortality rate is about 50% lower than white America's.

Alas, Krugman completely misses the mark. While America's higher poverty rate might affect overall mortality, there's no reason that it would hit middle-aged white men the hardest. White men in their 40s and 50s are among the highest earners in the U.S. (and the world).

Dartmouth economists Ellen Meara and Jonathan S. Skinner point to more "pessimism" among whites about their financial futures; Olga Khazan of The Atlantic concludes that "Middle-Aged White Americans Are Dying of Despair"; and Canadian epidemiologist Atif Kukaswadia says that "we have no idea" what is killing middle-age white Americans.

It's hard to believe that all these "experts" are completely ignoring the real reason. It's right in front of their eyes ... if they would just look down at their calendar:

White men aren't drawing our attention because they have become more pessimistic or "lost their narrative". Middle-aged white men are exceptional for the simple reason that they have volunteered for military service at a level higher than other demographic groups, and at a level much higher than that found in any European country.

Sweden doesn't have the level of income inequality that we have. But Sweden also doesn't have the world's largest military. The United States has more than 26 million military veterans. Ninety-three percent of them are male. Veterans are at much higher risk for suicide and substance abuse. According to the VA's own report, suicide kills 22 veterans every day.

Do The Numbers Add Up?

Of course, this theory is only true to the extent that the increased mortality rate among veterans can explain the increased mortality among middle-aged white men. The basic facts do show that it is primarily white middle-aged veterans that are dying from suicide:

• Among veterans, 92.6% of suicide deaths are white (compared with 87.7% among non-veterans).
• Among veterans, 91.5% of suicide deaths are classified as non-hispanic (compared with 87.2% in non-veterans).
• Among veterans, 85.3% of suicide deaths occur in those over age 40 (compared with only 55.6% among non-veterans).

From 1998 to 2014, the suicide rate among white non-Hispanics ages 45-54 rose from 16 to 25 (per 100,000). This is the increase that two different Nobel Laureates (Krugman and Deaton) are trying to attribute to a "weak welfare state" and a "lost narrative", respectively.

According to the U.S. Census Bureau, there are 12,752,000 white non-hispanic Americans between the ages of 45 and 54. This means that an increase in mortality of 9 per 100,000 translates to an additional 1100-1200 deaths per year.

According to the VA, more than 4.9 million veterans are between the ages of 45 and 54. Ninety-five percent of the veterans in this age group are male; ninety-two percent are non-white and ninety-four percent are non-hispanic. This leaves us with 4.02 million non-hispanic white male veterans between 45 and 54. The suicide rate in this cohort is 38 per 100,000 -- higher than the rate among all middle-aged men, and higher than the rate among all veterans. If we do the math, we see that non-hispanic white male veterans in this age cohort account for more than 1500 suicides every year.

Conclusion

The rise in premature deaths among white Amercian men in the 45-54 age group can be completely explained (and then some) by the number of military veterans in this cohort. If you remove U.S. military veterans from the data, the suicide rate among middle-aged white men is actually falling.

We can argue about why military service leads to increased rates of suicide, alcoholism and drug addiciton, But that argument shouldn't include an attempt to diagnose an entire generation with ennui. We are not having a crisis among middle-aged white men. We are having a crisis among veterans and they need (and deserve) our focus and continued (and increased) support.

Dear Liberals; Dear Conservatives

Cartoon by Dave Granlund

Dear Liberals, Please stop saying that because the Second Amendment was written in 1789, it only protects the right to carry muskets. It doesn't say "the right to bear muskets shall not be infringed". It says "the right to bear arms". Arms. Swords, guns, land mines, rocket-propelled grenades, fighter jets, nukes, sharks, lasers, sharks with lasers. Those are all "arms". Those are what "arms dealers" sell. Liberals more than anyone should understand that the Constitution evolves over time. In 1789, "citizen" referred to a white male. Today, it applies to men and women, black and white, brown and yellow, rich and poor. In 1789, "arms" referred to muskets. Today, it refers to AR-15s and M-1 tanks. This is the reason you seriously need to stop playing the "musket" card. Eventually, you will give your rifle-owning neighbor the idea to fight for his right to own all arms: machine guns, biological weapons, you name it. And when his case goes to the Supreme Court, to the Roberts Court, there's a good chance he'll win. Because the Second Amendment doesn't say "muskets"; it says "arms". Also, stop picking on the 2nd Amendment. The 2nd Amendment played no role in the Senate's recent failure to pass meaningful legislation to reduce gun violence. This battle isn't being fought in the courts; it's being fought in the legislature. If you want to write an angry letter, tell Harry Reid to grow some balls and fix the filibuster.

Dear Conservatives, Please stop saying that gun registries and background checks "treat law-abiding gun owners like criminals". I keep hearing that background checks are asking the gun buyer to "prove" that she isn't a criminal, instead of starting with the premise that the gun buyer is innocent until proven guilty. Well, guess what? When I buy lumber at my local hardware store, the cashier checks the signature on the back of my credit card. Am I offended? Nope. I'm happy that they are making sure I'm not a criminal, running up fraudulent charges and passing the blame along to me. As gun buyers, we should be ecstatic that we get to prove that we are not criminals. We don't want actual criminals shooting up schools and focusing the blame on law-abiding gun owners. When I board an airplane, I go through a fucking x-ray machine that can see my testicles. All to prove that I'm not a criminal. I'm 42 years old and I still get carded when I buy beer. Do I go bat-shit crazy and accuse the convenience store clerk of "treating me like a criminal"? No. I do not. When the next Dick Cheney comes to take all our guns, we don't want him to have a list of where all the gun owners live. That is a valid argument against gun registries. But please stop complaining that you are being "treated like a criminal" just because you have to fill out a fucking form. It's not a valid argument, and it serves to invalidate any other arguments you try to make. If you want to be treated like a criminal in this country, you don't need a gun. You just need to have dark skin and a hoodie.