The recent years of austerity and economic dislocation have taken their toll around the world, but this deterioration on top of the already existing harshness of life in the United States has taken a particular toll there. Nearly half a million excess deaths have occurred in the U.S. since 1999.
Specifically, these half-million excess deaths are among middle-aged White non-Hispanic United Statesians, according to a paper by two Princeton University researchers, Anne Case and Angus Deaton, published in the peer-reviewed scientific journal PNAS. Widening inequality is seen as a significant factor. This increase in the death rate, reversing historic trends, was limited to the U.S. among advanced capitalist countries and, within the U.S., limited to non-Hispanic Whites. The authors of the paper, “Rising morbidity and mortality in midlife among white non-Hispanic Americans in the 21st century,” write:
“This change reversed decades of progress in mortality and was unique to the United States; no other rich country saw a similar turnaround. The midlife mortality reversal was confined to white non-Hispanics; black non-Hispanics and Hispanics at midlife, and those aged 65 and above in every racial and ethnic group, continued to see mortality rates fall. This increase for whites was largely accounted for by increasing death rates from drug and alcohol poisonings, suicide, and chronic liver diseases and cirrhosis.” [page 1]
From 1978 to 1998, the mortality rate for U.S. Whites aged 45 to 54 fell by 2 percent per year on average, matching the average rate of decline in five comparison countries (Australia, Britain, Canada, France and Germany). But although, from 1999, other industrial countries continued to see a decline in mortality rates for the middle-aged, the U.S. White non-Hispanic mortality rose by half a percent a year, an increase that is unique, Drs. Case and Deaton report.
The authors calculate that if the U.S. White non-Hispanic mortality rate remained at the 1998 level, 96,000 deaths would have been prevented; had the previous rate of decline continued, a total of 488,500 deaths would have been prevented. The increased mortality rates are accompanied by “a large and statistically significant decline” in those reporting excellent or very good health and a corresponding increase in those reporting fair or poor health. This is a population that had not previously had unusual health results:
“[T]he post-1999 episode in midlife mortality in the United States is both historically and geographically unique, at least since 1950. The turnaround is not a simple cohort effect; Americans born between 1945 and 1965 did not have particularly high mortality rates before midlife.” [page 2]
Deaths other than natural more frequent
A sign of this midlife change is that deaths due to poisonings, suicide, chronic liver disease and diabetes have all increased since 1999. At the same time, however, mortality rates among Hispanics and non-Hispanic Blacks have continued to decline; Black deaths continue to be higher than the rate for Whites but the ratio between the two is narrowing, mostly due to the increased mortality of Whites.
The authors do not speculate on the reason for White deaths to increase in contrast to the trend of minority groups, but we might reasonably conclude that People of Color have had deprivation and economic difficulty imposed on them in greater numbers and more intensely, and thus are experiencing less of a change in historic circumstances than are Whites. The economic downturn that the world has lived through since 2008 certainly hasn’t bypassed People of Color — far from it — but the decline has not spared Whites, a group not as hardened to lower living standards thanks to their privileges.
The authors do gingerly dip their toes into declining living standards and rising inequality. They draw this general conclusion:
“After the productivity slowdown in the early 1970s, and with widening income inequality, many of the baby-boom generation are the first to find, in midlife, that they will not be better off than were their parents. Growth in real median earnings has been slow for this group, especially those with only a high school education. However, the productivity slowdown is common to many rich countries, some of which have seen even slower grow in median earnings than the United States, yet none have had the same mortality experience. The United States has moved primarily to defined-contribution pension plans with associated stock market risk, whereas, in Europe, defined-benefit pensions are still the norm. Future financial insecurity may weigh more heavily on US workers, if they perceive stock market risk harder to manage than earnings risk, or if they have contributed inadequately to defined-contribution plans.” [page 4]
It is not only the middle-aged who are feeling these deprivations, however.
“[A]ll 5-year age groups between 30–34 and 60–64 have witnessed marked and similar increases in mortality from the sum of drug and alcohol poisoning, suicide, and chronic liver disease and cirrhosis over the period 1999–2013; the midlife group is different only in that the sum of these deaths is large enough that the common growth rate changes the direction of all-cause mortality.” [page 3]
Worse conditions leads to worse results
It would not be proper to put words in the mouths of Drs. Case and Deaton, but it is possible for us to go beyond the scope of their paper, which is to quantify a previously unnoticed increase in mortality rates and offer general commentary on the macro-economic trends behind it. If we do go further, it could be reasonably concluded that neoliberal austerity — the continual pushing down of living standards, increased deprivation, overwork for those still employed, and increased unemployment or more precarious employment for many others — is a policy that kills.
Contrary to the assertion of Drs. Case and Deaton, productivity did not slow in the early 1970s. Pay slowed. Productivity grew 65 percent between 1979 and 2013 while pay increased eight percent for employees in that period, reports the Economic Policy Institute, and that trend certainly hasn’t reversed itself the past couple of years.
The present capitalist era of neoliberalism, with its increasingly harsh doses of austerity, does not fall out of the sky, but is the logical consequence of the relentless competitive pressures of capitalism and the consolidation of political power by the holders of economic power: industrialists and financiers.
This is hardly the first example of capitalism literally killing — mortality rates in the Soviet Union and other communist countries sharply increased following the imposition of capitalism. Mass privatization in the former Soviet bloc — the “shock therapy” instituted as the imposition of capitalism — is calculated to have led to one million excess deaths, according to a 2009 study published in The Lancet. Alcoholism and poverty skyrocketed in Russia following the fall of the Soviet Union; no surprise due to the economy shrinking 45 percent.
For that matter, health results in the U.S. badly lag other industrialized countries because the U.S. health system is designed to generate profits for pharmaceutical, medical-device and insurance companies rather than deliver health care. The U.S. spends an extra $1.15 trillion per year beyond what it would otherwise in comparison to health care spending in Britain, Canada, France and Germany, yet is well below average in life expectancy and infant mortality. About 22,000 people die and 700,000 go bankrupt per year as a result of inadequate, or no, health insurance in the United States.
It should come as no surprise that when people have life made more difficult, when the weight of corporate power and the governments that do the bidding of that corporate power constantly press down, health and well-being deteriorate. We ought to draw conclusions.