Poverty is deadly: why is the death rate for young white Americans rising?

• Author: Bailey, Ronald
• Position: Columns - Column

WHEN A PRINCETON University study released last fall found that the mortality rate for midlife non-Hispanic whites is rising, my thoughts turned immediately to McDowell County, West Virginia. My family hails from that county, which is known for having the lowest male life expectancy in the United States. (Female life expectancy is only the second lowest in the country, at 73 years; the lowest is found in nearby Perry County, Kentucky.) Men in McDowell County live an average of 63.9 years, compared to a national average of 76.3. In Fairfax County, Virginia, the average American male's lifespan is 81.7 years--nearly 18 years more than in McDowell.

During the post-World War II coal boom, the population of McDowell County swelled to nearly 100,000. (My father's family decamped from coal country to dairy farming in Virginia around that time.) The county's population, which is about 90 percent white, has since dropped to just over 20,000 today. Fewer than 6 percent of residents have college degrees, and the annual per capita income is $14,000. By comparison, some 30 percent of Americans over age 25 have bachelor's degrees or above, and per capita annual income stands at $28,000 nationally.

One more pertinent fact: McDowell County is where the first food stamps were distributed. On the occasion, the U.S. Department of Agriculture reported: "Mr. and Mrs. Alderson Muncy...were the first food stamp recipients on May 29, 1961. They bought a can of pork and beans at Henderson's Supermarket."

U.S. mortality rates have been steadily declining and average life expectancy increasing for well over a century. So the discovery that the death rate for middle-aged white Americans began rising around 1999 is alarming. The increase is accounted for entirely by those with a high school degree or less. The 2013 mortality rates for midlife whites with that level of educational attainment was 736 per 100,000; for those with some college education it was 288 per 100,000; for whites with a B.A. or higher their death rate stood at 178 per 100,000. In other words, whites who have only a high school degree or less are four times more likely to die between ages 45 and 74 than are college-educated whites. For comparison, the overall death rate for midlife black non-Hispanics is 782 per 100,000;, and for Hispanics, it is 270 per 100,000. In January, Columbia University researchers reported the white midlife death rate increase was actually a bit lower than originally...