“Stunning” Rise in Death Rate, Pain Levels for Middle-Aged, Less Educated Whites

One of the long standing patterns in economies showing economic growth is longer life spans, and falls are see the result of severe distress and dislocation, as took place in the period right after the fall of the Soviet Union, when the expectancies of adult men fell by over seven years.

The US has just become the first country to approach this appalling record. A stark warning about the level of distress in America comes from an important study by Angus Deaton, the 2015 Nobel prize winner in economics, and his wife Anne Case. We’ve embedded their short and readable article at the end of this post. The authors found that from 1999 to 2013, the death rate among non-Hispanic whites aged 45 to 54 with a high school education or less rose, while it fell in other age and ethnic groups. This is an HIV-level silent epidemic: AIDS killed an estimated 650,000 from the mid-1980s to present, while an estimated close to half-million died in half that time period who would have lived had their mortality rates fallen in line with the rest of the population. It is hard to overstate the significance of these findings. From the New York Times:

“It is difficult to find modern settings with survival losses of this magnitude,” wrote two Dartmouth economists, Ellen Meara and Jonathan S. Skinner, in a commentary to the Deaton-Case analysis that was published in Proceedings of the National Academy of Sciences.

This cross-country comparison from the study shows how extreme an outlier these middle aged whites are:

Screen shot 2015-11-03 at 6.01.10 AM

The big culprits are linked to despair, namely “poisoning” which is opioid abuse first and alcoholism second, and suicides. Case and Deaton dug into the underlying statistics, and found distressingly high levels of pain and impaired health in this age group, so pain and physical impairment may well be bigger culprits than economic distress:

Screen shot 2015-11-03 at 6.08.18 AM

And the rise in death rates took place among men and women, in all of the four major regions of the country the authors examined, and obesity rates were not a driving factor.

And unlike chaotic post-Soviet Russia, the US does not have a good excuse as to why this has been happening in a period of supposed growth, and even worse, with no one noticing until now. Yes, there have been warning signs of distress, such as the fact that US life expectancy has stopped rising, that death rates among white women had risen (and over the same time period examined in the Case-Deaton study), and that the US is alone among developed countries in having an increasing maternal mortality rate. And even though the chattering classes may not have been aware of the rise in the death rate of whites, it had been troubling researchers for some time. Again from the New York Times:

The analysis by Dr. Deaton and Dr. Case may offer the most rigorous evidence to date of both the causes and implications of a development that has been puzzling demographers in recent years: the declining health and fortunes of poorly educated American whites. In middle age, they are dying at such a high rate that they are increasing the death rate for the entire group of middle-aged white Americans…

“Wow,” said Samuel Preston, a professor of sociology at the University of Pennsylvania and an expert on mortality trends and the health of populations, who was not involved in the research. “This is a vivid indication that something is awry in these American households.”

But what is telling about the major news reports on the Case-Deaton study, and is similar to the earlier reports I read on the rise in death rates among white women, which when you drilled into the data turned out to be rural white women, is there are none of the usual anecdotes accompanying these stories. The reporters either could not find, or could not be bothered to find, flesh and blood examples of the acute distress that has been, and remains, invisible to the elites of this country. Indeed, the Washington Post almost goes out of its way to depersonalize what is happening. The headline to its story reads, A group of middle-aged whites in the U.S. is dying at a startling rate. Um “groups” do not die, unless they form a suicide pact. Individuals die.

Similarly, the earlier study on deaths of white women and this study stress the big role that Oxy-Contin and other opioids play, as well as alcohol abuse. But the look at the morbidity figures suggests that a significant part of this population is already in poor health, raising the question of what came first, the pain or the substance abuse. From the report:

Increases in midlife mortality are paralleled by increases in self-reported midlife morbidity….The increase in reports of poor health among those in midlife was matched by increased reports of pain. Rows 4–7 of Table 2 present the fraction reporting neck pain, facial pain, chronic joint pain, and sciatica. One in three white non-Hispanics aged 45–54 reported chronic joint pain in the 2011–2013 period; one in five reported neck pain; and one in seven reported sciatica. Reports of all four types of pain increased significantly between 1997−1999 and 2011−2013….

The epidemic of pain which the opioids were designed to treat is real enough, although the data here cannot establish whether the increase in opioid use or the increase in pain came first. Both
increased rapidly after the mid-1990s. Pain prevalence might have been even higher without the drugs, although long-term opioid use may exacerbate pain for some (26), and consensus on the effectiveness and risks of long-term opioid use has been hampered by lack of research evidence (27). Pain is also a risk
factor for suicide (28). Increased alcohol abuse and suicides are likely symptoms of the same underlying epidemic (18, 19, 29), and have increased alongside it, both temporally and spatially.

Although the epidemic of pain, suicide, and drug overdoses preceded the financial crisis, ties to economic insecurity are possible. 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 growth in median earnings than the United States, yet none have had the same mortality experience (lanekenworthy.net/shared-prosperity and ref. 30). 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 (31).

As an aside, the data pain and other indicators of diminished functioning (difficulties in standing, walking, climbing stairs; resulting limited social activities) suggest that the rise in Social Security disability claims are not entirely, and may not even be significantly, abuses of the system, but reflect a heretofore unrecognized deterioration in the health of a significant number of Americans.

I wonder if readers can help fill in the gap in these news stories, in terms of the lack of a picture of the people in this group. One of my sister-in-law fits the profile. She has only a high school degree, is now in her early 50s, and lives in a town of about 12,000, population down from a peak of 15,000, in the Upper Peninsula of Michigan, where the biggest local employer is a paper mill where my brother works. She was in good health when she was young, but had a bad reaction to medications she took after having a minor procedure. She became severely allergic as a result and I am convinced this is not hypochondria (as in I’ve seen her eat things that it turns out were problematic and watched her turn green). She can eat only a very limited diet and often has back pain (although she sees chiropractors rather than taking meds). She’s in the emergency room several times a year and seems to have little social life outside her family (she does have family members in the area). Even though she is upbeat much of the time, there is no way she could work; she seems to be incapacitated at least a day a month. I think her condition would be far more desperate if my brother did not have a decent medical plan, but since it is being crapified and she is not getting any healthier, it’s not clear if she will continue to get the same level of medical attention as she has till now. Plus the mill, which was formerly world class, has been badly mismanaged by private equity firms, starting with Cerberus, who installed no-nothing highly paid CEOs and stinted on maintenance, a cardinal sin in a capital-intensive environment. My brother worries they will break the union in two years, which will make working conditions intolerable (they are already much worse than they used to be) but I don’t see how he can begin to afford his wife’s medical care on Obamacare, particularly on an income lower than he has now.

Any other observations about this telling state of affairs very much appreciated. This is a shameful testament as to what America is becoming, and it is very unlikely that the right people will be ashamed.

Case-Deaton-on-White-Mortality-and-Morbidity
Case-Deaton on White Mortality and Morbidity

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233 comments

  1. Thure Meyer

    Probably also highly correlated with dipping income levels and of course the systematic destruction of our social support networks.

    Too bad we can’t outsource pain and death.

      1. JTMcPhee

        Business Opportunity! Post-National Departure Spas! Low cash entry investment! ROI 19% GUARANTEED! “Pick your poison, we have ’em all!”

        1. Anonymous

          Re death cult:
          And this month, with Obamacare Open Enrollment, the victims get stricken with OESD = Open Enrollment Stress Disorder, the result of “shopping around” among crapified plans.

          NB: OESD is by definition untreatable as your therapist is now out of network.

    1. Karen

      And don’t forget irresponsible employers and corporate lobbyists who have destroyed workers compensation systems in many states. The safety net is a myth. Throw in a healthcare system which is decades behind in effective pain management, and we do have the perfect storm of once productive and healthy people whose lives have become bleak and their futures destroyed.

    2. Pepsi

      In large chunks of the country, there is no economy. What else are you supposed to do but get drunk and die? The finance pilfering economy has no use for some huge percentage of the population, they’re going to suffer and die quietly, or they can fight and maybe we’ll have some tiny chance at fixing this world.

    3. Cindy L

      I’d like to see a comparison against rates of the health-insured. Many people lost their health insurance over the last 20 years, accelerating during the depression. Inability to afford to see a doctor could easily be a cause of increasing pain.

  2. member

    I’m working class and over 50. We are indeed being ground into hamburger. The prescribed painkillers tell only part of the story; self-treatment with over-the-counter remedies is rampant. The “foot care” aisle of the supermarkets where I live offers a stunning selection, thirty or forty different types of splints, braces, wraps etc for feet, ankles, wrists, backs…and crutches, canes, walkers too — these sections are definitely largest in stores here in the outer (i.e. poorer) parts of town.

    1. armchair

      Boom! This is what Big Data wants to know. What are their buying habits? Very useful for Big Data. Most of the rest of the post and comments are irrelevant to Big Data.

    1. Christian B

      One must be careful about prescribing exercise, since it increases oxidative stress. It is fine before disease sets in, but after it might do more damage than it fixes. Walking, however, is the exception.

      1. Ptup

        Oxidative stress? That reminds me. Let’s not forget about a population that has given itself up almost entirely to a profit seeking and treatment based medical industry that comes up with stuff like that, and teaches the public that cures come in pill form, like, well, Oxi.

      2. MyLessThanPrimeBeef

        Doesn’t exercise lead to faster release of carbon into the atmosphere by the individual involved?

      3. Jim Haygood

        ‘Walking, however, is the exception.’

        Evening before last we encountered a long-distance hiker who had traveled about 300 miles on foot over the past few weeks. We invited him over to take a bath, wash clothes, and eat a meal other than freeze-dried food.

        Besides suffering from rheumatoid arthritis and lupus (which visibly gnarled his fingers), he’d had quadruple bypass surgery five years ago, with a couple of stents installed. In his early 40s, from western Tennessee, he is probably drawn from the same population covered in the Deaton study.

        He said that long-distance walking is the best medicine, not only physically but spiritually, to cope with a personal health outlook that’s not bright. He said, ‘I want to do this while I still can.’

        1. fresno dan

          + 100 googol (fyi googol is the number 1 followed by 100 zeros – not to be confused with the search engine)

        2. German native speaker

          11 years of a Trigeminal Neuralgia Type 2 (constant severe phantom toothache on all teeth of one side of mouth and vise grip pain in the palate bone which feels as if an orange is pressing against the brain) condition, without so much daily long distance walking (in the Southwest deserts and on most sidewalks of Berlin), I would not have made it as far, especially mentally.
          Unfortunately, walking around on foot is no option in most of the US, and at this point, also not possible physically for me anymore. Do it while you can – I walked the Camino in Northern Spain.

        1. Christian B

          Not snark at all. Just google scholar oxidative stress and exercise.

          There is zero evidence that activities like running or cycling lead to better health in the AVERAGE person.

    2. so

      Maybe you should put in 30 yrs. of hard labor on concrete floors and see how your joints feel.
      Empathy might be a start.

      1. Ptup

        Why do you assume that “30 years of hard labor on concrete floors” are a source of this problem? Most of those jobs have been gone for ten to twenty years. And, I doubt that most of this demographic had such a job, anyway, but, that’s something that the economists that did this study could find for us, along with a map of the distributions of these early deaths. My guess is that they are in areas where there never has been much in the way of 30 years of hard labor in factories (rural south) and/or, of course, the rust belt, which lost it’s hard labor on concrete floors to Japan and China a long time ago.

        1. Yves Smith Post author

          No, they could not find that out. Go look at their data sources. And my brother DOES happen to work at one of those jobs you claim does not exist any more. Sheesh. And do you think it’s any easier standing on concrete covered by linoleum at a WalMart?

          I happen to have worked at upscale jobs and still managed to screw up my joints. I have to carry a shooting stick, which is basically a portable seat, with me because I cannot stand for any length of time without getting inflammation. The the only reason I can exercise at all is spending the price of a house with no mortgage on it on everything from orthopedists to witch doctors finding people who could do something about it (and no, I did not have an operation, that would clearly have been a fishing expedition and was not indicated). The witch doctors were far better value for the money, BTW, and the real solutions came from the professional sports mafia, who have to know how to fix injuries to get elite athletes back into service and are therefore both cutting edge and rigorous.

          And if I had that much trouble being high functioning and having the time and money to go after a medical problem and still got limited results, how the hell do you imagine that people who lack my sort of tenacity and resources can get anywhere? Your comment is astonishing arrogant and ignorant.

          It’s really easy to moralize at people when you know nothing about what it takes for them to get through their work day and manage the rest of their lives.

          1. Ptup

            I’m not moralizing, just trying to strip away the BS that usually accompanies this stuff. At a certain point, no matter what one’s financial situation is, you have to tend to one’s physical health first. Nobody else will, after the age of, oh, fifteen or so. But, I constantly hear excuses after excuses. And, as I said, our profit seeking through treatment based medical industry, walking arm in arm with our immensely profitable drug industry, has convinced most that their methods and products are the best way to attain proper health. And, this is the culture we live in. So, it only follows that a person brought up in this culture will self medicate pain and suffering away, instead of getting to work and fixing those problems the right way. It’s sad to see, but, I’m born working class, and watched it all my life. Btw, I worked many a job walking around on concrete, some at three in the morning (the latter is much more stressful to the body), maybe not for thirty years, but, I have to tell you, the late life jobs of sitting in a chair in a cube for eight hours a day were also very harmful to my body. So harmful that a regimen of regular exercise could not counteract those negative effects.

            But, in the end, it sucks to be discarded by society like a piece of trash. I’ll give you that. There is a reason that Trump and Putin are very popular people at the moment. That’s their voters.

            1. James Levy

              Get to work fixing those problems “the right way”? So now you are a medical genius who knows exactly what the “right way” is for curing the medical ailments of millions of people who work in physical jobs and/or live in the country? I moved to the country and in the first year dealing with all the things I need to up here injured my shoulder and my elbow. What miraculous cure do you have for them? Personally, I try to cope with the pain as best I can. Perhaps I’m not “getting to work” on your purported solutions fast enough, but when you injure tendons they tend to stay injured unless you can completely leave them be for a very long time or have access to top sports medicine which my wife and I absolutely do not.

              I can be hard on the working class for contributing to their own suffering, but you lead the league in blaming the victims.

          2. optimader

            Concrete floors, even with carpeting are brutal…Even when I was in HS doing hotel 2nd shift /weekend porter, an 8 hour shift and I would feel like someone threw me out of a moving car by the end of it.
            Speaking of cars, Ptup can ask any car mechanic/tech how they feel after a day on concrete stretching and bending over in awkward positions trying to hustle things apart and together on the clock. . Add a Midwest/NW winter. Brutal.

            1. Michael

              I run a bike shop. The sales floor is concrete. The service area (where we spend 80% of our time) has anti-fatigue matting on every square inch I can get at.

              There is a reason for this.

          3. German native speaker

            Ditto here, spent equivalent of two Maseratis / one house and years of time to try and remedy a chronic pain condition, and now am poor. “Normal” people without these resources were put on “medicines” that left them a vegetable. At least I had the intellectual resources and personality to fight. The medical professionals I encountered on both sides of the Atlantic left me appalled.

        2. Clive

          I think the point being made was that one shouldn’t end up blaming the victims. Unless you think that the people who are sadly no longer with us due to alcohol or narcotic abuse and sucidality were just asking for it?

          Please correct me if I’m reading too much into your brief but rather sharp comments but it does suggest that you think there are “worthy” illnesses like, say, cancer, for which the patients should receive prompt, effective treatments — conversely there are also “unworthy” illnesses like mental health problems, eating disorders, addiction and so on for which the patients should just go and jump in a lake (thus sparing the lucky rest of us from the terrible bother they’re causing)?

          No, you can’t save people from themselves. But you can — and civilised societies should — make enquirers about why they are choosing self-destruction.

          1. optimader

            But you can — and civilised societies should — make enquirers about why they are choosing self-destruction
            Bingo

        3. run75441

          “Most of those jobs have been gone for ten to twenty years”

          No these positions of standing and doing repetitive functions still exist. Maybe not on Wall Street; but, they exist in automotive assembly plants whether US or foreign owned, in injection molding plants, assembly plants, wire harness manufacturing, stamping plants, etc. They are not gone to the extent you believe they are.

          Furthermore, it does not take 30 years to achieve the damage to one’s spine and joints which go beyond a trip to the ortho-guy. Manual labor is tough on a person. As one ages and the spine looses its flexibility, the pain becomes more intense and the operations to fuse the disks require time off which much of manual labor can not afford.

          I doubt serious you have spent much time on the inside of a plant as your attitude betrays you.

          1. Ptup

            Oh, sir, been there, done it. And if you actually believe that there are many in America still doing these jobs on the same scale as in, oh 1970, take a drive through upper Ohio into western Pa., and then on up into upstate NY along the old Eire Canal corridor of former industrial towns, and get back to is on that one. Not the interstate, mind you. Get off and into the towns that now have no purpose anymore, but, still, somehow, go on.
            Besides, where there is a human doing a mindless, repetitive task, there is an engineer trying to figure out how to replace that human with a cost effective robot. Yes, even in China.

            1. Paul P

              Yes, there has been a big decline in manufacturing in the US. Look at Detroit and upstate New York. But this distorts the fact that US manufacturing is a huge part of the US and global economy. Saying that China is now the workshop of the world distorts the fact that when the numbers are looked at, the US remains one of the workshops of the world.

              “If the top 500 U.S.-based manufacturing firms were counted as a separate country, their total revenue would rank as the world’s third-largest economy.” (This is a quick grab from Wikipedia, citing the US Chamber of Commerce, but EPI, Brookings, the Congressional Research Service, and others report on the huge size of US manufacturing.)

              So, a lot of people are doing hard labor in manufacturing.
              And, as Yves points out, standing on the floor at Walmart
              in no picnic either.

            2. run75441

              Ptup:

              Since I live in Michigan, worked in upstate NY, central Ohio, and also Michigan; I can safely vouch for manufacturing still existing in the US and for the last 44 years. Open your eyes silly, manufacturing did not 100% disappear and its decline has been based upon labor intensive operations moving to labor intensive countries leaving capital intensive (Heckscher–Ohlin) in the capital intensive US (for now). We make winners out of losers.

              As a non-engineering “through-put analyst,” what would you like to know about brownfield factory reclamation? I am that guy who rearranges the shop floor to improve throughput, shorten queue time, decrease wait time, lower inventory, and minimize labor. Been doing it forever. You do not need engineers to muck things up.

              “More than 12 million Americans (or 9 percent of the workforce) are employed directly in manufacturing.” http://www.nam.org/Newsroom/Facts-About-Manufacturing/#sthash.wb47KWUB.dpuf Yes this is down; but then too, the people Yves is discussing started on the concrete floors 20 and 30 years ago in repetitive functions. The work force today is far younger.

              1. Ptup

                Sad to be picking through the bones of America’s past, but, whatever is left will be gone soon. It may even stay “onshore”, as corporations play international wage arbitrage, but, whatever stays here, or lands back here, will never be the clichéd old timey factory with union shop stewards ruling the roost. Modern factories are shelters for robots and the few humans trained to run them, with roving logistics drones travelling to and fro and tapping on laptops and phones. I know Obama likes to do a photo op in some factory that will revitalize some dismal place, but, the whole point is that the ultimate fantasy of companies that make things is to do it all in a zero human occupied building, and, you know, they are getting awfully close. The Chinese will probably be first. It ain’t your grandad’s assembly line, with the whistle blowing at quitting time.

                Furgetabout the time that Google, Apple, Uber, and others finally get the self driving truck moving freight, which isn’t too far away, from what I understand. Goodbye millions of the last middle class job a high school grad could strive for.

                1. optimader

                  there has been a big decline in manufacturing in the US

                  As a % of the labor force, but the labor force has approximately doubled since 1970. The Civilian Labor Force in the US has gone from 82,771k to 157,695k from 1970 to 2010 or approximately doubled.
                  More significantly, those “on your feet all day” manufacturing jobs have been replaced with less lucrative “on your feet all day” service jobs, most of which I will speculate are not fetching large multiples on minimum wage.
                  So your notion that a shift away from manufacturing labor (as a % of the labor population) to generally inferior service sector jobs is any sort of salubrious panache for personal health I think is at best ill informed.

                  Since 1980 there has been a downward trend in manufacturing
                  employment (see Figure 5), while employment
                  in service-producing industries continued to grow at an
                  even faster pace. As a result, the percentage of all nonfarm
                  workers in manufacturing declined from 24 percent in
                  March 1973 to 10 percent in March 2007, and workers in
                  the service sectors went from 70 percent to 83 percent.
                  This shift from manufacturing to service jobs in the
                  1970s and 1980s was most acutely felt by residents of
                  large industrial cities in the Northeast and Midwest.15
                  These regions lost blue-collar manufacturing jobs while…

                  http://www.prb.org/pdf08/63.2uslabor.pdf

            3. jrs

              Those are maybe the wrong places to look. I think much manufacturing that is left is in the south. Why? No unions, low wages. And some companies want some manufacturing back in the U.S., but not at union wages for sure.

            4. Adam1

              Yes industrialized food is probably an input to the problem, but you’re blaming the individual because it assumes they are too stupid to know high fat fast food is bad for them and then they are even more ignorant for at least not trying to balance that diet with exercise.

              And then you claim you’ve been there and done that. I’ve lived in at least 6 rural towns and cities along that Erie Canal corridor (and continue to) and mind you the largest industry, current and past, in Upstate NY is agriculture. There are plenty of extremely hard working people in factories and on farms. The industrial food system is assisting in the deaths of millions (the true part you referenced) but it’s a tiny cog in the Neoliberal agenda that is poisoning millions in Upstate NY (and across America) without having truthfully asking any of its victims if this is the way it should be (TINA). What do you expect when the cheapest food in town is high in calories and low in nutrients? What do you expect when your minimum wage job never keeps up with inflation? What do you expect when the family farm is verging on foreclosure let alone capable of supporting multiple families which means your brother and sister must move south for a job – or god forbid you take on $1M in debt to turn your 100 cow herd into a 400 cow CAFO? What do you expect when your good paying job gets shipped off to China and the student loans you haven’t paid off keep coming each month and your oldest is verging on graduation him/herself? What do you expect when that middle aged back injury is fixed by a 30 day supply of OxyCotin – enough to addict anyone – is handed out like candy by the medical-pharma complex (note, your Dr’s office has been turned into a pharma fast drug line like fast food)?

              If you haven’t noticed, eating better and exercising more does nothing to stop much of any of this. The best it does is increase the proportion that drink, snort, smoke or shoot themselves into oblivion because all the things important to them are being sucked away and feel outside their ability to control it. I’m all for ending industrial agriculture, but if you want change those chart you better be fixing more than the food supply. And exercise is like fixing public schools with charter schools. It’s another meme to distract you from the real problem.

          2. MDBill

            And please, let us not forget the warehouse, fast food, and other service industry workers who are on their feet most of the working day. And, sadly, this is a growing segment of our economy.

        4. Paul Tioxon

          Retail workers and food servers and fast food line workers are all on their feet with linoleum covered concrete. A half way decent restaurant will have heavy black rubber stress/no slip mats for line cooks to stand on who work over open flames, not just the grills for burgers or the cold cut prep bay for sandwich or hoagie shops. UPS, Postal workers, Fedex, Amazon, etc, fulfillment centers, giant warehouses where people are on their feet all day long and of course, construction workers, still the largest source of work for any grade/high school dropouts and those with GED/HS diplomas.

          Factory work so widespread in Philadelphia collapsed so fast and hard that the city alone lost 500,000 people in little more than a decade. Those jobs never came back and others like them disappeared from the suburbs. Some of the worst work today that will destroy young healthy bodies, much less middle age one, are the seasonal work for package handling at UPS or FedEx. The Philadelphia International Airport has a huge UPS hub, as well as many surrounding loading facilities for brown vans. The speed up demands and repetitive motion of lifting and packing and sorting is more of a farm system for bad backs, necks and TENDINITIS. Anyone doing repetitive motion from cashiers to secretaries to retail stocking and returns to carpenters knows about TENDINITIS.

          I first got it when I was still in my 20s after years of working in retail. One day I woke up and my elbow just gave out on me as I lifted a gallon of milk from the fridge. My whole arm just flopped down, unable to bend at the elbow to lift the milk. It was like that for about a week until I saw a chiropractor who treated it with electric accupuncture and cured it immediately!!! It was shocking to see my body completely betray me with weakness and no prior warning or indication that my arm could just become totally useless for any kind of work activity.

          1. participant-observer-observed

            Health care workers from nurses aids on up also are on their feet on hard floors.

        5. Jagger

          Here are some rural jobs that keep high school educated people alive: every sort of construction work or mechanic work, plumbing, electrical work, cutting lawns/landscaping, sawmill worker, cutting and providing firewood, jack of all trades, fishing, shrimping, hauling off junk and metal. I know I am missing some but all of those jobs are hell on the body. Some undoubtably worse than manufacturing work. Some can provide a middle class life if there is a lot of work but many are just survival. One reason hunting is so popular in rural areas is because it puts cheap food on the table for a family.

          Now the easy way to make quick and large sums of money is to sell drugs. The downsides are prison, getting shot, overdosing and selling your soul.

          Still plenty of miserable jobs in America today that will destroy the body fairly quickly.

        6. Kat

          Ever heard of retail or restaurant jobs? Those folks are standing all day long. I managed a restaurant when I was a lot younger and believe me, my workers and I worked our butts off and fortunately I only did it for six years, had I done it for 30-40 I am sure my body would be a complete wreck..

        7. fon

          get a clue dude. those jobs are all around us, all the time. they dont have to be in factories and they dont have to include heavy lidting to be considered hard labor. just walk out your front door and take a look at all the people around u that
          t make their living on their feet all day.i feel their pain(joint) and mine!!!

    3. Inverness

      How about affordable healthy food. The cheapest calories are often the least healthy. Oh yes, decent jobs that provide enough income and time off to lead a balanced lifestyle. It’s easier to judge others.

      1. MyLessThanPrimeBeef

        I am aware of at least two shortage – organic apples and olive oil.

        Healthy food inflation index – I have mentioned the need for it before. The substitution effect of GM/industrial foods for whole foods is killing us and masking huge food inflation.

        “American baby formula too expensive? Substitute with cheaper Chinese ones. Help fight inflation.”

    4. Ishmael

      One word for rural United States health problems — sugar! Mainly soda pop. People drink it by the gallons. In much of the rural US I see lots of people now so fat they would have been in a freak show in the early 1900’s. What does this lead to is diabetes and much of this goes undiagnosed, due to no or poor medical coverage, until they are close to dead. Add to that meth which is through out the poor parts of this country. I see lots of burned out white meth heads standing by the side of the road asking for money. Lastly lots of people don’t get off their ass any more.

  3. Pavel

    It’s called AMERICAN EXCEPTIONALISM.

    Yves, thanks for this — there is clearly a world of pain and hurt and despair out there, whilst the 1% and their politician-enablers cite the stock market as evidence of a “recovery”.

    There ain’t no recovery out there. Sorry boys.

  4. Timmy

    Perhaps this sheds light on rising disability rates – and the “slacker” narrative that comes with it – that, presumably, precede the onset of fatal medical conditions.

    1. Jetfixr in Flyover

      A lot of those people could have filed for disability a long time ago, but managed to keep on working.

      Find yourself without a job, and cant find a new one because you are over 40, or have real or perceived “health issues”, and you will file for disability, if its between that or losing the house and living on the street.

      Whodathunk that raising hard to avoid expenses, while continually cutting j6p’s paychecks would lead to a Great Recession that doesn’t end?

      1. J

        Yeah, I was in a rush to post before getting on the Subway and didn’t reread the article. Embarrassing, really.

  5. allan

    “After the productivity slowdown in the early 1970s, and with widening income inequality …”

    What a dishonest description by the WaPo. Widely available charts, for example this one, show that
    inequality in fact accelerated over several decades of steady productivity growth.

    A horrifying commentary on modern America.
    BTW, is the first sentence slightly garbled? “see” = “seen as” ?

    1. allan

      Oops. I seem to owe an apology to the Post – that line is actually from the Case-Deaton paper. I still think it is an historically inaccurate framing of what has happened over the last 40 years in terms of productivity and inequality. The workers did what they were supposed to. The system was gamed against them.

      1. jsn

        I agree the formal economic system has been gamed against them.

        The roll back of EPA and OSHA have contributed as well.

        Watching my extended family, which includes a great slice of this demographic, I’d guess the worst culprits are suburbanization, leaving the underemployed to stew in their isolated juices and what passes for food. McFood is so deeply subsidized (having more characteristics in common with petroleum than any diet should) actual food blows way to many budgets. “Super Size Me” colors this report it seems to me.

  6. Christian B

    Notice the similar trend lines in liver disease and suicides, that is not an accidental correlation. And it is no surprise that your sister got worse after she took medications.

    The health of the liver is crucial to our overall health, and alcohol, all medications, diets low in riboflavin and high in iron, all reduce liver function and increase oxidative stress. Oxidative stress imbalance is the root cause of EVERY late onset disease. Even with the HIV virus, it is not the virus that kills people, but the oxidative stress the virus creates that kills people. Even allergies are an oxidative stress event. Go ahead, look it up on PubMed.

    So you can see the vicious cycle in U.S uneducated whites: Person eats meat and drinks alcohol (because that is what uneducated people do), they get vitamin deficient, oxidative stress increases, their liver function decreases and other metabolic pathways slow down, they start to experience pain or neuro-degenerative diseases, they go to the doctor, doctors gives them medications and never talks about diet, medication further stress the liver, patient gets sicker. Oh, and stupid patient also has a gun which makes suicide so much simpler.

    I was close to being one of these people. My mother was certainly one. I have been on disability the last 15 years for several “auto immune” disorders including anxiety/OCD and possible Multiple Sclerosis (thanks to the great U.S. Health(dont)Care system I could not afford the MRI for a diagnosis). I never was any better on pharmaceutical medications. But after years of my own research I found out it was only a Biotin deficiency (I have Partial Biotinidase Deficiency) and an insane need for Riboflavin. Since taking those two supplements, and modifying my diet (Nordic Diet based on my genetics), I now take zero medications and have been in complete remission and perfect health for the last 9 months. The state I am in now I have not experienced for 25 years. If I remain in remission I will be off medicare next year.

    There is not Health Care in the U.S., it might be better called Disease Care. Of all the people that should be ashamed it is the Doctors. They are on the front lines and have the most leverage but they refuse to use it.

    1. Thure Meyer

      You bring up an interesting point about the typical diet most poorer Americans eat. Besides fast food and over processed food, GMO based high fructose corn syrup in every can and drink, feed-lot beef, pork and chicken. The obesity epidemic, quick fix medicine that only deals with symptoms, etc. it seems to go on and on..

      The enrollment problem faced by ObamaCare also seems to be an obvious metric as to what has happened to the health of the Nation.

      Is this the American Dream?

      1. jsn

        The study correlates little with diabetes, so it appears obesity isn’t the driver, but I fully second your GMO comment. This goes along with the astonishingly journalist resistant (though not Yves resistant) problem of estrogen mimicking compounds which disrupt any number of hormonal functions. We have re-made to much of our habitat for money extraction at the expense of life itself.

        1. Ivy

          Many illnesses and maladies include inflammation of one sort or another.

          A few easy steps are available to everyone to reduce inflammation.
          Adjust your diet and begin to see benefits quite soon.

          Eliminate artificial sweeteners
          Eliminate trans-fats
          Eliminate high-fructose corn syrup
          Note that it is harder to find foods without HFCs these days, but can be done

          1. tegnost

            A few more tips…don’t eat it if it doesn’t look like what it is, a brocolli, a carrot,celery, potato, chicken breast (better know where that came from), wash the pesticides off better yet peel everything unless you’re sure. Eating this way is pretty cheap in reality, no ground up anything, corn reconstituted potatoes frozen food…still eat brown rice even though it gets bad reviews. Get a bunch of indian spices at that mexican market in the pike place alley and you’ll blow yourself away I’m tellin ya. They also have a great selection of mates (I have no business interest there, just amazed by the spice wall)

            1. jsn

              Michael Polans diet: “Eat food (if your grandmother would not know what it is, it’s not food), mostly vegetables, not to much”

              1. MyLessThanPrimeBeef

                Grandma is a Luddite.

                Her diet sounds pre-modern technology.

                Organic vegetables – they were what humans ate 3000 years ago.

    2. Thure Meyer

      I also wanted to add that there is a pretty good timing correlation between this lack of of health and the introduction of feed lot beef, marketing of HFCS and Earl Butz’s mega-agricultural policies as Secretary of Agriculture [i.e., our overall approach to food].

      This particular age group (45 – 54) may be the first (but not the last) that shows the results of these polices and production choices. Add to that the general stress (loss of jobs, income, high debt), a deterioration of the general infrastructure and commons (e.g. lack of community and social support) and we may be seeing just the beginning of a social unraveling that will continue for years to come.

      1. jrs

        I often suspect you’d be better off eating a more junky diet with a low stress relaxing life, than a healthy diet with high stressors and pressures. Unfortunately most can not avoid circumstances being high stress, at best only the response.

      1. jrs

        They are probably consuming yet one more paleo grass fed red meat meal. But with less stressful lives. W.H.O. has come out recently with some pretty scary stuff on red meat though.

    3. MyLessThanPrimeBeef

      Education should be primarily about teaching students things like this, but instead, we waste it on producing machine parts for the system.

      And you’re right about doctors. An ounce of prevention is worth a pound of cure. “This is what you do so you don’t have to come see me.”

      “I will lose money spending the time going over this stuff. But I don’t care. I got into medicine to help people.”

  7. William Hunter Duncan

    It seems abundantly clear to me this is a direct result of NAFTA, the hollowing out of the industrial base of America, and the busting of unions. Most of the jobs created since, for those without a college degree, have been low-paying service jobs, soul-crushing work in a lot of cases. Probably a lot of them also went into the military, had a bad experience and got dumped after.

    With TPP and the outlaw of cash, it would get a lot worse. And as far as I can tell, the globalist neo-liberal economic monopolizers and the neo-conservative warmongers, have no problem with this outcome. It’s called subduing the mob.

    WHD

    1. aet

      Why only whites, then? These stats show similarly-situated blacks and hispanic Americans are NOT suffering from this increased mortality, do they not? In fact, for those groups, mortality rates have continued to decline, just as they have for Europeans, during the time covered by this study.

      So what’s the explanation for the differences in the stats apparent amongst the differing racial groups of middle-aged Americans?

      Increases in drug & alcohol abuse – with such increases attributed to stress resulting from tougher economic conditions – didn’t ONLY happen to white people – thus something more must be going on – but what?

      1. jsn

        I’ve been ruminating on that question also. From the data as presented blacks still have higher overall mortality while hispanics are appreciably lower. So black and white are converging while hispanics aren’t dying at anything near the same rates. I think I’ll freshen up on my Spanish.

        Enzenberger wrote a book in the 1980s called “Dreamers of the Absolute” that, among other things, made the case for the middle class being the natural constituency for terrorism because it has the most to loose emotionally and physically from loss of social position. Between the suburbs isolating this American cohort and Pharma and the NRA facilitating their efficient exit, we have not developed his expected political reaction, instead the American white middle class seems to be self exterminating.

      2. TedWa

        Why only whites? My guess – Mostly whites were effected by the loss of tens of millions of jobs through NAFTA and other trade agreements, jobs that used to provide a very good living wage. Thrust to the same level of poverty as most blacks and hispanics have endured for generations it’s only natural they would not be able to survive as well.

      3. MyLessThanPrimeBeef

        Maybe they have more to fall, as they were, relatively speaking, a little higher up on the totem pole, but really not by much, than those other groups.

        And when they all hit bottom, it all equals out…a sort of convergence takes place.

        The worst kind of equality…for the working serfs.

      4. Benedict@Large

        The explanation is quite simple. White privilege is being taken away. Non-whites were always treated like crap. They’re used to it. It’s something new for the white folks.

        1. EmilianoZ

          Yep, it all depends on what your expectations of life were. There’s this equation:

          Happyness = Reality – Expectations

          (I think I got it from the blog “wait but why”)

          Non-whites always had low expectations to start with.

          1. neo-realist

            Some non-whites start out w/ high expectations as little kids, assuming healthy family structures, till they start encountering overt racism in the school system from peers as teens and in seeking employment and housing in addition to the police stops and hassles.

            1. rexl

              I love it when non-whites tell whites what their problems are caused by, and I know they (non-whites) like it when whites tell them(non-whites) the cause of their problems.

      5. TarheelDem

        Something else going on. The crippling cult of “personal responsibility” or more accurately an unhealthy stoicism. That creates a double-bind situation. When the issue is a widespread economic, social, and political one — not a personal one.

        And also the collapsing managed care MBA-dominated health care system that has deserted completely a lot of communities for gigantic medical complexes.

        1. jrs

          I’d see stoicism as as good an answer as any, stoicism would certainly not see one’s circumstances as entirely one’s fault etc. but as parts in much larger things individuals do not control. Definitely a step up for how many of these people probably view themselves (blame themselves). And it would dis-value external success, again a step up.

          It won’t lead to revolution, but probably at this point, nothing will.

      6. jrs

        Probably less social support as well … some minority communities actually provide a lot of social support, that is not often found in white culture.

      7. William Hunter Duncan

        Tighter communities, black and Hispanic. Better support systems. And fewer expectations.

        1. rexl

          Like Chicago, or Detroit, real tight. And immigrants just got here, they are surprised by indoor plumbing.

  8. John Waite

    “Something had to happen; and he knew nothing would…”
    Last line of Edward Dahlberg’s novel Bottom Dogs (1929).

  9. nobody

    Joe Bageant, from “Karaoke Night in George Bush’s America”:

    By the time my people hit 60 they look like a bunch of hypertensive red faced toads in a phlegm coughing contest. Fact is, we are even unhealthier than we look. Doctors tell us that we have blood in our cholesterol and the cops tell us there is alcohol in that blood. True to our class, Dottie is disabled by heart trouble, diabetes and several other diseases. Her blood pressure is so high the doctor at first thought the pressure device was broken. Insurance costs her as much as rent. Her old man makes $8.00 an hour washing cars at a dealership, and if everything goes just right they have about $55 a week for groceries, gas and everything else. But if an extra expense as small as $30 comes in, they compensate by not filling one of Dot’s prescriptions — or two or three of them — in which case she gets sicker and sicker until they can afford the copay to refill the prescriptions again. At 59, these repeated lapses into vessel popping high blood pressure and diabetic surges pretty much guarantee that she won’t collect Social Security for long after she reaches 63. If she reaches 63. One of these days it will truly be over when the fat lady sings.

    Dot started working at 13. Married at 15. (Which is no big deal. Throw in “learned to pick a guitar at age six” and you would be describing half the Southerners in my social class and generation.) She has cleaned houses and waited tables and paid into Social Security all her life. But for the last three years Dottie has been unable to work because of her health. (Did I mention that she is slowly going blind to boot?) Dot’s congestive heart problems are such she will barely get through two songs tonight before nearly passing out.

    Yet the local Social Security administrators, cold Southern Calvinist hardasses who treat federal dollars as if they were entirely their own — being responsible with the taxpayers’ money — have said repeatedly that Dot is capable of fulltime work. To which Dot once replied, “Work? Lady, I cain’t walk nor half see. I cain’t even get enough breath to sing a song. What the hell kinda work you think I can do? Be a tire stop in a parkin’ lot?” Not one to be cowed by mere human misery, the administrator had Dot bawling her eyes out before she left that office. In fact, Dottie cries all the time now. Even so, she will sing one, maybe two songs tonight. Then she will get down off the stage with the aid of her cane and be helped into a car and be driven home.

    1. James Levy

      I had the privilege of corresponding with Joe Bageant and your quote points to a deep well of compassion he had for his fallen fellow souls. Perhaps it will be compassion, rather than analysis, that may get us out of this mess.

      1. Masonboro

        I miss Joe. If you haven’t read “Deer Hunting with Jesus” I highly recommend it as a short,funny, and insightful look at why poor whites vote conservative against their economic interests.

        Jim

        1. MDBill

          Joe’s later Rainbow Pie was pretty good too. I had the good fortune to hear him lecture a couple of times and to shake his hand. I miss him too. He played at important role in changing the way I view our society.

  10. hemeantwell

    I searched for the word “depression” but didn’t find it used here. Susceptibility to pain and, to give it a twist, a translation of psychosocial misery into somatic pain are a hallmark of depression. Opioid use ramps this up by promoting a turn away from, or less reliance on, social ties for relief. The potential for a self-reinforcing spiral to develop is very strong.

    1. jefemt

      Note when the decline in health line spikes: 9/11 and Obama. Game, Set, and Match.
      Depression after Viet Nam, Carter/Iran, 9/11, immigration, a black president, a changing climate? How could a poorly educated white be depressed after so many positive events? The kool aid sessions in grade school and the drum beat of media advertising consumerism and who we should aspire to be… trotted out and promised- obtained in our dreams vicariously.
      Grab a bag of Bugles, dissolve into the plush rent to own Lazy-boy, take your eye off the game or Dancing with the Master Chefs. Look out the window of the rented manufactured home to behold the driveway full of payment-intensive motor toys, and ponder the choices, and the victimhood. Could I have gone to Rome, Florence, Macho Pichu? Its all the damned immigrants, Muslims, and Obama. Man, my back hurts. Fail to notice the cummerbund belly signaling pre-diabetes.
      Deride the obvious bicycle-commuter guy you see on your daily commute as an enviro-whacko pine cone eating hippy as you nearly clip him with the mirror of your F-350.
      Stereotypes are dangerous- implicit judging- but they do come from an observed meme. It seems to me that the latest military import for Afghanistan, America’s opioids, are Huxley’s Soma. And if the DARE messages got through, and you are anti-drug, a 12 pack of Burgie, Schmidt, Colt 45…Made in America as well.
      Much needed for the head, heart, and body, trying to not go insane as we stew in the juices of our cognitively dissonant wurld.

  11. I

    If this isn’t planned, it might as well be. Poor people seem to be systematically directed into lifestyles designed to kill them quickly before they hit 65 and start collecting benefits. Cigarettes, fast food, meth, alcohol, cheap passive entertainment. It’s a witches brew.

    1. Pavel

      Good point. Apart from that don’t forget the crap fast-food lifestyles the poor and middle-class are peddled by the various Big Food and Supermarket companies. The *obesity* (that’s not “overweight”, that’s “obesity”) rates in the US are now 33%.

      Do Hillary, Jeb!, Rubio, and even Sanders give a fsck? I’m hoping the latter truly does, but he has the least chance of winning. Never forget the MSM and electoral college and all the rules of politics are stacked waaaay against anyone who truly dares to fight against the system.

    2. Pavel

      An afterthought: after re-reading the comment above, I was reminded how the UK government would “titrate” the tobacco excise taxes back in the 70s and 80s (and perhaps now). It was a careful analysis of how much money would be brought in from cigarette taxes vs how much would be saved (from paying pensions, health care, etc) if the smokers would die at age 50 or 55 instead of 65 or 70.

      People would think that a patient dying of lung cancer (from smoking, basically) at age say 58 was a tragedy, but for the UK Treasury… ka-ching! as Lambert would say. That early death saved tens of thousands (at least) of pounds of government welfare/health spending.

    3. tegnost

      The psychology has a part to play here. Are you sure it’s not “nowhere to go, nothing to do, looked down upon by your peers, kicked, treated like dirt, or less,and then piously lectured as to “what are you going to do?” like there was actually an option? “Well I think ‘m going to design an iphone app and a video game which of course will make enough money for my grandkids to go all ivy league, what do you think I’m going to do? What they really mean is “at some point you’re going to have to get off your high horse and take that mcdonalds job, they hire everyone who applies and then you’ll be fine” and they think that because (sorry Christian B this one crosses all spectrums, not just poors who drink because why the hell not?) they’re stupid. I work for a lot of diiferent intelligence levels and am exposed intimately with many more and no one has a corner on the market. The lesson of naropa comes to mind- the more you know about one thing the less you know about everything else.

  12. grayslady

    My first thought when I read this story yesterday was that these are the individuals most likely to have spent their lives doing manual labor. Construction jobs, for example, pay well but the physical toll has to be tremendous; and how many years can you continue to punish your body without eventually feeling the strain?

    Also, even the most sophisticated pain management clinics rely too heavily on drugs and injections. When I had excruciating pain from a pinched nerve last year, the spinal steroid injection didn’t work for me at all. Fortunately, my excellent doctor sent me to a first-rate physical therapist who showed me a very simple neck exercise to control the situation. For five months I needed hydrocodone plus the maximum amount of acetaminophen daily just to manage the pain while I doggedly practiced the exercise. Finally, one day when I was sitting at the computer, reading the news, I realized that the pain was gone and immediately stopped the hydrocodone. I still do the neck exercise several times a day, especially when I feel an occasional twinge of pain, but I sometimes wonder what condition I would be in without some excellent medical advice and my own dislike of any kind of pill. I imagine that people in rural environments simply don’t have access to first class medical care, nor do they have the tools to research their options. They end up believing that pain medication is their only option.

    1. tegnost

      PT was one of the best things to ever happen for me, bad accident led to the need originally, after fully recovering I still do it because it makes all variety of aches and pains go away. 55 and still occupied in the physical trades I think it’s overwork and repetition that do you in. My PT focused generally in the core, hips etc,,, and has helped me to have one body not an upper half and lower half, or a one side or the other side, sort of a holistical thing couldn’t do without it highly recommended but you have to be committed theres always something “important” to do….

    2. tim s

      I’m glad to hear another person realize the importance and benefits of such simple exercises. I have also come to realize how important strength and flexibility are, and how a lack of this can start a death spiral of conditions.

      I have a herniated disk in my back that used to lay me out for days at a time until I discovered a certain type of leg press at the gym that strengthened some core muscles. One hour at the gym a week now keeps this condition in check. I also have to avoid sitting in any position that puts pressure directly on my tailbone. I sit on an exercise ball at work.

      Speaking of work, computer/mouse intensive activity, coupled with guitar playing and getting older resulted in problems with my left hand. After years of not being able to type properly and play the guitar at all, I finally came up with a combination of stretches and strenthening exercises (baodang balls) that have be back to near full hand health.

      Sometimes these seemingly isolated problems are connected with issues elsewhere in the body. My hands wouldn’t be getting better if I were not also working on my arms.

      Since finally realizing the benefits of yoga several years ago, 30-45 minutes of yoga every morning have done wonders for me physically and hence mentally. I will and do trade sleep for this yoga time.

      I wish that we in the west in general would begin to realize the benefits of such simple activities, as has been done in the east for time immemorial. We are so sick in so many ways, and simple things like this really can make a difference. What so many doctors and medications have not been able to do for me, strengthening my body and increasing flexibility have for the most part.

      Starting small, no matter how small, is critical, as is sticking with it. These exercises can be done at so many times and in so many places. While there may be exceptions, there is practically no downside to doing this either. Nor is there a cost-prohibition. The poorest of the poor can take steps of this nature to improve their health. An incremental increase in physical health will improve the mental health, and visa versa.

      1. MyLessThanPrimeBeef

        Good post.

        We should be looking to spend more resources at health care and seek out simple, free or low cost ways to improve our health as well, although organic foods may not be cheaper, but they are good for ourselves and critters like butterflies, bees, crickets, etc.

      2. optimader

        L4-5 S1.. the bain of men over 50.
        John Glenn reflected later in life when they were retreading him to go up in the Space Shuttle that the one thing he would have done differently if he had a do-over was to spend time doing stretching/yoga for flexibility.

    3. reslez

      In my personal experience, doing the right kind of exercises and being very careful to avoid repetitive movement has been much more helpful than formal medical treatment when it comes to RSI (repetitive stress injuries). Of course, for many jobs repetitive movements are extremely difficult to avoid. I work in IT and bring my own keyboard to work, a Kinesis Freestyle that allows me to sit without hunched shoulders or a numpad that increases travel distance to my mouse and stress on my arm. However I can imagine situations like call centers where workers don’t have this kind of flexibility. They’re set up to fail.

      I was first diagnosed with carpal tunnel, ulnar compression syndrome, and tendinitis when I was in the military… age 22… due to a brutal work schedule and terrible ergonomics. I was in so much pain daily I remember describing it as being hit by a car. The military doctor prescribed a daily dose of aspirin and not much else. I’d always loved computers but feared I’d have to find a new way to earn a living. Fortunately I was more or less able to heal myself, no thanks to the doctors, through a combination of strength exercises and scrupulous self-monitoring. If something starts to twinge, I evaluate it immediately. Was I sitting weird? Doing a certain movement repetitively? I researched PT on my own and found exercises to help to eliminate/cure golfer’s and tennis elbow. When I experienced a rotator cuff tear last year (I’m currently age 37) I looked up treatments online, decided to try remedies at home instead of a round of expensive doctors, pain medication, and possible surgery (of dubious long-term benefit). The injury is now healed… though I was careful to identify the repetitive movement that caused it and will be adding strength exercises going forward.

      I’ve seen these kinds of injuries hit friends who went through the rounds of therapy and surgery and never recovered, but they didn’t do the research I did. Some PTs are much more on the game than others. Some of the most helpful exercises are not that well known.

      1. grayslady

        Some PTs are much more on the game than others. Some of the most helpful exercises are not that well known.

        So true. It wasn’t until a second therapist I saw showed me a pilate exercise–more for complete spine than for cervical spine–that I found I could exercise my neck more comfortably while stretching my total spine. I no longer need the pilate exercise to do my neck exercise now (although it feels nice when I do it occasionally), but, at the time, it was the breakthrough I needed. Who knew?

  13. Sam Adams

    Wait for the student loan burdened millennials to start outliving thier parents and begin to leave the basements. This is not going to be pretty.

    1. JTMcPhee

      Us older folks are subtly being told it’s time to “retire” and then quickly die, so the (poorer masses of the) younger generation can “come into their inheritance while they are still young enough to enjoy it.” And clear the path for those young’uns to Get Jobs… Got to love all the many ways us mopes are taught to savage each other, do the petty thieving from each others’ wallets and purses and little entrepreneurial yard sale and vegetable stalls, the thieving that Dickens and Dumas and so many others chronicled way back when, in an earlier era of Vampire Squiddery…

      And that leads to that bumper sticker that has so many levels of meaning, often seen on the back of a giant SUV or “recreational vehicle,” “We’re Spending Our Children’s Inheritance…” Extended middle fingers all around the lower circles, pointed inward not upward where they ought to be directed, while the Rich Folks look down from Elysium, and titter and sneer…

      1. MyLessThanPrimeBeef

        It’s time to retire? (Retire now)

        Yet, Hilary is talking about raising retirement age. (Retire later)

        The only way possible is by artificially ageing everyone by a few years.

        Next year, we will all be 5 years older.

    2. Thure Meyer

      I like that image – leaving the basement.

      Maybe that’s why our collective consciousness has spawned so many zombie movies lately.

      We are sensing some sort of apocalypse which will be fulfilled once the millennials (staring madly into their smartphones) emerge into reality.

  14. DJG

    Responding to Yves’s last paragraph: Trying to fill it all in. Anecdotally, I have driven from Chicago to Philadelphia to visit a friend just about every spring the last dozen years. I have broken my trip in eastern Ohio (places like Zanesville), northeastern Ohio (Youngstown), and western Pennsylvania (Beaver Falls). Coming from Illinois, which has experienced deindustrialization, I am never prepared for the “third-world” conditions of the broad swath of eastern Ohio and western Pennsylvania. In Youngstown, the job market sems to center on getting a job at chain restaurant, maybe the Ruth’s Chris, if you’re lucky. In western Pennsylvania, the old manufacturing towns are reduced to nothing. The largest employer in Beaver Falls is a semi-fundi Presbyterian college. The downtown is so despressed that even the Salvation Army resale shop had gone under. In Mansfield, Ohio, which once had several large factories like Tappan Ranges, the largest employer may now be the prison.

    Add in despair (despite all of the churches, many of which are closing). Add in high fructose corn syrup. Those *may* be personal choices.

    Add in lack of industrial policy. Add in forty years of Thatcherism and worship of a mythical free market. Those are things that the voting public could have had some control over, yet abdicated, as I see regularly here in Chicago.

    1. european

      The most obvious link are the working hours, which are very high in the US (according to Richard Wolff), at least compared to Europe. Very little vacation, ridiculously short maternity leave, no social safety net (at least none of central european standards). Can’t be good for ones health.

      1. participant-observer-observed

        This factor of psycho spiritual and social alienation due to job insecurity, frequent relocation, working numerous jobs w crazy hours etc adds up to more problems and exacerbation of health issues than is recognized.

    2. flora

      Between 2000 and 2010 the U.S. lost 5.5 million manufacturing jobs, with 2.1 million jobs lost between 2008 and 2010. 42,200 American factories closed, almost 75% of them employed over 500 people. That’s a huge loss in jobs. Now 5 years later the factory closings and job losses are even higher. Congress cuts safety net programs.

      See Bill Moyers’ 2013 essay “Joblessness is killing us.” Its about Sardinia, but applies to the US.
      http://billmoyers.com/segment/bill-moyers-essay-joblessness-is-killing-us-the-pope-says-so/

      1. aet

        Solution is to tax those with wealth, perhaps by taxing all types of income, possessed by both individuals and firms, and re-distribute to all – but ALL, no “means testing”, no “morals test”, in fact no pre-conditions whatsoever for the receipt of such, so as to get administration costs as low as possible – in the form of a guaranteed annual income.

        Simultaneously, the State ought to provide recreational drugs AT COST to any adult who wishes to use them, without pre-condition – this, solely to prevent the distributed “guaranteed annual income” cash from fleeing the district to, or accumulating in, the gangster’s safe, so that that cash circulates locally instead of being quickly drained off to somebody’s big foreign non-local bank account, there to sit unused and un-circulating and unspent for decades, and thus to lose its power as demand-stimulating, activity-generating cash.

        For welfare to work, you have to first legalize the dope.

        1. dk

          A better circulation of revenues could be achieved though more equitable wages; taxes and redistribution are not an optimal path (and they don’t provide the self-respect that comes with direct compensation for produced value).

          And better economic conditions could well reduce the demand for “dope”. Also, “legalization” pushes the production and distribution in the direction of larger producers, which means more displaced, less localized profit from the market. You may mean “decriminalization”.

    3. roxan

      Yes…it’s poverty with no end in sight. My home town is in W.Va., across the Ohio River from Steubenville. Like Steubenville, it has become a ghost town. The once busy streets deserted, the mills partially torn down and then left to rot, stores boarded up. There is no way to sell one’s house and leave, and yet, rents are high even though jobs don’t exist. Taxes and utilities also became high because there weren’t enough people left to pay for keeping the lights on. The water was no really potable. Everyone used bottled water. Streets were full of gigantic pot holes, bridges unsafe and so on. I hadn’t seen seen the place in years, but went back to care for my mother. She developed dementia and her house was three inches deep in roaches. Buckets of them fell out of every cupboard I opened. The exterminator said the whole town had vermin problems from all the abandoned buildings. He was probably the only guy with a job I met. Every service a person could need was gone. No locksmith, no vet for the cats, nowhere to buy parts to repair things, even a pane of glass. Another relative had developed heart trouble and then cancer, at age 55, from stress and chain-smoking. Her son was glad to have a sub-minimum wage job loading trucks part=time at night. The hospital was on strike because they paid so poorly, their employees were on welfare. I can’t begin to describe how it felt to see these areas look like that–like being in one of the End of the World movies, only it’s real. I look at photos of the area on Google and just feel stunned.

  15. Anon

    I think there are two factors at play here:

    First, let me note that I am white, but in an ethnically mixed marriage. I live in urban SoCal. I think that socializing in white culture is far too alcohol-based. Other ethnic groups (e.g. Hispanic, Black) think dance music is essential to a party — there are always other things to do than drink. For this reason, whites are particularly prone to social drinking becoming alcoholism.

    I only really noticed this since 2008 (note the liver disease stats show a clear change in trend around 2008), but way too many people whom I viewed as functional social drinkers have alcohol problems. There is no question in my mind that economic distress has fed this. In one case a financial industry worker lost his job and never really got back on his feet: now late 50s and in assisted living. Similar story for someone in advertising: now home but in extremely poor health. Another was already struggling, but in a robust economy with a job to keep him busy might have pulled through. Just on the one block of the street I live on I can name 4 more people whom I think have alcohol problems, though some of them are functioning alcoholics with jobs.

    I pretty much agree with Christian B. that another serious problem is health care. Doctors give drugs too easily and have too much difficulty understanding when new symptoms are the results of drugs you’re already on that should be discontinued, so people end up consuming a wild cocktail of foreign substances that the body can’t handle. Once again I can name three people on my street whose lives appear to me to have been destroyed by bad medical care (one also has an alcohol problem).

    My husband had an experience where he had to take himself off an abusive steroid treatment (requiring two additional drugs due to complications), while the doctor was claiming that there was no “cause and effect” between side effects and the drugs. Of course all symptoms (except the minor redness in his eye which was being treated) disappeared with the drug cocktail. This, BTW was at one of our premier teaching hospitals.

    Medical training of doctors in this country is clearly deficient — and I do wonder whether standard medical protocols (i.e. not at the level of the individual doctor but much more entrenched in the norms of how doctors behave) are not designed to feed the medical establishment’s bottom line (medication that requires repeat visits, treatment that is “recommended” but shouldn’t be) rather than treat the underlying conditions.

    1. Felix47

      Well the problem is way too many doctors. When patients don’t get what they want they shop around. That is why the US needs to put all doctors on salary and let them decide who to treat and with what…….with no economic incentive…..and eliminate patient satisfaction as a primary metric. Let the people who went to medical school figure it out. It takes a lot of years to figure out who one can help and who one cannot. Now it is just whether the X-Ray or Labs justify a treatment. A lot of this is due to a vast change in medical culture as it has been internationalized in the US. Having practiced in the Indian subcontinent for a long time I can say that often the indication for surgery there, for example, is whether the patient has money…..and not necessarily the outcome. This private model has now been structured into the US system. Often treatment in the government hospitals is better than in the private sector and many sophisticated patients have figured that out. Less complications and a lot cheaper.

      1. JTMcPhee

        From my little perch as a (retired recently) nurse inside the Medical Industrial Complex I might have to strongly disagree, from what I have seen at least, that patients “shop around” for procedures or meds of personal choice in any significant numbers and outside of the privileged few that have Lamborghini medical coverage. But agree at least with the bit about seriously working at putting all doctors on a nationally set salary. With of course the caveat that the few will always figure out how to (“carried interest,” e.g., and “inversion,” etc.) game the system and if possible re-privatize and monetize and financialize it. The gaming algorithms are too well known and part of the culture now, part of the variables in the political economy, and there are too few clarifying and rectifying vectors that exist and are applied any more.

        The political economy apparently requires and can accommodate a certain amount of “slack,” baksheesh, grease, whatever you want to call it. But any more, the “slack,” which depends on a steady (and possible mandatory and unsustainable growth?) creation and delivery and distribution of Real Wealth, has in sheer demand and volume swallowed all the “productive” stuff that had the potential (did it? Really? I wonder…) to make it possible for everyone “to eat to their hunger and drink to their thirst. What’s the current notional value, and what are the various categories of, the various derivative “contracts”? And how much of a destabilizing and vulnerability-generating hazard-menace-peril does that category, all by itself, pose to the ordinary people of the world? And how many other “overhangs” are hanging over us all, just waiting for that last impact of that last grain of sand to overcome the stiction that keeps it all from collapsing to a lower energy level?

        And that “what does the patient have the money to pay for,” the “wallet biopsy” as it’s called, has certainly become a part of the medical diagnosis and treatment and billing structure that has supplanted the ol’ Hippocratic Oath and “Marcus Welby, MD” and so forth.

        What’s the fix, if there is one short of collapse and Reconstruction? If there is one?

      2. BEast

        That sounds like a terrible idea to me. People who switch doctors because the first isn’t helping them are often right. Just one example: the woman I knew whose doctor told her she was depressed when she was actually in heart failure, and probably had been for years.

        Even if patients are incorrect, the demand that they cede all decision-making about their health to an authority figure is likely to cause them to be more passive about taking care of themselves in general. That’s not conducive to patients’ good health. Doctors need patients to be actively involved in their care, to report symptoms and side-effects, to ask questions. “Do as I say, I’m the doctor” is both outdated and counter-productive.

    2. Stephanie

      Interesting point re: dancing and drinking definitely true in the upper Midwest as well, for at-home gatherings. White people here still dance at weddings, but they are a lesson in generational and geographical differences within families. The younger the guests, the less likely they are to “partner dance” (remember Martin Mull’s “History of White People in America”?), and then after a certain age they stop dancing altogether. Older, more rural folks will still step out for a waltz or a polka but then get back to drinking when the music changes. Not sure a what impact this would have on overall health other than pointing to a lack of socially acceptable expressions of enjoyment, coping mechanisms, shared community and traditions (unless there is a staunch religious bond). None of which may have seemed imperative to preserve when times were good (again, unless religiously oriented) but are glaringly absent when times are bad.

  16. John

    And no one has even mentioned the vast quantity of environmental toxins that were spewed into our surroundings since ww2 to which the working class no doubt has higher exposure to than upper class individuals. Leaded gasoline, dioxin, pcb’s, herbicides, pesticides, all sorts of endocrine disruptors, etc.

  17. No One

    Every time you think capitalism could not be a worse economic system, is shows a yet more cruel, toxic, and unfair side. Humans have to rid themselves of this poisonous economic system, which captures the minds of the rich and the would-be rich and won’t let up. However, as Marxism teaches us, capital needs the working class, but the working class does not need capital. It’s time to end capitalism before all the gains of the past 10,000 years wind up in the pockets of a few billionaires, and everyone has to face far worse times than their parents or grandparents ever imagined. Shorter lives, mass extinctions, catastrophic climate change, plastic from the depths of the ocean to the insides of our very cells: what other gifts does capitalism have in store for us if we allow it to stay the course?

    1. jrs

      Yep it’s killed more by this point than the harmful manifestations of Communism ever did, not that I defend those of course, and the death toll keeps rising.

  18. Switchblade

    I have been married for 26 years, and in that time my wife and I have witnessed numerous friends and family members who have slowly killed themselves. Drugs and alcohol were the leading cause of death in the people we watched kill themselves in a slow motion dance with death. In each and every case I can look back and see the handwriting was on the wall 20 years before these individuals succumbed to their own personal despair.

    From the vantage point of having survived to the age of 61, I can honestly say that having grown up in the golden age of the American middle class in the 1950s, and 1960s cursed many people I know. When the high point of your life is over by the age of 25 people tend to want to mask the ugly decline in any way they can. As a generation we boomers were sold a Walt Disney vision of the future, and then the Peter Pan ride turned into a Dystopian nightmare with a headlong race to the bottom. This Mr Toad’s Wild Ride features HB1 Visas in mass, unaffordable healthcare, toxic GMO foods, a another massive housing crash in 2016, and the general sense that we are headed to hells half acre. The outlook from where I stand is beyond bleak, when you look at where our owners are taking us.

    I hated the conservative (fascistic) movement since Mario Savio woke me up with his famous speech when I was eleven years old, and I have been forced to watch this slide into inverted totalitarianism with a fully conscious mind for almost 51 years. I swear the Greek allegory of the “Cave” perfectly defines what I have witnessed first hand. People will kill you if you even try with a soft voice suggest what is really going on.

    1. AnnieB

      “People will kill you if you even try with a soft voice suggest what is going on.” I so understand. The effect is ostracism from mainstream society. Even raising a question about the morality of our endless wars leads to silence. I don’t understand what has happened to our society since 9/11. It’s as if a mass brain washing has occurred with the word “terrorists” being the trigger for blind unconsciousness. The politicians running for POTUS never even mention “war”. No one asks questions about it in the debates. Often I feel like I’m insane, but I know that I’m not. Try on that state of mind.

  19. alex morfesis

    Chinese shoes, krappy roads & lousy car seats…krappy roads have increased the micro bruising of our internal systems weakened by our bodies muscular support system disintergrating with our lack of movement/workingout from our modern adjustment to not walking or not working physical labor, including reduced at home physicality from modern miracles like dishwashers and vacuum cleaners…chinese shoes are a big menace…badly designed, destroying the balance of most people, leading to massive body stress…car seats and seating in general in most places are a joke…i try to buy older furniture made in usa prior to dismantling of unions as it almost always feels more comfortable and functional…to explain better about microbruising internal systems which in my mind is a cause of “cancer” …our muscles are designed to hold things in place…when they are not doing the job…our body parts start pulling in manners they were never designed to do…thats my two cents in this three penny opera…

  20. MyLessThanPrimeBeef

    Less educated.

    Perhaps those not less-educated have won this round of Darwinian competition, beating their less educated fellow serfs.

    But we can not assume just because someone is less educated, he or she is not as wise or wiser.

    And that’s what we are losing.

  21. Jetfixr in Flyover

    Just what we need. A bunch of rich, urban city-dwellers telling us why we are effed up, and lectures about “eating better” when there is no time or budget to do so.

    “Poorly Educated” in my instance is being an Airframe and Powerplant mechanic for 35 years, fixing corporate jets for the rich and famous to fly around in. You would think the 1%ers would go out of their way to make sure guys like us are well paid. You would be wrong. Seems that “the free market” (whoever the hell that is) has decided that my experience commands no premium, and if I disagree, I’m more than welcome to pack my crap and go elsewhere…….in a horrible job market.

    If you fall off the treadmill for any reason, you are screwed. No “second chances” if you are age 40 or older.

    OTOH, if you are still working, you get run into the ground, working 60-70 hour weeks of “mandatory overtime”, for month/years (I was a foreman/supervisor for nine years at one of the jet OEMs……never less than 800 hours of overtime a year. One year I hit 1100). The dirty secret is that companies make bank doing this. Employee benefits come out of the “first 40”. Beyond that, withholding continues, but that money is kept by the employer

    Or you are working a second job, to try to make enough money to fill in the budget holes caused by those pay cuts/2% a year pay raises you have been subject to since 1982.

    Lets face it. The sooner the boomers die off, the better off the country thinks it will be. Especially old white guys, who seem to be the root cause of everybody’s problems.

    Don’t worry. I’ll be dead soon enough myself. I’m shooting for the “early heart attack or stroke” retirement plan, instead of the “homeless, living in a cardboard box under an overpass” plan.

      1. Jetfixr in Flyover

        The second you become a financial “liability” you are thown under the bus, no matter how good a job you are doing.

        Laid off in 2004, again in 2009. Even with AAA+ performance reviews. Took five months to find a new job in 2004, almost a year to find a part time/1099 job in 2010, that eventually turned into a full time job. Both times, took a 30% pay cut from the previous job. “It is what it is, feel free to look for a better job if you dont like it”.

  22. abynormal

    “Did you know that heroin is cheaper than beer in Pennsylvania?”
    Many users start using heroin after their prescription painkillers (such as Oxycontin) become too pricey. While turning to heroin appears to be a less expensive opioid substitute, these individuals often discover the hidden costs of heroin only when it’s too late to undo the consequences of their newly formed habit. http://heroin.net/about/how-much-does-heroin-cost/

    sadly, beautiful photography http://www.washingtonsblog.com/2013/11/us-drug-afgahnistan-opium.html

    A drug that is highly successful in reversing heroin overdoses is being carried by some police agencies as a way to give quicker treatment before paramedics arrive http://www.usatoday.com/story/news/nation/2014/01/30/police-use-narcan-to-reverse-heroin-overdoses/5063587/

    Heroin-Linked Deaths Surge 39 Percent, CDC Finds http://www.huffingtonpost.com/2015/01/12/heroin-deaths-cdc_n_6459130.html

    “Man staggers through life yapped at by his reason, pulled and shoved by his appetites, whispered to by fears, beckoned by hopes. Small wonder that what he craves most is self-forgetting.” Eric Hoffer

  23. Felix47

    We have the money. We can give all Americans a guaranteed basic income. Then people would have time to build communities and other activities. When people feel irrelevant to society they fall apart. That is the problem with retiring as well. In my job this disaster is all I see. The mortality numbers are the extreme case and the problem cuts across a lot more than a small subgroup.

      1. MyLessThanPrimeBeef

        I am suspicious of the kind of education in which the recipient expects a more lucrative career for additional exposure under it.

        “It should enable you to lead a happy, healthier life, but not necessarily to afford a more expensive mansion.”

        “But I have a Ph.D. I should be making more for those years of suffering. Never enjoyed it.”

  24. Fair Economist

    With the rate of poisonings (basically opiate overdoses here) increasing by 6-fold, far more than the reports of pain incidence, the driver in the *death* rate is absolutely the availability of opiate painkillers. Given that it’s well-known that chronic use of opiates reduces endogenous endorphins, we can be sure that the opiate use is at least partly responsible for the increased reports of pain and psychological misery.

    The problem with blaming dietary and work-related causes for the white-specific problem is that blacks and hispanics have, broadly, the same problems with unhealthy food, low pay, and physically stressful jobs. I’m not saying that eating junk food is harmless, I’m just saying it can’t explain this particular pattern. Opiates, however, are much more available to whites in this racist society of ours. Opiate use messing up the body’s pain control, motivational, and contentment systems, on the other hand, pretty much explains all of this.

      1. Fair Economist

        No, I do think it’s the (main) efficient cause. All races and classes are dealing with the various insults of modern society, and chronic pain is nothing new (there’s an old joke that you should be happy if you’re older than 50 and you wake up with pain, because it means you’re still alive.) But it’s the groups getting the opiates who are having the significant worsenings in pain, depression, and suicide. It makes perfect sense, because our own endorphins are critical to dealing with pain, sorrow, and purpose, and we *know* chronic opiate use (note: doesn’t have to be abuse, just use period) profoundly disrupts the natural endorphin system. And lo and behold, the groups getting more opiates are having more trouble with pain, depression, and suicide.

        The opiates themselves are also the proximate cause, because they’re so dangerous for chronic users. But they’re also the ultimate cause. Hispanics are also getting the job troubles, the lousy food, and the tough working conditions. But they’re not poisoning themselves accidentally or killing themselves deliberately with these soaring rates.

    1. Yves Smith Post author

      Case, who herself suffers from chronic pain, disagrees with you. She is genuinely not sure which way the causality runs whether the pain led to the med use or the med use led to the pain.

      1. Fair Economist

        Of course an individual can’t generally tell which led to which. You need to compare the course without using drugs to the course with and an individual can only do one path at once. But these demographics strongly suggest it’s the drugs leading to the pain.

  25. flora

    In the midwest there’s a silent meth (speed) epidemic that’s destroying low income women who are trying to patch together 2 or 3 part time jobs to pay the bills, take care of the kids, do the housework, help their equally stressed husbands. They gotta keep going, gotta keep going, gotta keep going. No downtime to rest or relax.

      1. participant-observer-observed

        At LA County hospital I saw plenty of 35yo people, male & female w 95 yo bodies worn out by meth in the ICUs. It is also plague of urban areas.

        1. Yves Smith Post author

          Yes, it’s a big gay club drug. I know distantly someone who died of meth, and someone (a tech guy) who managed to get off it. I have the impression a lot of people get on it recreationally or are workers who use it the way students used to use coffee, and now use Adderal, to be able to do mental work when you are tired or need to concentrate well. It seems be be particularly susceptible to the slippery slope phenomenon: in the early stages, users feel more in control of their use of meth than they really are.

          1. Fair Economist

            Meth has the additional problem that the drug itself makes users feel more in control. I’ve known some meth addicts and it would be funny, if it weren’t so sad, to listen to the elaborate plans for quitting they spin when they’re on it. Then three days later they’re on a binge again spinning a different plan.

            And yes, the ones I knew got addicted just as you say – a little for recreation or to get work done. Then two years later they’re 20 pounds overweight and explaining they can’t go shopping because the IRS has installed cameras in all the grocery stores. I wish I was exaggerating. It’s very depressing.

            @participant-observer-observed – there’s a significant geographic component to drug abuse. For some reason the West Coast urban areas, especially LA, have much more of a meth problem than East Coast urban areas. I understand heroin goes the other way.

  26. PQS

    My cousin fit this profile perfectly: male, early 50s, no real education beyond some tech school, at the time unemployed with no good job prospects, no wife or kids. He committed suicide. It was quite a shock to the family, as he had no record that we knew of physical or mental illlness. After his mother had to be put into a nursing home (after he had cared for her for several years), and she passed away, then he was “on his own”. Then his dog died. Then a few months later he killed himself. Just no future, we all suppose, that seemed bright enough to keep going. This was a “nice guy” – no weirdness, no personality/drinking or drug problems, just a good person who got crushed by this so-called “society” and saw no other way out. And it wasn’t total economic despair: he died with $10K in the bank, and family who could and would have helped him if he needed it.

    What are we doing to each other? Why are we letting the Big Egos and Money dictate this fate to us?

    1. reslez

      On my mother’s side of the family I have 8 aunts and uncles. Baby boomers in their 50s. Two are in good health, 2 are NOT obese, 1 is already dead. I only know of one with addiction issues, but since I’m in the younger generation I might not know everything. Their parents died in their 50s — father of cardiac, mother of stomach cancer. So this might not be representative, but when I look at random people on the street my guess is this isn’t terribly atypical for high school graduate boomers.

      Uncle A – one of two who graduated college. in good health AFAIK
      Uncle B – dead of bowel cancer
      Aunt C – heart attacks
      Aunt D – cancer
      Uncle E – knee surgeries, obese, cardiac risk factors but no heart attacks (yet?)
      Aunt F – apparently in good health but borderline obese
      Aunt G – autoimmune disease similar to ALS
      Uncle H – in good health but addiction issues

    2. James Levy

      That hits home. Although educated way above my station in life, my own line of psychic defense is not robust and runs thusly: wife, dog, chickens. My two brothers and two children live too far away and have too many of their own issues to have a decisive impact on my day-to-day mental wellbeing. My closest friends also now live hundreds of miles from here and I see them extremely inoften. It would be a struggle to keep going if any one of those supports was removed. Two down and living could easily prove intolerable.

  27. Cat Burglar

    My neighbor, a postal worker, listens to talk radio, and likes to bring up the “they’re building detention camps” meme when we talk politics. She’s on the right track, but I tell her to just look down our street — why go to the trouble of rounding people up and dispatching them when you can see it happening right here?

    Here in the rural West, where I live, it has been clear for some time that there is a class of people surplus to the economy who are just going to be warehoused until they die young. They may be warehoused using painkillers, jail, medication, disability payments, or marginal work, and then, through a combination of poor diet, inactivity, overdose, liver failure, car accidents, and violence, they disappear. What we are seeing is a least-cost solution being imposed, seemingly by default to market processes. The study results weren’t a surprise.

    In the little Oregon desert town where I work on the family ranch, most of the baby-boom generation men have skills in logging, running ag machinery, truck and auto repair, and can usually figure out any type of machinery. Women in the same generation usually have experience in retail and service work. But the increased mechanization (and increased debt service for farmers and ranchers) have cut the need for workers by over 90 percent since the 70s. There are only few ranch jobs around, but episodic work cutting wood, doing cleanup, doing metal salvage, and other things, make people a little money.

    The increased cost of housing has kept these men and women out in our tiny town because it is the only place they can afford — a succession of women with kids have lived in one trailer in town just because it is rent free. One man that lives thirty miles from the nearest store can get rides, but can only drive himself around town on an old riding lawn mower. The volunteer fire chief has been on medication for years, is a wizard at getting equipment donated, but doesn’t seem to be able to get it together to get his EMT certification. Another group of men lives on disability — one man gets by on a little rent money from people that can park their trailers near his house (owned by the dog his late sister left the house to, which prevents a neighboring state from selling it to recover Medicaid costs). Most of the women have trouble with pain, and have to take painkillers. Life in town is punctuated by medical emergencies and car accidents. Their kids seem to be in worse physical shape, and to have fewer work skills. While the study singles out white men and women, the neighboring Indian reservation has all the same troubles — my hunch is that the less-educated white baby-boomers have just been lagging behind less-advantaged groups and have finally caught up with them (though I’m not sure data confirms this hunch).

    Social Security expansion, single-payer health care, more social housing, and outreach to the uniformed by social programs would help. Efficiencyunbounded has become the enemy of humanity.

    1. MyLessThanPrimeBeef

      The solution doesn’t seem to teaching kids in those towns programming so a few can move to San Jose. That doesn’t solve anything for the B and C students left behind.

      Maybe we, as a society, have to praise inefficiency as well as idleness.

      1. PQS

        I thought Big Finance had turned both idleness and inefficiency into an art form…but apparently the spoils go only to them…

    2. abynormal

      Excellent summation Cat Burglar. Agree…”hunch is that the less-educated white baby-boomers have just been lagging behind less-advantaged groups and have finally caught up”. i don’t need data…beginning 2011, i traveled by car from mid-FL to IL for a year…the human landscape is the same.

      it is not going to happen…it Is happening.

  28. ckimball

    Remember when an apple was an apple. Because of the debasement of our food sources our diets no longer work to counteract the effects of those pleasures used by
    people after work to relax and play or forget. Those who work
    hard all the time do not have the time or energy to look into the
    GMO issue nor the funds to buy organic. And then there is the
    awesome effort and focus it takes in an unsupported culture to
    change perspective about our diets which are often rooted in family
    and culture and become dependencies which are believed to
    help us emotionally.
    I have a store on an island (about 12,000 people). Some years
    ago (perhaps 8) I began hearing stories from customers expressing
    their excitement about experiencing relief from all kinds of pain.
    They talked about classes they were taking from an herbalist on
    the island who created a five week program ‘to quiet inflammation’.
    Although I was not in pain I took the course and have repeated it
    five or so times and will return again because there is always more to learn and it supports me to regain my awareness of how
    I am at the effect of my diet. The culture here has been affected by
    these classes which started small and are word of mouth. Now they are offered on line and in different communities around us. Some of the restaurants on our island now offer a proportionately correct anti inflammatory selection thanks to the persistence and recommendation of the teacher. (a professional herbalist with a background in biochemistry, neurobiology, medical research, nutrition and health) This pedigree is very low key in the back of
    her book. Our community has been the recipient of treasure untold.
    The education which we have been offered demonstrating the practical application of these subjects is wondrous and rare.
    Except for luck how can people without energy or time find this?

    1. MyLessThanPrimeBeef

      Those who work
      hard all the time do not have the time or energy to look into the
      GMO issue nor the funds to buy organic

      Again, the primary goal of education should be to enable the student to live happy, healthy life, instead of all these stories of educated people looking for diet/health information on their own.

      Moreover, democracy can’t exist when citizens are too tired, or lack energy, to do much else beside trying to survive. No time to look into the GMO issue or any other issues. People laugh at the professional citizen idea – citizens paid to exercise citizenship (thus, professional citizens), in order to combat professional politicians.

  29. washunate

    And unlike chaotic post-Soviet Russia, the US does not have a good excuse as to why this has been happening in a period of supposed growth, and even worse, with no one noticing until now

    I don’t follow this?

    When you combine a drug war undermining public health with a two decade long economic depression and extreme concentrations of wealth and power, and put it in the larger social context of car-dependent sprawl and processed foods and stressful work environments, this is what you get. Preventable suffering and death, on a massive scale.

    This notion that there is no explanation and no one has been noticing strikes me as the worst kind of academic ignorance. Just to give one example, here’s Milton Friedman (yes, that guy) literally using the word poisoning in an interview a quarter century ago:

    Paige: Let us deal first with the issue of legalization of drugs. How do you see America changing for the better under that system?

    Friedman: I see America with half the number of prisons, half the number of prisoners, ten thousand fewer homicides a year, inner cities in which there’s a chance for these poor people to live without being afraid for their lives, citizens who might be respectable who are now addicts not being subject to becoming criminals in order to get their drug, being able to get drugs for which they’re sure of the quality. You know, the same thing happened under prohibition of alcohol as is happening now.

    Under prohibition of alcohol, deaths from alcohol poisoning, from poisoning by things that were mixed in with the bootleg alcohol, went up sharply. Similarly, under drug prohibition, deaths from overdose, from adulterations, from adulterated substances have gone up.

    http://www.druglibrary.org/schaffer/misc/friedm1.htm

    1. DW

      Great article.
      Washunate: I believe you have misunderstood the vocabulary.
      Ms. Smith is not saying there is no explanation, she is saying there is no excuse. That is very different.

    2. Yves Smith Post author

      With all due respect, as bad as America is in many ways, what is happening here bears NO resemblance to the social and economic dislocation of the sudden collapse of the USSR. The fact that a large demographic cohort is having that sort of outcome without that level of stressor is indeed damning, and even more so that it took demographers to document its severity. This is basically a class of people the media ignores, and the elites have deemed acceptable to rot on a trash heap.

      1. JerryDenim

        I would agree the elites officially have written this group of Americans off, but I believe they still get plenty of attention from certain sectors of the media. These are Obama’s bitter dead-enders who “cling to god and guns “. Fox News has built an empire out of appealing to their fears, biases and resentments and spinning their confused pain into pure electoral gold for the Republican party. It looks to me like Fox News at least has got this group wired and dancing to their tune.

      2. washunate

        I appreciate the response. That’s what I didn’t follow. Whether you were agreeing that this is some kind of surprise, or whether you were indicting pundits/media/establishment for being so surprised. The headline, for example, uses the word stunning.

        ***

        I’m still a little confused about how you are employing the breakup of the USSR. It was a bad time. What we have experienced in the US over the past couple decades is a bad time. I don’t disagree that the former is relatively worse than the latter. GDP per capita even today is much higher in the US than in Russia. But I do disagree with attempts to mitigate or whitewash how bad things have been in the US for the lower classes. The most effective comparison to me is not with an extreme historical example, but rather with what America ought to look like today versus our actual state of affairs. We were making strides from civil rights to hunger to environmental protection. The value of labor productivity was, broadly speaking, accruing to those doing the work.

        Then we abandoned that course and embraced trickle down economics and the looting of the general public by connected insiders. Just like the breakup of the USSR, this was an anthropogenic political creation, not some act of nature. Unlike the USSR breakup, ours is a long process rather than a relatively time-constrained event. We run the largest prison system on the planet. That it’s not as bad as the Soviet gulags does not detract from how horrifically, systemically bad it is. It is racist. It is dehumanizing. It is destroying families and entire communities. It is, in short, class warfare. It is destroying the very idea of the future: many of our nation’s most impoverished young people have no meaningful sense that there is going to be a future in which they are alive to do anything. It is collapse. Social collapse is what we have. It is there all around us for those who wish to see the truth of what we have done. We run the worst healthcare system in the industrialized world. That it could be worse does not detract form how bad it is. On the Fed’s consumer survey, households that own a home have about 36 times the median net worth of renters. 15 million children live in households that deal with food insecurity. 81 million workers made less than $30,000 in wages last year. We have terrible real estate development policies and agribusiness/food policies and working conditions (including the most horrific types, like prison labor and enslavement) and so forth. These are well understood themes that echo throughout the comments on this post.

        If one has maintained continuous, gainful employment over the past couple decades (or a nice retirement pension), America has been a great place to live. But the other America has been brutal. One of the biggest temptations dangled by the predator class in front of those of us that are reasonably educated and comfortable is to underestimate that brutality.

  30. Marina

    i am a white woman, nearly 72, taking morphine er due to chronic pain. i have never abused the med as i take it at the low level at which it was first prescribed. i came off of it once, but my pain was horrendous. it is like having the worst flu one could have, the very reason i went on the med after chemotherapy for ovarian cancer. i have some college, pretty much self-taught, life-long reader, little to no social support although i have contact with others who live in my senior building and some nieces i see on major holidays and keep in touch by email and phone occasionally. i live in a senior building, a tax credit apartment from which the owners of this and similar buildings rake in massive savings in millions each year in taxes and profits from ever increasing rents. i never married. life is not worth living. retired early due to ovarian cancer, but health has deteriorated steadily, savings depleted as well as small retirement monies, never made a lot of money during working life, now living exclusively on SS and can afford no supplemental insurance. it’s not enough. expenses keep rising–energy, food, medicine, the major ones. no money for extras. can’t afford cable, land line and internet are exorbitant plus apt. costs $200+ in energy costs in air and heating seasons. i am incontinent due to multiple abdominal surgeries. supplies are exorbitantly priced, another monstrous expense each month and now read they are impregnated with chemical that causes cancer. may have to sacrifice my cat soon. can’t afford to keep a car. i can’t afford end of life care or even to go to a doctor very often, much less go to an emergency room for anything at all. i know the alternative i face, yet i am so much better off than millions and millions of others. Sites like nakedcap and counterpunch are an intellectual lifeline as are literary magazines/sites for me and i have an extensive library.

    1. MyLessThanPrimeBeef

      And they say, with falling energy prices, SS will stay flat.

      No inflation, according to ‘them.’

      “I think nothing will help faster than printing money and giving it to the people. Government trickle down spending has too many middlemen and takes a long time to get down to people like you and me. Besides, they spend a lot of it overseas anyway.”

    2. James Levy

      Good luck, and if you humanly can, keep the cat. I don’t pray but you have all my best wishes.

    3. PQS

      I so hope you reach out to your nieces over the upcoming holidays…I would imagine they would be horrified to know how dire your straits are and would be happy to help in any way they could. (Even if not monetarily – perhaps with some other kind of support/assistance for services/etc.?)

      I know there’s pride and all that, but your post seems like a cri de cour to me…hope you can stay well enough to enjoy a few more pleasantries.

  31. anonymous

    I fit somewhat the situation being described…after the Graham Leach Bliley Act 1999, my ability to earn income as a professional finance consultant became increasingly diminished. I used to do short contract work for scores of different banks all over the world, but with mergers and bank failures, especially after 2007, my client base was reduced by 80%. The shock of my income evaporating so quickly and so unexpectedly led me to believe that I had failed my family: my wife and my young son. I could not provide adequate housing, clothing, food, and medical care…and it is hard to be a loving father and husband when you hate yourself so much because of these failures. Because I coud no longer provide for them what I thought was an acceptable living, I becamely deeply suicidal. Which I still am…I have just managed to keep pushing back my “shove-off” date by telling myself I want to be around a bit longer to see my son grow up more and more into a wonderful young man. But I keep a medicine vial chocked brim full with strong prescrption pain killers, muscle relaxers, and sleeping pills in my pocket 24/7 (these I have squirreled away from past prescriptions for severe pains in my back and neck (some due to accidents, some do to birth deformaties.) Interestingly one of the deformaties that causes the most pain I have recently discovered seems to be traced back to the period in the 1950s when the Marine training location, Camp LeJune, (some where in So Carolina, I think) was improperly separating black sewer water and potable water (My mother and father met and lived on the base…I was concieved and born on the base). So my pain is real, my depression is real, and …I am too embarrassed to talk to anyone about all this because in our neo-liberal world I am supposed to be able to find something to do to make a living for my family….right. So now just trying to appear cheerful, while waiting for the right time and place to pack it in. Dear God, I am very sorry!

    1. Masonboro

      You are referencing Camp Lejeune near Jacksonville NC on the Southern coast where Marines train for amphibious assaults. There is a water pollution problem associated with birth defects that was at first denied and then accepted to some extent although I haven’t heard anything lately (I live about 35 miles down the coast). This Wiki link gives some detail.

      Hang in there. You were not the only victim by far.

      https://en.wikipedia.org/wiki/Camp_Lejeune_water_contamination

      Jim

    2. griffen

      Camp Lejeune is North Carolina.

      My experiences since 2009 mirror, at least somewhat, those you describe. Lay off in 2009, again in 2012. While working in financial services has mostly proved beneficial, maintaining a sense of sanity since 2009 has proved a difficult goal. Outside of the world of biggest banks ever, it’s a consolidation story.

      I’d just encourage you to be well and be positive.

    3. Chris Williams

      Hang in there mate. Plenty of us over 50s who can’t find work we once had.

      I was on anti-depressants for years. Now, I go running three times a week and try my hardest to stay thin and as fit as can be. No meds for me, unless you include alcohol and weed.

      You will solve your immediate problems, but imagine the lifetime of hurt and pain you will cause your family. I know, my partner’s father took the easy way out and she is still traumatised by it 40 years on.

    4. cwaltz

      Your son NEEDS you. You need to find a way to get healthy for him. If you don’t have insurance please see if you can find a community health center to help you find a counselor. Sometimes an objective third party can provide you with perspective and help you find solutions to what feels like insurmountable problems.

      Speaking as a person who lost a father and brother to suicide, it’s really painful to always wonder how different things would be if they hadn’t chosen the route they chose and to wish you could have done something differently to save them. Suicide sends a message to those left behind that they weren’t good, smart or important enough to stick around for. I’m sure that isn’t a message you want to send to your son.

  32. GraffitiGrammarian

    I’m sure distress and despair are part of it, but what about the polluted food supply? Less-educated, lower-income whites are the biggest consumers of processed foods. And processed foods are now horribly toxic, what with industrial oils that include trans-fats, steroid, antibiotics and pesticide residue in meats, and genetically modified staple crops — virtually all corn and soy in the US is GMO, and corn and soy appear in some form or other in nearly all processed foods.

    I wouldn’t be at all surprised if it was the poisoned food supply that helped to do them in.

  33. GraffitiGrammarian

    Processed food was invented mostly by big corporations after WWII — they had been supplying the Allied forces will all sorts of products (like machine oil) and wanted to keep making money in peacetime, so they figured out how to adapt what they were doing to all sorts of consumer products, including food.

    Today, processed foods are nearly always quite a bit cheaper than whole foods and are much less expensive than chemical-free foods (ie organics).

    People will less education are more likely to eat processed because they don’t know as much about what goes into it, but it’s also largely a matter of money. They just can’t afford to buy more wholesome foods.

    1. Jetfixr in Flyover

      My trip to SFO a few years back was illuminating. All kinds of healthy restaurant choices. For three times the price of the typical Midwest meal.

      The Flyover income base won’t suport healthy choices. Not to mention the fact that rabbit food doesn’t supply the energy needed for the typical non “creative” job

  34. Lambert Strether

    I want to set down some random thoughts on this post (which I have the sense will be the first of more posts on this topic):

    0) As I’ve been saying, they call it “class warfare” for a reason.

    1) I would really like to see data like this mapped. I’m guessing it’s highly correlated to the rust belt, and deindustrialized American generally, but I’d like to be sure. Assuming that it is,

    2) I’d like to know who much of a role private equity played in destroying all these communities. I’m guessing they have a lot of despair and death to answer for; a lot of blood on their hands. As a subsidiary question, I’d like to know about union pension fund investment in these private equity firms.

    3) This reminds me of “The World’s Longest Yard Sale” (Tip: Bring plenty of cash!) Twenty years ago, private equity arranged to ship the work out of the country, and today, people sell off their possessions by the road to strangers passing through. (Of course, if they were “urban” “professionals,” not stuck in BFE, they’d be renting out a spare room on AirBnB; but the barrel whose bottom is being scraped is the same barrel.)

    3) I believe this “white working class”* population is the population referred to by Obama in his famous remarks on “bitter” people who “cling to guns and religion,” which took place during the 2008 Pennsylvania primary, Pennsylvania being a heavily de-industrialized area. These are also the voter segment that Obama’s faction threw under the bus in 2008 when they took over the party apparatus. There are two problems with Obama’s formulation:

    4) First, then as now, I reject the refusal to credit working class people with agency. (The contrast between Obama’s navel-gazing oratory on his choice of ministers in the Jeremiah Wright affair, to the subsequent loud cheers from his faction — no sense of “clinging to” there! — and the casual and mechanical attribution of motives to working people was just a little much for me to stomach then, and is now.)

    5) Second, I think I understand better today the idea that “you can’t take people’s historical context away from them” (which cuts a lot of ways when you think of it). So, while not denying agency, I don’t want to erase context either. (Some people do well in a rigged game; but that doesn’t mean everyone can — or should — do well, and perhaps the penalties for not doing well are far worse than they should be.) So, while I do think “eat well,” or “do yoga,” or, the great American mythos, “study hard” are all worthwhile exercises of agency, they also, when context is ignored or erased, degenerate into What about-ism, or what I might label Better-ism, where some individuals are worthy of concrete material benefits from the political system, and others are not, like the Victorian distinction between the deserving and the undeserving poor. However, it’s extremely difficult, stressful, and expensive to be poor. Sometimes, there isn’t a yoga studio in your neighborhood, and sometimes, “junk food” is a rational caloric choice (especially if vegetables are more expensive, as they tend to be). The advice to “be a better person” is also a “tax on time.” Why should people have to pay that tax in the first place?

    6) I have no doubt that Democratic reactions to this study will be framed in terms of proximate causes only and especially drugs; Hillary was already gearing up for this. There are several advantages to this: (1) The prospect of drugs, like methadone, to undo the effects of other drugs, like Oxycontin, which will make Big Pharma happy; (2) the prospect of walking around money for the “helping professions,” who lean Democratic, to solve “the new drug crisis”; (3) tragic and/or heartwarming stories for TV campaign ads; (4) progressives can have good feels, especially about themselves, without doing anything more than a minor policy tweak.

    7) To my mind, if you want to end despair and death in the white working class, you would create a better context: (a) single payer health care, (b) expanded Social Security benefits and lowered Social Security eligibility age, (c) a Post Office bank, so everybody (and especially women) could have a bank account and avoid check cashing sharks, (d) a jobs guarantee, so people had better options than the Dollar Store or the Army, and (e) free college, so parents could feel their kids would have a better life without going into terrible debt. Of course, the Democratic loyalists regard all these proposals as anathema, which is a problem. Oh, and (e) throw some banksters in jail, for schadenfreude, since IIRC places like Youngstown, Ohio were ground zero for the foreclosure crisis, and if you lose your job and your house, that’s about the best recipe for despair I can imagine (though I would think the resulting unpayable medical bills would run a close second).

    NOTE * I hate that locution since in use it implies that “working class” can never be a political construct.

    NOTE Adding, this post also reminds me of Albert Hirschman’s “Exit, voice, and loyalty.” This cohort has no voice (the Democrats threw them under the bus, remember?). And to whom would they be loyal? Hence, exit.

    1. James Levy

      I would just like to add this caveat: never tie anything to the presumptive “good” of the people you are talking about. Blacks aren’t good because they are black, or because America has screwed them over for centuries. Some are good and some are bad. Just as some white working class people are good and some are the nasty bigots some want to assume they are. The questions that we have to address are structural. You are right to talk about context. And most important, we can’t condone a politics of robbing one set of the workers to ameliorate the plight of another set of the workers. That’s the game the Republicans seem to play best. They feed the white working class a steady diet of hatred for blacks and Hispanics for taking “their” money. This is anathema to me. We’ve got to be talking about helping all those who need help and getting the funding from those who simply don’t need all they have (and my answer to those who say “how do YOU know how much anyone needs?” I say, “if you are a grownup and can’t tell the difference between what people want and what they need, you are one sorry fool.”

    2. tim s

      Regarding #5

      Noone needs a studio to do yoga. Call it stretching & strengthening, if you will. Breath, functional physical mobility, and a few feet to stretch out are all that is needed. That is why I say it is an option to most everyone, regardless of social status.

      The lack of flexibility can lead to many physical problems, and our sedentary, repetitive motion lifestyles these days can lead to weakness and inflexibility. This is true for the richest as well as the poorest. Will remedying this situation cure all of one’s problems? No. Will it improve their health, physically & mentally, and give them a better chance to take on those other challenges? – I testify that it absolutely can. I can’t tell you how depressed I was with back and hand problems and all of the related stress. These ailments are now manageable, if not cured, and I am in much better condition to take on what else comes my way.

      One step at a time. This is low-hanging fruit for most everyone.

      Yoga was not started in a studio by wealthy hipsters. Look to its origins and take inspiration there.

      1. Yves Smith Post author

        I’ve taken yoga and you need to be taught the postures. It’s not something you can learn on your own. And you can hurt yourself in yoga. I agree with the general idea, but this again (and I don’t mean to sound harsh) is people prescribing to others when they don’t know their barriers to adopting new behaviors.

        1. optimader

          Yoga has some basic stretching exercises and more complicated stuff some people are just not built to engage in (like me). It doesn’t need to be complicated or painful. Refer to a basic PT stretching guide, it is self explanatory.
          After an accident a Physical Therapist at Mayo Clinic told me many years ago, “Do this this and this….slooowly If it hurts don’t do it!” Good advice as it turned out.

    3. abynormal

      6) the puppets will play drugs pretty much like you describe but the quantity and low price of heroine seems almost staged. VA, KY, TN and most of the Appalachia have been experiencing a decade shaved off their life expectancy. prescription drugs cost was replace by heroin quickly. this is a first when you consider heroin main arteries were cities.

      from 2013 https://www.wsws.org/en/articles/2013/11/26/oxya-n26.html
      Last month’s report by the Trust for America’s Health (TFAH) identified West Virginia as leading the nation in drug overdose deaths, with a rate of 28.9 per 100,000 residents. The state’s fatal overdose rate increased by 605 percent between 1999 and 2010, and has jumped 1,056 percent since 1979. The majority of these deaths are attributable to the abuse of addictive prescription painkillers

      April 2015 An Appalachian Tale: Heroin Hurricane
      http://goodmenproject.com/featured-content/an-appalachian-tale-heroin-hurricane-wcz/
      Addiction doesn’t discriminate. Many years ago, I sought help through a local mental health center. The therapy I received came in the form of pills. It would come to be known in our region as “Hillbilly Crack.” I spent three years suffocating in addiction’s quicksand.

      Not caring, in my foggy world, I battled my husband. And in return, he watched me snort reason after reason. Four hundred reasons were supplied to me every three months masked in an orange prescription bottle. While I cut off the plastic straw and sucked a burning sensation into my nostrils, I never noticed the poverty around me. I couldn’t see the hurricane brewing in my city.
      The hurricane has landed.

      Legislature has cracked down on legal pharmaceuticals making them more expensive, and harder to get. Today, once legal addicts turn to illegal methods. They strap rubber ties around their arms. They insert needles filled with a cheaper, more potent drug called heroin. And, many are dying. Death doesn’t know any age. It doesn’t care if you came from a good home. Death is leaving families without their sons and daughters. Death is here.

      from 2008 ““The worse off are getting worse,” Ezzati says. “There’s just more inequality.”

      It’s not the type of inequality that one would expect in the United States, says Richard Suzman of the National Institute on Aging.

      “One generally associates declines in life expectancy with Russia and the USSR after the fall … and countries in Africa in the midst of wars, etc.” Suzman says. “The fact that life expectancy has actually declined in quite a few counties is quite surprising.”

      The declines should not just worry those living in the places affected, says James Marks of the Robert Wood Johnson Foundation. They “should worry us all. These counties may be the canary in the coal mine (indicating) the deterioration in the U.S. health standing relative to the rest of the world.” http://usatoday30.usatoday.com/news/health/2008-04-21-life-span-study_N.htm

      the speed of this epidemic, compounded with the next few yrs of ‘growth’ should make ‘the body snatchers’ a nonfiction.

  35. Jetfixr in Flyover

    Forget about what any lying politician says…….look at their actual policy decisions (aka picking winners and losers).

    Winners: multi national corps, banksters, Big insurance/medical insurance complex, big Pharma

    Losers: Pretty much everyone else

    I’d mention that “working class” includes Engineers (of all kinds except financial)

  36. Dorothy J McNoble

    I am a retired general surgeon and have worked for 25 years in hospitals serving the “poor and underserved.” I specialized in emergency general surgery (gallbladder sepsis, perforated bowel, recurrent hernias in the obese). I saw the heartbreak of health crisis imposed on the “working poor.” Initially I resented the EMTALA laws which made hospitals and on call doctors do surgery or provide care, irrespective of the patient’s ability to pay. ( I provided hundreds of thousands of dollars of free care and that may be the aspect of my practice which, in retrospect, I am most proud). As the product of a Franciscan education, I always believed it my duty to give back, and I have worked for single payer health care since completion of my residency in 1986. My fury at the cruelty of the system, and the insecurity about health care among a huge percentage of the population has made me want to try to change the system. I have offered my services to many non-profit health care research organizations since retirement, as I really understand the system. None has taken me up on it. (I lack “bona fides” in spite of reasonable credentials, because I spent my career in the totally non-prestigious practice of caring for poor surgical patients.
    (I have written a couple of essays on the ACA and the debacle of the electronic records system, as it has been implemented, but I have not published since 1991. (Two law review articles. I was formerly a trial attorney).
    Anyway, thanks for your compassionate comments.
    Dorothy

    1. Yves Smith Post author

      Yes, we’d very much like to hear what you have learned from your experience and what issues you think are being missed in the problem definition/analysis and policy prescriptions.

  37. ekstase

    The comments on this are fascinating, and people seem to have covered a lot of the causes of this widespread despair. If you’ve lived long enough to see people break, and to try to figure out why some did and some did not, a lot of it adds up to whether there was a loving society around them, or an indifferent/cruel one. Maybe we should look at the things that make life worthwhile, which include material things like safe food and a decent place to live, but also a sense that there is a greater common good that we are born into, born for, and which we own. When that is stripped away, we are all living in one big gigantic lie, and that gets tiresome.

  38. Observer

    Shrinking white middle class.

    Employment precarity causes stress, and stress is a killer. Stress triggers the fight or flight reaction, which stimulates the immune response, which exacerbates inflammation, which is frequently accompanied by pain. Stress can also cause or contribute to high blood pressure, along with a number of other chronic health problems. Paradoxically, it also reduces the ability to fend off infection. Over an extended period of time the physical effects of stress result in chronic long term adverse effects to health. Psychologically, stress also contributes to depression.

    In a country where access to basic health care is tied to employment, no full time job equals no health care coupled with increased stress. Even with full time work in industries where wages are below liveable levels, healthcare benefits are unaffordable. At the county clinic, there is no funding to treat the cause, only the symptom (pain). By the time a person reaches the ER, the underlying problem has compounded and is no longer cheap or easy to treat.

    Even with health insurance coverage, it’s increasingly difficult to find and keep a GP. Crapification of plan networks and an increasing tendency for medical students to specialize (because specialization pays better than becoming a GP) contributes to this problem. GPs are trained to look at a problem more holistically, identify root causes, recommend non-invasive treatment first (such as diet, exercise, therapy, or medication), and only recommend a specialist as a last resort.

    IMHO, increased stress resulting from increased employment precarity, coupled with lack of access to basic health care such as regular visits to a GP, equals increased pain, poorer overall health, increased depression, and increased mortality.

  39. Ron

    I think the diet angle is big in this. Poorer people (sad to say) will consume cheapened fake food products in order to manage budgets, and in the process they may poison themselves. Pick up a can of soup now and read the label. It’ll be full of things such as hydrolyzed vegetable proteins, textured proteins of various types, yeast extracts, MSG, and of course HFC syrups. The hydrolyzed this and thats, the textured this and thats, and the yeast extracts are all things thought to cause (from my non-expert readings) an increase in free glutamate in the body, which is exactly what MSG does. Free glutamate is thought by some to burn up neuron receptors, and these poor folks can’t afford to loose any of those. It’s probably a negative cognitive bias which then produces future decision making processes that give even poorer results.

    There are those who say artificial sweeteners (especially the big name ones put into sodas) – have the same effect that MSG has been associated with – the destruction of neuron receptors.

    Twenty or thirty years ago, food was not so fake. So, if this trend is new (relatively), then maybe there is a darned good reason to look at possible fake food and fake food additive to health correlations. The group of people referenced in the anomaly would be much more likely to consume cheapened products.

    Sodium fluoride is thought (by some) to lower IQ (Chinese and Indian studies) – and certainly doesn’t help these people. SF has been injected into tap water in urban centers since the sixties, and in rural centers since the seventies or eighties. So, the timing of SF in water supplies is coincident with the decline of the anomaly group as well. There’s another study that should be done.

    It’s probably mostly a diet thing, and it’s not just the biggie fries.

    1. optimader

      Twenty or thirty years ago, food was not so fake.
      I think it would be more accurate to look at it as there being an ongoing onslaught of processed foodlike substances with a coordinated marketing juggernaught delivering consumer impressions to the susceptible.

      OTOH, maybe due to my proximity to a large population center, I have unprecedented real food choices from ethnic markets, far far more than the choices I had as kid. When I was growing up, half the year or more, most vegetables came out of a can..Waxed beans creamed corn shudder.. green peas..
      Ethnic immigrants still know how to cook and apparently make the time to do it. The markets that cater to them are a good value and have a great variety of choices. Just scrub the bejeezuz out of it.

  40. MarkJ.Lovas

    Thanks for the details, comment, analysis, and providing the original. From what I read elsewhere, there wasn’t such a clear picture.

  41. Renee

    My brother was a teensy bit older than this demo (he was 57 when he died). Always single, born with a “mild” case of cerebral palsy, got busted for marijuana in the early 70s and he was raped, but this was a family secret until shortly before he died.
    He never finished college, got a bunch of tech jobs, then in the 2000s all his job kept getting outsourced to cheaper places. One time he had to go to Korea to train his replacements.
    Finally he was let go from his last job, in his mid-fifties. With my and my mother’s help, he was able to COBRA his medical insurance, as the effects of his cerebral palsy began to cause neuro issues, which made working pretty much out of the question. As he was being wheeled into surgery shortly before his COBRA insurance was to expire, it was canceled due to a medical issue. Then his insurance ended and no surgery, and his attempt to get on SSI Disability was denied. I was trying to reverse that, but in the meantime, his health deteriorated and my brother was reduced to buying drugs from overseas – who knows what were in them?
    I blame our lack of a medical system to cover all for my brother’s death. Obamacare might have helped him, but who knows? Without continuity of care, a complicate case like my brother’s might have simply been overlooked.

  42. VietnamVet

    The decline in longevity of white males in the USA and Soviet Union are similar because they are result of the exact same causes; lowered status, insecurity from collapsing institutions and the loss of family supporting jobs that led to alcoholism and suicide. The boys from Harvard who tore apart Russia are now chiefs of staff to the western oligarchs who are tearing apart Europe and North America with their forever war against Islam, austerity and wealth inequality.

  43. Wade Riddick

    Could be plenty of things. You know the economic – whites are finally getting treated more like blacks by corporate America (inner city hollowing out of jobs, etc.). Consider the following medical angles:

    Antibiotic overuse kills healthy flora, leading to arthritis – which, in the long run, is aggravated by NSAIDs like Celebrex because they both inhibit the regulatory T-cells for self-tolerance and they shrink joints by inhibiting the stem cells that repair them. These two side effects, though, can take years to manifest.

    Gut flora also maintain the bodies cannabinoid and opioid networks according to a study in mice ten years ago.

    Gut flora issues are inherited from the mother, as are some autoimmune problems, so you may be looking at a generational snowballing effect. It may take time to get so bad.

    By virtue of the fact that blacks and Hispanics receive less medical attention, they may be less exposed to these forms of malpractice (broad-spectrum antibiotics) and thus spared in the long run. Hard to say.

    It is true that this group of whites has been targeted for opiate sales – and it started back when the death rates began climbing. Opiates can, over time, backfire and sensitize you to chronic pain as receptor levels drop (as can NSAIDs). Of course, we could send people to physical therapy and give them methylcobalamin shots for their chronic pain (like I do) but that doesn’t line the pockets of big pharma, so TINA.

    It’s quite easy to prevent opiate addiction in most patients when they take these pills. Throw in some low-dose naltrexone with the script – but then corporate America doesn’t get addicted, repeat customers, so we don’t talk about that in any of the articles on the opiate epidemic. (Doctors get harassed for Suboxone too.)

  44. OIFVet

    First “they” engineered the disposable trinkets, now “they” have engineered the disposable human beings. It’s heartbreaking to read some of the posts on this thread. My father died young for lack of access to healthcare. It is still painful, even more so because it is getting worse for more people and it is getting worse because that’s what TPTB want. I have good healthcare myself, a measure of security, and can afford to enjoy proper healthy food. But being down for two weeks now with strong pain from an old Army injury, I wonder what difference it makes to have these things if none of them can help to fix what is already broken. I refuse to take painkillers, and surgery is not an effective remedy, so for the time being all I can do is grin and bare it (pot helps) until the pain goes away. It does that, only to return at a random time in the future. And yet I am lucky. I can barely begin to comprehend what being one of the unlucky human beings entails.

  45. Bridget

    I’m guessing it’s more a change in patterns of the prescribing of, and subsequent addiction to and/or abuse of, prescription pain killers than it is more pain, bad food, and lack of exercise.

    1. Yves Smith Post author

      I don’t mean to be hard on you, but people who have not had pain or chronic soft tissue injuries have no idea what it is like. As indicated, the co-author of the piece does not see evidence that the drug abuse started out as drug abuse. What the authors DO point out is that opiods are prescribed far more often to treat maladies that include pain than in other populations. And class factors can be at work: the doctors don’t prescribe physical therapy or other treatments, or perhaps the patients can’t rest injured joints enough to get any semblance of repair and recovery.

      If you’ve never had serious pain or a chronic joint/soft tissue problem, you can’t relate. Even if you do all the right things with serious sprain or strain, it’s usually a full year before you are 90-95% recovered, and full recovery often never occurs (this is particularly true with ankle sprains: one bad sprain and you will never be the same again). And as Clive pointed out earlier, the sort of diet and physical overwork-related health issues discussed here seem to be treated as if they were not as deserving of sympathy as cancer, when with quite a few cancers, there are also lifestyle roots (certainly in lung, bladder, colon, and cervical cancer).

  46. Bridget

    I did not mean to suggest at all that the people do not have pain. Only that they did not suddenly begin having more pain in 1999. They just started dying of overdoses in 1999. A loved one of mine died in 2001 of pancreatic cancer, and she was administered morphine for months before she died. The hospice people talked a good deal about how the treatment of pain had undergone great changes in the years immediately preceding her illness, and how the focus had changed to preventing pain instead of letting people suffer. I suspect that many people receiving prescription pain meds became addicted and died of overdoses. Since I posted my comment, I have been googling around and have discovered that, yes indeed, overdoses from prescription pain meds has become such an epidemic that new federal regulations have been recently enacted to curtail the prescribing of these drugs, Oxycontin in particular.

    I can’t vouch for the accuracy of the historical narrative, as the author of this Daily Kos piece has not footnoted his sources, but here is the best narrative I have come across thus far, although it’s written from the point of view of someone who is not happy about the changes: http://www.dailykos.com/story/2015/04/15/1375189/-The-War-On-Doctors-How-The-DEA-is-Scaring-Doctors-from-Prescribing-Pain-Medications#

    1. Bridget

      Here is a CDC piece that says that the amount of pain Americans report has not increased, but the prescribing of pain meds has quadrupled since 1999. Data on numbers of deaths is also discussed:

      http://www.cdc.gov/drugoverdose/data/

      Anyway, it just caught my eye that the increase is deaths was so inexplicably sudden, that something else had to be at work than a sudden increase in pain, or bad food, or a bad economy.

      I still can’t think of an explanation that covers the racial differences, though. So, there is probably more than one thing behind these deaths, but I believe it’s very likely that the overdoses are due to new patterns of prescribing painkillers.

      1. Bridget

        Sorry for all the posts. This is the last one. This article discusses the campaign by drug manufacturers to persuade doctors to prescribe more pain medications, and details why older and poorer Americans are the most susceptible to adverse repercussions.

      2. Yves Smith Post author

        Not dispositive. It is widely acknowledged in the US medical profession that pain has been undertreated. Lots of research on this. And you did not read the study, which was embedded in this post and has data tables. Pain HAS increased in THIS population in the reported time frame, and other health indictors have also fallen (% reporting poor health, health issues limiting ability to function and engage in social activities). And the article did point out that opioids are prescribed more often in this population to treat pain than in other groups.

    2. Yves Smith Post author

      Go read the data in the study. The data tables dispute what you are saying. There WAS an marked deterioration of health in this population on multiple axes. And the rise in poisonings, which is not just opioid use, but also alcohol deaths, started rising sharply in 2001-2 and has been a steep slope up since then. Yes, there has been both an Oxy-Contin and a heroin epidemic. But to make this problem all about that is to greatly oversimplify the problem, and to ignore the role of pain and serious physical disabilities among a significant portion of this population.

  47. Eureka Springs

    Lost a dear friend last month to a sudden heart attack at 55. He was smarter than most and managed to complete higher education than his parents. But he worked free lance, always up and down on the income game. Stressor for sure. Quit smoking in his early forties.

    A point I didn’t see mentioned in post and comments (perhaps I missed it) … this rise in death rate at a time when so many have quit smoking. Curious.

  48. JerryDenim

    I agree the average poor American has an atrocious diet, I’ve seen what goes inside the average shopping cart at a rural Wal-Mart and its horrifying, but I think people blaming the shocking increase in uneducated white male mortality rates on diet seem to be disregarding the data in order to promote a pet topic. The divergence in the mortality rates from expected norms relative other advanced countries was only for US high-school educated whites. It’s not like low-education, low-income black or Mexican Americans eat any healthier than their white cohorts so diet can not be the reason for the white mortality anomaly. I think this is really all about perceptions and expectations amid a radically changed economy. Just being white and having a penis used to actually count for something in this country, and as shocking as it seems in 2015 white men with only high school educations used to actually be able to find good paying jobs, keep them, buy homes, buy toys like boats and lake cottages, raise families and even retire comfortably at 60. It’s summed up fairly well by the internet meme “Old Economy Steve”. http://www.quickmeme.com/Old-Economy-Steven/?upcoming

    White men between 45 and 54 are old enough to remember the tail end of those times and may have been lucky enough to have held one of those good paying unionized jobs right before the factory closed down and was shipped off to China or Mexico. They got a taste of the good life perhaps, but they weren’t able to hold onto it. At the very least they grew up seeing that old American economy work for their fathers and they thought it was going to be the same for them. I ran across an interesting article/study yesterday that dovetails very well with this topic concerning the telomere lengths of various ethnic groups of poor Detroiters. There were some interesting anomalies in that study between ethnic groups that seemed to suggest personal perceptions and expectations could play a very large role in the length of one’s telomeres which is a yardstick for overall health and life expectancy. http://www.huffingtonpost.com/2015/05/08/poverty-race-ethnicity-dna-telomeres_n_7228530.html

    I’ve read studies linked here showing the more unequal the society the lower the overall level of mental health and the higher the number of people who report being dissatisfied with their lives. I’m not trying to downplay any group’s level of suffering and I’m definitely not saying it’s all in these people’s heads, I’m just trying to say there are things besides ‘sticks and stones’ that can break bones. A lot of the harmful economic trends, like off-shoring/trade policy and financialization which threw uneducated white males out of work in America were in play well before the millennium, but I think that’s when it all came to a head due to several factors. You could still buy sporting goods, electronics and appliances that were made in America up until about the late nineties and then it all disappeared. I blame NAFTA and China’s ‘most-favored-nation’ trade status followed by full entry into the WTO. Clinton and his Republican friends in Congress passed Graham-Biley-Leachy effectively driving the last nail into the coffin of Glass-Stegal and Washington refused to regulate derivatives. (which unleashed the housing bubble that exploded in 2008) Some of the factors that I believe helped hide the pain of American deindustrialization during the Clinton years: 1.) the gigantic stock bubble/dot.com boom, ( 2.) the United States brief uncontested reign as the world’s only super power after the fall of the Soviet Union, (3.) the Greenspan put/ easy credit and (4.) super cheap oil thanks to a OPEC vs. Non-OPEC price war. By 2000 the post halloween sugar high was was all over and the belly-aches and cavities had began. White guys who thought they were going to be ‘Old economy Steve’ like their dads and uncles found out they weren’t – then the depression, heavy drinking, pill-popping and the coincident bad health effects began.

  49. Sanford Calef

    I am in my mid fifties.
    I work in manufacturing.
    And most people my age I that I know have some type of chronic condition. Most are overweight and diabetic. Some have cancer.
    About 6 close friends and co-workers my age have died
    due to cancers, heart attacks, strokes in the last decade.
    (I’m not counting the 3 acquaintances shot in the Waco Biker shootout.)
    One co-worker at 36 just had a stroke last month and is paralyzed.
    (he seemed in great health.)

    Of my 5 siblings, 2 have caught disabling diseases and are on disability. 2 are diabetic and on meds. As are their spouses.

    As for me I am in OK health, but cannot be sure as I haven’t had a checkup in a few years.(Can’t afford one.)

    Good health…in the blue collar world….over 50…is rare by my observation. Perhaps it is the toxins in the air and water.
    Perhaps we are now like the Romans who lined their aqueducts with lead and ruined the health of the empire.

  50. Ignacio

    This study is very important, in my opinion much more important than the recent release on the impact of processed meats on colon cancer released by the WHO (and I am not a US citizen). It identifies a target population whose life standards have deteriorated to the extent of causing a remarkable rise in morbidity. It has been identified in the US but this does not mean that other subpopulations around the world are suffering similar deterioration masked or unmasked with better social safety nets. I don’t want to sound cynical but I think that the results shown in this study should be like the canary in the mine and prompt an urgent revision on what is socially wrong in the US and elsewhere.

    I read about this study yesterday linked in another fine blogspot (Economist’s view) and it really impacted me. The WHO release has prompted a wave of tweets although I bet that consumption of processed meats is not a good predictor on the likelihood to suffer colon cancer. This study is quite different, it does not look at causes (there will be a complex interactions between different social factors causing the rise of morbidity) but the outcome which is really stunning. I hope it has the impact and consequences it deserves.

  51. dk

    How odd… that’s almost my cohort, I’m in the 55-59 age group.

    I’m 57, I dropped out of high school, I’m white and male … yes, it seems a lot of us have died of drug-related misadventure; an associate in the cohort who has stayed in touch with childhood acquaintances (I didn’t) has regularly remarked on it (absent knowledge of this study). I myself never got along well with peers, and made friends outside of this group, but have thought to notice a similar trend; I thought it was just a subjective observation (or paranoid delusion) on my part. Alcoholism and drug overdoses, yes, that. Quite a lot of suicide; too. Lots of cancer… again, I thought that was understood as a scourge.

    Many in this and adjacent cohorts had poor nutritional components in childhood: heavy and regular exposure to all kinds of over-artificially colored foods, also sugared and non-organic flavor-enhanced including breakfast cereals and beverages, These kinds of products began to see at least relative improvement in component ingredients in subsequent periods, especially the artificial coloring has become comparatively less antagonistic.

    I also had a profound “food allergy” since early childhood, but independently devised a cure, and am free of it since 1989.

    And for what it’s worth, in 1996 I suffered a traumatic back injury, and endured just shy of three years of uninterrupted excruciating pain. I refused opiate and other pain medication (they impeded work and enhanced depression); in 1999 the nerves to my right leg were finally ground to the point of severance and the pain stopped (I permanently lack about 50% of function in the leg, and have some related kidney dysfunction).

    I have also had some other chronic health issues and made some poor lifestyle choices (including an extended period of severe drug abuse), but self-selected diet and physical discipline have supported my survival to date (and I’m now in remarkably good health, considering).

    I have managed to avoid work that entails standing on concrete floors for long periods, and have observed that all peers who do such work suffer considerable pain and joint problems, significantly increasing in their 50’s. Such work includes: store, restaurant and warehouse/shipment workers, security guards, school teachers (most stand a lot), postal workers. Also, some do a lot of work-related driving and/or travel; vibration from vehicular transportation is rough on internal organs as well as skeletal components and joints. I do note that most people have incredibly poor posture, and this can significantly contribute to physical and psychological issues, especially in combination with impacts of physical stress related to standing and/or sitting for long periods. There are some social (class correlated) components to posture as well.

    For what it’s worth, I have never accepted medical insurance or much of the accompanying treatment, and have found that negotiation payment for treatment and paying cash up front is much cheaper (like 60%-80%, no joke) than what people pay with other approaches to health care/maintenance cost (I do spend more than most on fresh(er) and less-processed foods). Absent “health” insurance, and generally not participating in the social support system, I have also eschewed all kinds of medications (except for occasional use of antibiotics). Yves mentions the “professional sports mafia” as a source for effective alternative medical treatment, this has been a good (and affordable) source for me as well (and I do some work in the field).

    With the exception of one other peer, all members of my age group (not just the school dropouts) including females, with whom I am in contact, take one or more prescription anti-depressant medication. For that matter, almost everyone I know in all (!!) age groups (and other demographic categories) takes these or some other nominally mood-enhancing or psychological palliative (mostly but not exclusively by prescription); I find this alarming (but would suicide rates would be higher in all sectors if it were not for this use?).

    Quite a lot are heavily caffeine dependent. Some have reduced alcohol (and/or other “recreational” drug) consumption in their late 40’s and 50’s, possibly in reaction to the notable ambient incidence of deaths related to these substances. Deaths by substance-related poisoning or misadventure, and by suicide, have been steady throughout, and into recent years.

    1. Kat

      In regards to anti depressant use, which has skyrocketed, what I wonder is this. I know the class of medicine which are SSRIs are dangerous for a certain segment of the population due to the inability to tolerate the medicine. Medicines in this category include Prozac, Paxil, Celexa etc. Drug companies were forced to put on the labeling finally about “if you have suicidal feelings”. For people that can not handle the SSRIs, one side effect can be feeling suicidal. In this age group also with women that are going through the change of life, I believe doctors are increasingly putting women on anti depressants rather than hormone replacement therapy due to the breast cancer risk. The study that came out in 2002 about the risks of hormone replacement therapy for women had a reduction in hormone replacement therapy perscriptions of 80% according to this article. http://www.theguardian.com/society/2014/oct/20/women-menopause-symptoms-hormone-therapy

      My doctor recommends for her female patients anti depressants in this age category that are having difficulty going through the change of life. They can help a lot unless you are a person that can not tolerate the medicine and gets suicidal on the medicine. Also if a regular doctor is prescribing, the follow up can be lacking versus going to a psychiatrist where the patient is monitored regularly on the medication.

      Here is an article on anti depressant usage in the US increasing substantially.

      http://www.health.harvard.edu/blog/astounding-increase-in-antidepressant-use-by-americans-201110203624

      One particular stat in this article: 14% of non-Hispanic white people take antidepressants compared with just 4% of non-Hispanic blacks and 3% of Mexican Americans.

      Here is another interesting stat for this age group: 23% of women in their 40s and 50s take antidepressants, a higher percentage than any other group (by age or sex)

  52. Chris in Paris

    I have lost friends in their 50s and 60s by at least 2 a year for the past 10 years. In the US, that is. When I visit America I’m frequently surprised or even shocked to learn of friends’ and acquaintances health issues. Knee replacements, back operations, prescriptions to expensive and addictive pharmaceuticals…and everyone over 50 seems to be on some kind of heart medication. I don’t see ANY of that in France. To be honest, the people I know who have passed away were either in their 90s or very heavy smokers.

  53. Karl

    Wonder how much this tag line at the bottom of well-paying public job notices affects a White Working Class male’s self-esteem and longevity?

    “Women and minorities encouraged to apply”

  54. Karl

    Then there’s Hollywood;

    Every white male portrayed in American movies and television to and including commercials, is either a stupid redneck, a bumbling idiot, shown up by his smarter wife, a rapist or if allowed any strength at all, a gun waving killer, legal or illegal.

    You think there’s a problem with depression now? Wait until the boys that have watched this propaganda reach middle age.

    Longmire, on Netflix, is the one exception.
    The actor that plays him is an Australian, BTW.

      1. allan

        Or a smart and focused law enforcement agent. Both in film and on TV.
        There is the usual Star Trek crew style rainbow diversity, but many of them are white males.
        Even in 99 Homes the sheriffs were nice people doing a bad job.

        Seems like Hollywood is if anything too fawning.
        The original comment blaming it for what’s happened in the real world to middle age whites is ridiculous.

    1. optimader

      The reason this is done and it is overwhelmingly the case, is that it is easy and least risk.

      In the case of commercials, which akin to old time vaudeville requires the fast set up of a simple storyline thread, a classical approach is portraying a bumbling/incompetent foil (enter dumb white guy) to contrast the intelligent straight person (in commercials, the enlightened consumer– be it the eyerolling daughter, enlightened wife, minority neighbor etc.)
      Commercial media is all about the money and risk aversion. Negative stereotyping has substantially rendered down to portrayal of the incompetent (or evil) middle age white guy as this stereotype represents the lowest risk for political correctness blowback (negative consumer impression).

      If I cared to take the time, I would look u an excellent Tavis Smiley interview of Jimmy Walker (aka JJ on a TV Series “Good Times”) produced by Norman Lear back in the mid 1970. Jimmy Walker bitterly lamented the general inability, with few exceptions of black actors to be cast in negative character portrayals and referred to it as a from of discrimination in his trade.

      OK I looked, this is it
      http://www.pbs.org/wnet/tavissmiley/interviews/comedian-actor-jimmie-walker/
      Comedian-actor Jimmie Walker

  55. Lambert Strether

    A word on the “It’s diet” explanation. The red line on the chart shows the deaths per 100,000 starting to increase in the late 90s. Have any of the “It’s diet” proponents tried to explain this? If so, I missed the comment. If not, I think that “explanation” treads dangerously close to deflection and distraction.

      1. IsabelPS

        I have seen that chart juxtaposed to the charts of obesity before.

        I also remember a very interesting article on the New Yorker, I think (years ago), about how Americans were getting smaller, instead of taller.

    1. Ron

      Diet may affect the ability to cope. It’s well known that poor levels of vitamins and minerals can affect coping ability. The suspected receptor burn out would not help people trying to cope, although the level of diet induced degradation that would be needed to effect the observed results in the demo has not been determined, AFAIK.

      Diet induced inflammation may be a problem in this demo group, and (from my readings) could affect the ability of people to cope. I’ve read that meat consumption (omega 6) should be balanced with omega 3 (nuts, fish) or inflammation may result. Inflammation might predispose people to more traditional ailments. I eat one small serving of meat every few days, and consume a rather large amount of nuts (walnuts, almonds, brazil nuts and cashews).

      1. Ron

        It may be that it has become more critical for people to watch the diet because of changes made in recent decades, to processed foods, and the use of newer additives. It may be that some of these changes are coincident with the time periods referenced by the demo group, or not. It’s unknown, but – it’s certainly not out-of-hand irrelevant.

  56. lambert strether

    Oddly, or not, I haven’t seen any coverage of this survey in “progressive” outlets like Salon or Think Progress. Did I miss it?

  57. Ron

    I’m 59, so am at the top of the demo. To the best of my knowledge, I have no problems. That is, I have no pain, no meds, and no chronic (or any other type) of condition. I did have some thrombosis about five years ago, and that was a wake-up call which convinced me to start walking every other day (4-6 miles usually). I have a two year degree, so am a little above the demo in that regard, but it’s not proven to be much different (job wise) than the demo.

    I eat extremely well (it’s really not expensive to eat veggies). Veggies are a lot less tasty, and certainly not as gratifying as junk food, but I’ve learned to jazz them up with hot spices. If I see textured vegetable protein or yeast extract or hydrolyzed vegetable protein or autolyzed yeast or MSG on a label, I don’t buy it. If I see the soybean oil is ranked too highly in the ingredient list, I don’t buy it. Ditto for the HFC syrup. I eat some sardines and smoked herring (love the latter, but don’t eat as much of it as I’d like because it’s smoked). I haven’t been to a hospital in about fifteen years, and that was for a preventative checkup. I never drink tap water, and instead I mostly consume spring water (but it’s usually the cheap stuff (at $1/gal).

    I don’t have all my teeth, but am probably past the age where I’d be trying to impress anyone. Can whistle through them real well though. So, I’m tossing this in there just as an FYI (maybe I’m doing something right) sort of thing.

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