Why is life expectancy dropping for low-educated white Americans?

Reader Norm sent me a link to this news article that reported on a new study that said that life expectancy had dropped dramatically for white people who did not have much formal education.

The steepest declines were for white women without a high school diploma, who lost five years of life between 1990 and 2008… By 2008, life expectancy for black women without a high school diploma had surpassed that of white women of the same education level, the study found.

White men lacking a high school diploma lost three years of life. Life expectancy for both blacks and Hispanics of the same education level rose, the data showed. But blacks over all do not live as long as whites, while Hispanics live longer than both whites and blacks.

Although a rise in life expectancy is the norm, dramatic declines over a short period are not unprecedented. But they are usually identified with wars, famines, or major social upheavals like the seven-year drop for Russian men following the collapse of the Soviet Union.

Needless to say, this new result has set off a scramble to find explanations, with initial speculations based on correlations. Given that there have been a lot of changes in the last two decades, there is no shortage of ideas. Some have suggested an increase in risky behaviors such as abuse of prescription drugs and smoking. Others have suggested that people have less access to health care and more people have to go to work.

Kathleen Geier at The Washington Monthly points to other studies that suggest that it could be due to rapidly rising income inequality.

But the real puzzle is why this is causing a decline among white people only. When socio-economic data is disaggregated by race and ethnicity, it is almost always the case that blacks and Hispanics do worse. If rising income inequality is the cause, why are the minority groups able to still increase their life expectancy despite bearing a disproportionate share of its negative effects?


  1. raven says

    I blamed the fundie xians.

    If you look on a map, most of those steep declines are in the fundie heartland of the south central USA, West Virginia and so on.

    Poor, lower class white women in fundieland are likely to be…fundies.

    It’s hard to prove though. Statistics are almost never collected based on “fundie xian”. This is an undefined demographic and not really synonymous with “evangelical” any more.

    As to mechanisms, some possibilities.

    1. Maybe they rely of faith healing instead of medicine, a common belief of no utility and some danger.

    2. Maybe their lives are so bleak, they just don’t care enough to keep themselves going.

    Another commenter proposed:
    3. Maybe it is because they tend to be married to high school dropout white fundie xian males. That would do it for a lot of women.

  2. punchdrunk says

    Could be that white poverty pools in rural areas, where there’s a lack of infrastructure and access to public services.

  3. Rodney Nelson says

    These are the people least likely to be covered by health insurance. Few if any of them receive regular medical exams or preventive medical treatment. They are more likely to have untreated chronic ailments than any other demographic. The average cost of a mammogram is $102. That’ll pay for a lot of groceries, so they’re not likely to have annual mammograms.

    Barbara Ehrenreich’s Nickel and Dimed: On (Not) Getting By in America has a discussion of poor medical care for the working poor. In today’s economic situation, many of the working poor are getting even poorer and fewer employers are offering health insurance for hourly paid employees.

  4. smrnda says

    I thought the study showed that even though life expectancies rose for Black Americans of the same income level, they were still lower than that for whites? Could it just be that (perhaps) there’s been a leveling of the standard of living between racial groups, in that poor white people are now not likely to be better off than poor Black people? I’m not sure how that fits in with Hispanics having a higher life expectancy though.

    The role of fundamentalism is something that I’d be willing to look at, particularly how it affects sex education since a major factor is probably lots of teenage mothers who, once they become mothers, can never really get ahead in terms of education, employment or standard of living. It might be worth looking into this in terms of what states or regions rely on abstinence based sex ed.

  5. mildlymagnificent says

    Anyone with a continuing interest in inequality should get their hands on a copy of “The Spirit Level”. Not only does it rank all the rich countries of the world by various indicators of inequality, it doublechecks the method by doing the same ranking for the states of the USA.

    Unsurprisingly, it finds for both sets of data that the greater the inequality, the worse the outcomes. http://www.ted.com/talks/richard_wilkinson.html for those who don’t want to bother with the book.

  6. Anonymouse says

    I think insurance is a huge part of it. After a routine physical ($60 co-pay), I got the bill for the routine bloodwork–$600, with a discount of $580 for having insurance. That’s just criminal. If they can afford to discount the bloodwork to $20, there’s no reason why the insurance companies have the price jacked up that high to begin with.

  7. Anonymouse says

    I think part of the right-wing nostalgia for the 1950s is a fact they’d rather keep hidden–the 1950s is when the age of first-time motherhood plummeted to the teens, the lowest it’s been in this country’s history. A teenager tied down with a baby or three is not going to be able to pursue an education or a career, and if she’s trapped in a religion with the idea of “traditional” patriarchy, she’ll be nearly 100% responsible for the baby/babies, guaranteeing that she’ll be too busy to notice what’s going on around her for years to come.

    This is one reason Warren Jeffs started marrying off 12- and 14-year-old girls in the Mormon cult.

  8. Henry Gale says

    My guess is that the largest concentrations of poor whites are in rural areas. The largest concentrations of poor blacks and Hispanics are in urban areas.

    So in addition to not having enough money for health care, those in rural areas suffer more from access to health care. Here when I say access I mean geographical distance.

    Appalachia is one of the most under-served regions in the nation.

    From wsws.org

    Kentucky suffers a major doctor shortage, according to an analysis by the Lexington Herald Leader published May 27. The paper found that for every 100,000 people in the state, there are 213.5 physicians, compared to the national average of 267.9 doctors per 100,000 people. Just to reach the national average, about 2,200 more physicians would be needed to serve the state.

    For the Medicaid-enrolled population, the shortage of doctors is particularly sharp. Many doctors, dentists, and clinics will not accept Medicaid patients because of low and late reimbursements for their services and an antiquated system of paperwork involved in filing with the state.

    Dentists are especially scant in the mountains, exacerbating poor dental health rates. According to a 2008 study published in the Journal of the American Dental Association, adult residents in the coalfield region of Appalachia suffered “a high rate of complete or partial edentulism [toothlessness], an infrequent orthodontic treatment, great unmet orthodontic need and less demand for orthodontic care than was suggested by their clinically determined need.”

    Poor people, who often have the poorest nutrition and a higher incidence of tobacco use, are at a far higher risk of losing their teeth or developing life-threatening abscesses, infections, and cancers of the mouth and throat. Some of the poorest families receive dental care only through traveling dentists providing basic screenings as charity.


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