Obe­sity, not de­spair, killing folks

CU study also blames in­crease in drug over­doses

The Denver Post - - NEWS - By John In­gold John In­gold: 303-954-1068, jin­gold@den­ver­post.com or twit­ter.com/johningold

De­spair over eco­nomic and so­cial sta­tus is prob­a­bly not to blame for a star­tling rise in death rates among mid­dle-aged white Amer­i­cans, ac­cord­ing to a new study from re­searchers at the Univer­sity of Colorado.

Af­ter years of de­cline, mor­tal­ity rates across the coun­try have be­gun to in­crease, and life ex­pectancy in some parts of the coun­try is fall­ing. The new study, though, pushes back on the pop­u­lar nar­ra­tive that this trend is the re­sult of a loss of hope among mid­dle­class whites. That nar­ra­tive sug­gests de­spair has led to health prob­lems, self-de­struc­tive be­hav­ior and ear­lier deaths.

“I think that ex­pla­na­tion re­ally caught fire be­cause of the po­lit­i­cal cli­mate we are in,” said Ryan Mas- ters, an as­sis­tant pro­fes­sor of so­ci­ol­ogy at CU’s In­sti­tute of Be­hav­ioral Sci­ence and the study’s lead au­thor. “But the ev­i­dence is in­cred­i­bly weak for this ex­pla­na­tion,”

In­stead, Masters and his col­leagues at CU con­cluded that two things are driv­ing the trend: drug over­doses and obe­sity.

And, while both of those could be re­flec­tive of a cul­ture in cri­sis, the re­searchers found death rates from other causes that could also be as­so­ci­ated with de­spair, such as al­co­hol abuse and sui­cide, held mostly steady. In separate re­search, they found that death rates in African-Amer­i­can com­mu­ni­ties fol­lowed sim­i­lar pat­terns, re­fut­ing the ar­gu­ment that this is a whitesonly phe­nom­e­non.

To Masters, an ex­pert in the grim field of mor­tal­ity rates, the re­search sug­gests that some­thing be­yond psy­chol­ogy is push­ing people to ear­lier deaths.

“I look much more to the struc­tural changes or pol­icy changes that might have fu­eled some of these deaths,” he said.

So Masters and his co-au­thors, grad­u­ate stu­dents An­drea Til­stra and Daniel Si­mon, went on the hunt for those changes. Their study was pub­lished on­line Wed­nes­day in the In­ter­na­tional Jour­nal of Epi­demi­ol­ogy, a peer-re­viewed aca­demic pub­li­ca­tion.

They found plenty to be wor­ried about.

Decades-long progress in fight­ing heart dis­ease, di­a­betes and other meta­bolic dis­eases has slowed, con­tribut­ing to ris­ing death rates, they found.

“When it comes to mor­tal­ity, we are just start­ing to see the real health con­se­quences of the obe­sity epi­demic,” Masters said.

But the big prob­lem Masters and his team iden­ti­fied is the opi­oid epi­demic. Drug-re­lated deaths of mid­dle-aged white men have in­creased 25-fold since 1980, ac­cord­ing to the study. The re­searchers found that deaths for whites from drug over­doses be­gan ris­ing in the late1990s. Those ris­ing death rates, though, co­in­cided with pre­scrip­tion opi­oids com­ing onto the mar­ket — lead­ing Masters and his co-au­thors to con­clude that the over­doses were the re­sult of changes in the health care sys­tem, not de­spair.

“We just made highly ad­dic­tive painkillers widely avail­able,” he said.

To fur­ther check the “de­spair” the­sis, Masters and col­leagues looked more deeply at other causes of death that could be borne out of de­spair: al­co­hol abuse and sui­cide. For both causes, the CU re­searchers found that the rates were more or less sta­ble. And when there were in­creases, those in­creases oc­curred across age or racial lines, mean­ing they weren’t spe­cific to mid­dle-aged whites.

“There’s sim­pler ex­pla­na­tions,” Masters said, “than try­ing to evoke psy­choso­cial de­spair and ris­ing pain.”

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