White women dying younger since 2000
Rural areas hardest hit; overdoses, smoking, drinking, obesity blamed
White women have been dying prematurely at higher rates since the turn of this century, passing away in their 30s, 40s and 50s primarily because of decaying health in small-town America, according to an analysis of U.S. health and mortality statistics by The Washington Post.
Among African-Americans, Hispanics and even the oldest white Americans, death rates have continued to fall. But for white women in what should be the prime of their lives, death rates have spiked. In one of the hardest-hit groups, rural white women in their late 40s, the death rate has risen by 30 percent.
In modern times, rising death rates are extremely rare and typically involve countries in upheaval. In affluent countries, people generally enjoy increasingly long lives, thanks to better cancer treatments; drugs that lower cholesterol and the risk of heart attacks; fewer fatal car accidents; and less violent crime.
White men are also dying in midlife at unexpectedly high rates. But the most extreme changes in mortality have occurred among rural white women, who are far more likely than their grandmothers to be smokers, suffer from obesity or drink themselves to death.
Public health experts say the rising white death rate reflects a broader health problem which has made the United States the least healthy affluent nation in the world over the past 20 years. The reason these early deaths are so conspicuous among white women, these experts say, is because in the past the members of this comparatively privileged group have been unlikely to die prematurely.
Experts in African-American death rates agree that rising death rates among whites are a concern. But they stress that African-Americans continue to have shorter life spans and face severe health challenges exacerbated by racial segregation and discrimination.
“The truth is that white death rates are still much, much lower than they are for African-Americans,” said Bridget Catlin, senior scientist at the University of Wisconsin. “My concern is that people will think, ‘Oh, it’s whites that need to be helped.’ “
White women still outlive white men and African-Americans of both sexes. But for the generations of white women who have come of age since the 1960s, that health advantage ap-
pears to be evaporating.
For this article, The Post examined death records from the Centers for Disease Control and Prevention, breaking the information down geographically, county by county, by level of urbanization and by cause of death.
Big cities and their suburbs, metropolitan areas of more than 1 million people, looked strikingly different from the rest of the country. The Post divided these populations into urban and rural categories, with the rural population encompassing smaller cities as well as small towns and the most remote places.
The statistics show decaying health for all white women since 2000. The trend was most dramatic for women in the more rural areas. There, for every 100,000 women in their late 40s, 228 died at the turn of this century. Today, 296 are dying. And in rural areas, the increased mortality started even earlier, as far back as 1990. Since then, death rates for rural white women in midlife have risen by nearly 50 percent.
Some regions have been hit especially hard, such as the belt of poverty that runs across the northern tier of the South, incorporating much of West Virginia, Kentucky, Tennessee and Arkansas. But significant increases in white mortality also showed up in the small-town and rural Midwest, such as Johnson County, Iowa, home of the University of Iowa. Parts of the West were hard hit too, such as Nye County, Nevada, and Siskiyou County, California.
In the hardest-hit places, 21 counties arrayed across the South and Midwest, the death rate has doubled, or worse, since the turn of the century for white women in midlife.
In Victoria County, Texas, a rural area near the Gulf Coast, deaths among women 45 to 54 have climbed by 169 percent in that time period, the sharpest increase in that age group of any U.S. county. The death rate climbed from 216 per 100,000 people to 583.
Lisa Campbell, medical director for the Victoria County health department, said a third of adults in the county are obese, roughly in line with the national average. Also, 1 in 5 smokes, above the national average. Campbell said she has been struck by how many white women she knows who have some kind of cancer.
“It’s kind of weird, actually,” she said.
The chief factor in this rising death rate is an epidemic of opioid and heroin overdoses that have been most common in working-class and rural communities.
In Walker County, Alabama, less than an hour northwest of Birmingham, the population of 65,000 is 91 percent white, and opiate addiction is rampant. The coal mines have been shutting down for decades. Nearly 1 in 5 working-age people are listed as disabled. Since 1999, the death rate for white women 35 to 44 has jumped 170 percent, The Post found.
The county’s sheriff says that 4 out of 5 arrests are for drug-related crimes.
“When we see somebody dead under 50, we automatically think drugs,” said Walker County Circuit Clerk Susan Odom, whose sister died of a drug overdose. “Died at home? Drugs.”
Another killer is heavy drinking. Deaths of rural white women in their early 50s from cirrhosis of the liver have doubled since the end of the 20th century, The Post found.
Also, the suicide rate is climbing for white women of all ages and has more than doubled for rural white women ages 50 to 54.