Obesity, not despair, killing folks

CU study also blames increase in drug overdoses

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.”