White People Problems (July 11, 2017)
If you are not hep to the jive talking that cool cats and their hot mamas use among themselves these days, you may not have heard the wonderful phrase “white people problem”. This refers to a minor event that nevertheless has become a huge issue to someone whose privilege blinds him/her to the fact that their suffering is so absurd that their audience is not only unsympathetic to their plight, but amused at their cluelessness. Furious Facebook posts complaining of Starbucks running out of nonfat milk (thus compelling the victim to substitute 2%) or smears in one’s spray tan are examples of this phenomenon.
There is a white people problem that is a little different than those, however. It is something that is no longer normally seen in the world except under conditions of epidemic, war and famine, and that is decreased life expectancy. This was first observed in the late 1990s in the Southwest in white people between 45 and 54 years of age. The excess deaths are mostly from drug overdoses, alcoholism and suicide. Heart disease, cancer and pain issues are also well above traditionally normal levels in this group of people.
This is not happening to all white people, of course. It’s an American-only phenomenon, clearly yet another distinguished case of American exceptionalism. And it is confined to middle-aged white Americans with no more than a high school degree (if that). But it’s no slouch of a trend – the death rate for this group is now higher than it is for black Americans in general, and the same as for black Americans of similar age and education (all of whom, incidentally, continue to experience decreasing illness and mortality – unlike their white counterparts).
So what’s going on here? Well, the authors of the two papers on this subject posit that this problem has its roots in the labor market, since a progressively rotten economic reality and the social ills that accompany same have been well documented in that demographic. They go a bit farther than that, though, and opine that these people are dying of “diseases of despair”. The anguish caused by the permanent loss of their formerly comfortable lifestyles is resulting in the increased use of alcohol, opioids and suicide, and this is what is driving the death statistics, they say.
Hispanics and African-Americans suffer far more economic disadvantage than does this group, yet they have less morbidity and mortality. So whether it is their intention or not, the researchers are saying that this increase in mortality is stemming not so much from the increased hardships suffered by these people, but from the loss of their Great Expectations. Which sort of makes it all just another white people problem. So, is it?
It happens that America isn’t unique among more-or-less civilized countries in seeing a decline in longevity in a large portion of its population. Something very similar happened in Russia after the fall of the Soviet Union. 1990 was the peak year for life expectancy for Russians, and the mortality rate for middle-aged people dropped dramatically after that (between 1990 and 1994, about six years for men and four years for women).
I remember news stories from that time taking note of the dramatic increase in mortality of Russian men, and attributing it to greatly increased alcoholism (albeit in response to the social and economic instability of the time). Much like what is being said about the American cohort now. So I thought I’d see if the years have brought any new insight into the Russian version of this experience.
It turns out that although increased alcoholism was indeed an issue, far and away the biggest causes of the increase in deaths during that time were increases in cardiovascular disease, infections, and accidents. The medical system had become became suddenly and hugely unavailable and/or dysfunctional, and people suffered accordingly. Interestingly, just as currently here in the U.S., the increase in mortality occurred almost exclusively among the more poorly educated Russians.
I have had a lot of rude things to say over the years about medical care in the United States, and I’m not going to take any of them back. But I would like to say that I think that the sudden decrease in access to the medical system here by people who were accustomed to using it, because of loss of insurance, decrease in effectiveness of insurance and decreased care generally due to economic issues is playing a much bigger part in this mess than the powers that be want to acknowledge.
It’s painful and difficult to acknowledge that maybe your life isn’t turning out quite as you’d planned or hoped. But THAT is pretty much a universal experience of adulthood. I think it is unkind and unfair and total denial of a bitter reality to assert that what people need is not better access to health and medical care, but attitude adjustments.
“The personal is political” is an old feminist rallying cry from the 1970s that only old feminists like myself seem to remember anymore. If this isn’t a perfect example of that, I don’t know what would be.
--dr. diane holmes
Copyright © 2017