White women in the U.S. have historically enjoyed low mortality
rates. But in recent years, the death rate for adult white women
15 to 54 years old has increased even as the rates for black and
Hispanic women have declined, according to a new analysis from
the Urban Institute.
The researchers focused on women's mortality rates because
they're lower than men's and because death rates reflect the
overall health of a population. If mortality is increasing,
other measures of health are also getting worse.
Black women have a much higher mortality rate, but it has
declined significantly—23 percent since 1999. Hispanic women
also posted declines. (Hispanics of all age groups, both men and
women, have lower mortality rates than average, a demographic
phenomenon known as the Hispanic paradox.)
Part of the jump in the death rate for whites is explained by the
epidemic of prescription painkiller abuse and overdoses that
disproportionately affected whites. But that accounts for only
half the total increase, according to the report. Other causes
of death on the rise include suicide and respiratory disease.
Some declined, including traffic deaths, homicides, and the
cancers most closely linked to smoking.
Though overdose deaths among blacks also increased, the rise was
smaller. And overall mortality for black women fell
dramatically, with declines in deaths from cardiovascular
disease, infectious disease, and cancers, among other causes.
Each of these broad racial and ethnic categories is a big group,
with different social and geographic circumstances. So the
analysis doesn't mean "that death rates are rising for all white
women, everywhere in the U.S.," notes the Urban Institute, a
Washington, DC, think tank. Other research has shown that
longevity is decreasing for poorer and less-educated white
women.
We don't have enough evidence to tell whether the increase is a
temporary one linked to painkiller abuse or if it's a long-term
shift. The authors cite examples of other short-term spikes in
mortality. Deaths increased for black women in the U.S. during
the crack epidemic. For Russian men, death rates linked to
alcoholism are still high but appear to be declining.
A grimmer possibility: The pattern may reflect "a systematic
reversal in the long-term trend of mortality decline" for white
women, according to the Urban Institute paper. Such a shift
could be linked to social and economic circumstances. Poorer
people generally have poorer health for a variety of reasons,
and growing inequality could be weighing on death rates.
"It’s possible that as this group of women ages, there could be a
reversal of a very long-term decline in the death rate," said
Nan Marie Astone, a senior fellow at the Urban Institute and the
lead author of the report. America isn't really used to the idea
of declining life expectancy. The next few decades might change
that.