It's hard to write well about being white. White folks, including me often don't like to think much about being white, and people of color are annoyed at how much less perceptive we are about our own situation. Pshaw, you didn't realize that decades ago? But I was floored, by recent epidemiological research, I saw yesterday morning, and am going to try to react and process it, although I'm sure what I have to say will look pale and insufficient to many.
The study in question is discussed here by the New York Times. It was released Monday, and one of the co-authors won the Nobelesque award for Economics last month for past work. The upshot is that death rates for white Americans age 45-54 are going up, not down, and have been increasing steadily since 1991 and are back higher than they were in the early 90s. What's interesting is how localized the demographic phenomena is. During the same time, death rates fell for other ethnicities in the US, and for younger and older people of all ethnicities, and for white folks of the same age range in other countries. Middle aged blacks still had a far worse mortality rate than middle-aged whites, but it was falling steadily in this time, and middle-age Hispanics have a much lower mortality rate than for whites or blacks, for instance, and were falling at rates comparable to other country's overall trends.
The thing is the researchers also did a fair bit of work to isolate WHY middle aged White Americans are increasing their mortality rate. It isn't the diabetes, or heart disease, or cancer; those are all big killers, but ones we are getting better at treating and going down slowly. The effect is especially pronounced among white Americans 45-54, who never went to college, whose death rate increased massively over the last 15 years. In fact, the overall upward trend appears to be linked to 3 main and related factors, death by suicide, death by alcohol and drug poisoning, and death by liver failure. And those three actually decreased slightly for white Middle age Americans who have attended college. The jump in deaths for alcohol, drug, and suicide reasons among middle age white Americans who never went to college is so strong, that it is pulling up the overall numbers.
As the Atlantic puts is "Middle Age White Americans Are Dying of Despair" and my friend adds "And Heroin." So far every indication is that is a cultural problem, rather than a purely medical one. It's not that our treatment strategies for suicide or liver cirrhosis are getting worse; it's that the culture of middle aged white folks has changed in the last 15 years, in ways which have been less and less able to resist self-destruction.
I volunteer for a suicide and crisis line, and talk with lots of struggling people. I spent Sunday night going over recent research and theories and epidemiological data about suicide with my superiors. Over the last year a white family friend almost old enough to be in the demographic were talking about killed himself, and a younger closer friend of the family very nearly did. It is tempting to talk about what I know, and the sorts of experiences I've had. It's tempting to look at the disintegration of the American middle class, and the economic shifts of the last 15 years, especially the last 7. But that ain't it. This is effecting folks who wouldn't have been candidates for the middle class even 15 years ago, far, far more than folks who are in the crumbling middle-class range. The suicide increases are definitely part of it, but not as significant as the drug deaths.
No the right experiences for me to invoke, are my interactions with white folks in the bottom 1/3rd of the American economic range. I think about the rural poor where I went to college, who pioneered rural meth production back in the early 90s. I think about the meth heads in my own town. I think about the folks working 3 part time jobs who do a little meth now and then to try to keep up with their insane work loads, (or the long-distance truckers) but try to resist becoming full methheads. I think about my friend's ex, who was secretly addicted to Oxycontin (a prescription painkiller) he got on the black market for several years before he was caught and divorced. Heroin in particular has a very white demographic these days. My home state is struggling with needle exchange programs in poor rural counties, where needle exchange had once been a very urban health strategy (even when urban whites were taking advantage of it). It's not that other ethnicities or nations, don't struggle with drug problems or despair, but I suspect they have better cultural understandings of these struggles already in place. I think of a poor white factory worker I know slowly drinking himself to death, and about how he keeps struggling to find other ways to deal with things, but with mixed success. A 2012 Health Affairs study found that life expectancy for white, female high-school dropouts has fallen so much over the past 18 years that these women are now expected to die five years younger than their mothers did.
There are economic roots involved here, of course, the crumbling of manufacturing and construction, the fact that more Americans will fail to be able to navigate retirement well than in many past decades, the more impressive economic safety nets of other countries, etc. But it seems that whiteness and white self-understanding must be part of the issue too. My guess is that white cultural identity has been so strongly tied to economic ambition and superiority for so long, that it is hard for white folks to make sense of their own worth in absence of economic success to point to. Other ethnicities, I suspect have long ago needed to adapt to other finding ways of recognizing self-worth other than economic success. But white culture still sucks at this. Certainly, I at least struggle with it, and many of my white acquaintances certainly seem to too. And meaning of life questions, well those are sorta our bailiwick as philosophers aren't they? So here's a challenge. How can we articulate clearly WHY middle age, poor white people shouldn't slowly destroy themselves?
I don't know as much about the factors in drug overdose and alcoholism, but I know on suicide the three main lumpings of factors (according to the interpersonal theory of suicidal behaviour, at least) are "frustrated belongingness" "perceived burdensomeness" and "acquired ability." Roughly, what pushes people to WANT to commit suicide is some combination of perceptions that they are a burden to others, and that they do not really belong, and then what pushes them from willing to able are things that decrease their fear of dying. Presumably the popularity of slow and uncertain methods of self-destruction among poorer, older, whites indicates that fear of dying is still strong, but that belongingness is eroding and perceived burdensomeness is increasing.
So it seems to me that white culture, and white philosophy needs to respond by finding ways to strengthen a sense of belongingness and of non-economic worth, especially for poorer, older white folks. Maybe it's overly pragmatist of me, to see philosophy, like education systems or legal systems as a structure for responding to public problems. Maybe it's wrong to even try to use racial reasoning to make white people more comfortable being white people (even if it's by noting that other ethnic groups seem to do better here and wondering if we can learn productively from their past struggles and successes). I'm treading perilously close to suggesting some form of white pride, which never seems to go well. Yet something in the neighborhood of pride has surely been key to how many people have succeeded in finding self-worth in non-economic ways in the past.
Sigh, OK, I guess I have no conclusions, only musings. What are your thoughts? Are you seeing older white folks destroying themselves with alcohol, despair, and opioids? Do you have a diagnosis, or suggestions for coping at a cultural level, rather than merely case by case?