military and medical personnel around a person on a gurney in an emergency room

Economic Indicators

Some of the most interesting U.S. economic indicators that have been discussed recently in the news have not been the dusty traditional tools of economists such as GDP, but instead have been indicators from the field of health. Or ill-health, as the case may be.

Several examples demonstrate the point:

I first heard about this when it was reported in The Atlantic last year that a study by economists Anne Case and Angus Deaton, “Rising morbidity and mortality in midlife among white non-Hispanic Americans in the 21st century,” was published in Proceedings of the National Academy of Sciences (PNAS). They found that middle-aged, uneducated white non-Hispanics in the United States are sick and dying in greater numbers than they should be.

To make that news even worse, the trend is going up, not down.  Compared to health trends in Hispanics in America, as well as to trends in other developed countries, life for this very large subsection of the American population has been getting demonstrably worse.

Mortality Rate for 45-54 Year-Olds, by Country

line graph showing declining death rates for U.S. white non-Hispanics, U.S. Hispanics, France, Germany, United Kingdom, Canada, Australia, and Sweden.
Three causes of death accounted for the mortality reversal among American white non-Hispanics: suicide, drug and alcohol poisoning (accidental and intent undetermined), and chronic liver diseases and cirrhosis.

According to Case and Deaton, the study’s significance is that while midlife increases in suicides and drug poisonings had been previously noted,

that these upward trends were persistent and large enough to drive up all-cause midlife mortality has, to our knowledge, been overlooked. If the white mortality rate for ages 45−54 had held at their 1998 value, 96,000 deaths would have been avoided from 1999–2013, 7,000 in 2013 alone. If it had continued to decline at its previous (1979‒1998) rate, half a million deaths would have been avoided in the period 1999‒2013, comparable to lives lost in the US AIDS epidemic through mid-2015.

Another study from the Commonwealth Fund showed that not only is this trend going in the wrong direction, but the gap between what life expectancy should be and actuality is large for white non-Hispanics, and is particularly large in middle age:

Mortality Gap for White Americans, by Age

bar graph showing widening gap between expected and actual mortality rates for non-Hispanic whites
Change in deaths per 100,000 people between 1999 and 2014. (CDC Wonder Database / Commonwealth Fund)

Many are getting sick from causes that are largely behavior-based, although that doesn’t necessarily mean that the behaviors are within their control.  And with the more traditional causes of death such as heart disease and cancer, they are more likely to die from them than other people are.  As Olga Khazan explained it,

That means not only are middle-aged white people drinking more, using more opioids, and killing themselves at higher rates, more of them are getting sick with the diseases that usually kill older people. And when they do get sick, they don’t get better.

Finally, Jennifer Karas Montez, an assistant professor of sociology at Syracuse University, has found that death rates are rising among particular groups of American women:

Between 1990 and 2010, life expectancy of low-educated white women declined by 1.2 years. That 1.2 years is about 13 years of progress washed away, so what seems to be minor changes in life expectancy signal really big problems going on underneath the surface.

Some of the possible causes are poverty and over-prescription of opioids.  These can lead to drug-related overdoses, cirrhosis of the liver, and suicide — all of which are symptoms of hopelessness.  A strong network of social relationships through work, marriage, and other community institutions has unraveled at the same time.  The Commonwealth Fund report found that

on a range of social and economic indicators, middle-aged whites have been falling behind in the 21st century. For example, they have lower incomes, fewer are employed, and fewer are married. (Until 2014, they were also increasingly without health insurance, though that trend reversed with the Affordable Care Act’s coverage expansions.)

Taking your cue from these studies, challenge your students to look at these indicators and discuss both their causes and effects. What are some reasonable alternative explanations, and how can they be verified or discredited? What other indicators can they find in other fields that can be interpreted as economic indicators? Can they find historical parallels that might explain what is happening?  And finally, what is the likely impact of these trends on politics and society?


BulbgraphOnOffUse chapter overviews for a broad overview of the topic; delve into details with the Study Questions’ mini-lesson answers.


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akamran2014

Dr. Annelies Kamran is Senior Editor at WorldView Software, Inc.

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