Journal Article

The Epidemic of Despair Among White Americans: Trends in the Leading Causes of Premature Death, 1999–2015

Gennuso, Keith P., Remington, Patrick L., Ugboaja, Donna C., Stein, Elizabeth M.

2017

Overview

Objectives. To evaluate trends in premature death rates by cause of death, age, race, and urbanization level in the United States. Methods. We calculated cause-specific death rates using the Compressed Mortality File, National Center for Health Statistics data for adults aged 25 to 64 years in 2 time periods: 1999 to 2001 and 2013 to 2015. We defined 48 subpopulations by 10-year age groups, race/ethnicity, and county urbanization level (large urban, suburban, small or medium metropolitan, and rural). Results. The age-adjusted premature death rates for all adults declined by 8% between 1999 to 2001 and 2013 to 2015, with decreases in 39 of the 48 subpopulations. Most decreases in death rates were attributable to HIV, cardiovascular disease, and cancer. All 9 subpopulations with increased death rates were non-Hispanic Whites, largely outside large urban areas. Most increases in death rates were attributable to suicide, poisoning, and liver disease. Conclusions. The unfavorable recent trends in premature death rate among non-Hispanic Whites outside large urban areas were primarily caused by self-destructive health behaviors likely related to underlying social and economic factors in these communities.

• Publisher: American Public Health Association
• Subject: Accuracy / Adult / Adults / African Americans / Age / Age Distribution / Age groups / AJPH Rural Health / Alcohol / Cancer / Cardiovascular disease / Cardiovascular diseases / Cardiovascular Diseases - ethnology / Cause of Death / Continental Population Groups / Data / Death / Death & dying / Demographics / Disease control / Drugs / Economic factors / Epidemics / Epidemiology / Ethnic groups / Ethnicity / European Continental Ancestry Group - statistics & numerical data / Female / Health behavior / Health risk assessment / Hispanic people / HIV / HIV Infections - ethnology / Hopelessness / Human immunodeficiency virus / Humans / Liver diseases / Liver Diseases - ethnology / Low income groups / Male / Mental Health / Middle Aged / Minority & ethnic groups / Mortality / Mortality rates / Mortality, Premature - ethnology / Neoplasms - ethnology / Other Chronic Disease / Other Race/Ethnicity / Poisoning / Poisoning - ethnology / Population / Premature mortality / Public health / Race / Residence Characteristics - statistics & numerical data / Rural areas / Rural communities / Rural Health / Social factors / Statistics / Subpopulations / Suburban areas / Suicide / Suicide - statistics & numerical data / Time periods / Trends / United States / Urban areas / Urbanization / White people