# Increasing Midlife Mortality and Morbidity in White Americans in the 21st Century

> **NIH NIH R01** · NATIONAL BUREAU OF ECONOMIC RESEARCH · 2020 · $226,285

## Abstract

OTHER PROJECT INFORMATION – Project Summary/Abstract
The goal of this project is to understand the underappreciated and understudied deterioration in health among
middle-aged American men and women, especially among white non-Hispanics. All-cause mortality rates for
white non-Hispanics aged 45–54, after three decades of decline, have been rising since 1998. The increase has
been driven by drug and alcohol poisonings (accidental and intent undetermined), by suicides, and by cirrhosis
and chronic liver disease. If white non-Hispanic mortality rates had continued to decline at 1.8 percent a year
after 1998—the average rate of decline for whites in the previous two decades—about 500,000 deaths would
have been avoided through 2013, a number comparable to cumulative AIDS deaths in the US. There has been
no corresponding change in the rate of mortality decline for non-Hispanic blacks or for Hispanics. In the same
age group, morbidity among white non-Hispanics has increased for a range of measures, including self-
reported physical and mental health, chronic pain, ability to conduct activities of daily living, including work,
self-reports of heavy drinking, and clinically measured liver function. In contrast to the midlife group,
mortality and morbidity have continued to improve for those aged 65 and above. The project will drill down
into these overall statistics, disaggregating by location, by age, by educational group, and by race and ethnicity,
as well as by making comparisons with other wealthy countries. It will also attempt to understand the reasons
behind the decline in midlife health. There are six specific aims: (1) to document the geographical distribution
of the additional midlife deaths across the US and to link mortality and morbidity patterns across space to
spatial patterns of income, poverty, inequality, employment, unemployment, and education, (2) to compare
mortality and morbidity patterns across rich countries, (3) to investigate the racial and ethnic dimensions of
midlife mortality and morbidity change in the US, to try to understand why non-whites and Hispanics have
been largely exempt, (4) to understand the concurrent steepening in mortality and morbidity education
gradients, (5) to investigate the links between morbidity and mortality, and particularly the role of pain, which
has been important in the prescription of opioids, and which is itself a risk factor for suicide, and (6) to
investigate the hypothesis that long-term unfavorable economic changes for those currently in midlife,
particularly those with low educational attainment, have played a role in precipitating increases in morbidity
and mortality. The long-term aim of the project is to understand an important and unusual reversal in the
normal progress of morbidity and mortality decline, and to be better able to predict whether it is a temporary
phenomenon confined to this age group, or whether it is likely to spread into other age groups, particularly the
elderly. Our m...

## Key facts

- **NIH application ID:** 9979723
- **Project number:** 5R01AG053396-05
- **Recipient organization:** NATIONAL BUREAU OF ECONOMIC RESEARCH
- **Principal Investigator:** ANGUS S. DEATON
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $226,285
- **Award type:** 5
- **Project period:** 2016-08-01 → 2022-04-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9979723

## Citation

> US National Institutes of Health, RePORTER application 9979723, Increasing Midlife Mortality and Morbidity in White Americans in the 21st Century (5R01AG053396-05). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/9979723. Licensed CC0.

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