# Why did poorly educated whites' dysfunction, poor health, and death start rising in the late '90s?

**URL:** <https://boards.straightdope.com/t/why-did-poorly-educated-whites-dysfunction-poor-health-and-death-start-rising-in-the-late-90s/749164>\
**Category:** Factual Questions\
**Created:** [March 16, 2016, 2:22pm UTC](https://boards.straightdope.com/t/why-did-poorly-educated-whites-dysfunction-poor-health-and-death-start-rising-in-the-late-90s/749164 "2016-03-16T14:22:32Z")\
**Posts on this page:** 20\
**Page:** 1

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**Author:** ![SlackerInc](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/slackerinc/32/275_2.png) [@SlackerInc](https://boards.straightdope.com/u/SlackerInc)\
**Post date:** [March 16, 2016, 2:22pm UTC](https://boards.straightdope.com/t/why-did-poorly-educated-whites-dysfunction-poor-health-and-death-start-rising-in-the-late-90s/749164/1 "2016-03-16T14:22:32Z")

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It seems to have started, [if you look at the graph in this NYT article](http://www.nytimes.com/2015/11/03/health/death-rates-rising-for-middle-aged-white-americans-study-finds.html?_r=1), before any economic problems hit them: employment was high, wages were rising. But they have increasingly been dying from suicide, drug overdose and alcohol-related problems like cirrhosis. Experts are puzzled, but they do note that:

> [@](#):
>
> Increases in mortality rates in middle-aged whites rose in parallel with their increasing reports of pain, poor health and distress…

One thing I wondered was why there was no mention of nutrition or obesity in the article. They should have talked to Michael Pollan. Smoking is still rampant among that group as well, although I’m not sure if it has actually gone up since the mid-'90s. Any other hypotheses?

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**Author:** ![Really\_Not\_All\_That\_Bright](https://avatars.discourse-cdn.com/v4/letter/r/e8c25b/32.png) [@Really\_Not\_All\_That\_Bright](https://boards.straightdope.com/u/Really_Not_All_That_Bright)\
**Post date:** [March 16, 2016, 2:30pm UTC](https://boards.straightdope.com/t/why-did-poorly-educated-whites-dysfunction-poor-health-and-death-start-rising-in-the-late-90s/749164/2 "2016-03-16T14:30:18Z")

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If you look at the article and the study, you can see that opioid dependence (substance abuse being one of the main drivers of the increased death rates) is much higher among middle-aged whites because they are much more likely to be prescribed opioids. It doesn’t explain why _that_ is the case, and the authors note that the phenomenon does not fully account for the increased death rate.

I suspect the overall trend - particularly among the less educated - is driven by stagnation in the employment market.

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**Author:** ![SlackerInc](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/slackerinc/32/275_2.png) [@SlackerInc](https://boards.straightdope.com/u/SlackerInc)\
**Post date:** [March 16, 2016, 2:37pm UTC](https://boards.straightdope.com/t/why-did-poorly-educated-whites-dysfunction-poor-health-and-death-start-rising-in-the-late-90s/749164/3 "2016-03-16T14:37:13Z")

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But it started well before that stagnation.

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**Author:** ![Really\_Not\_All\_That\_Bright](https://avatars.discourse-cdn.com/v4/letter/r/e8c25b/32.png) [@Really\_Not\_All\_That\_Bright](https://boards.straightdope.com/u/Really_Not_All_That_Bright)\
**Post date:** [March 16, 2016, 2:38pm UTC](https://boards.straightdope.com/t/why-did-poorly-educated-whites-dysfunction-poor-health-and-death-start-rising-in-the-late-90s/749164/4 "2016-03-16T14:38:38Z")

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Wages were rising among the more well-to-do in that period. But wages were falling relative to inflation for the lower income quintiles (or at least not rising much).

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**Author:** ![SlackerInc](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/slackerinc/32/275_2.png) [@SlackerInc](https://boards.straightdope.com/u/SlackerInc)\
**Post date:** [March 16, 2016, 2:42pm UTC](https://boards.straightdope.com/t/why-did-poorly-educated-whites-dysfunction-poor-health-and-death-start-rising-in-the-late-90s/749164/5 "2016-03-16T14:42:34Z")

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[Take a look at this graph.](http://graphics8.nytimes.com/images/2011/11/02/opinion/110211krugman2/110211krugman2-blog480.jpg) I don’t see the correlation.

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**Author:** ![puddleglum](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/puddleglum/32/137_2.png) [@puddleglum](https://boards.straightdope.com/u/puddleglum)\
**Post date:** [March 16, 2016, 3:41pm UTC](https://boards.straightdope.com/t/why-did-poorly-educated-whites-dysfunction-poor-health-and-death-start-rising-in-the-late-90s/749164/6 "2016-03-16T15:41:18Z")

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In the article it says the increase in mortality is entirely due to increases and suicides, alcoholic liver disease, and drug overdoses.  
I am not an expert but I have heard that the two most popular types of drugs among the demographic are opiod painkillers and benzo sedatives. Both of these drugs depress breathing and taken together they are very deadly.

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**Author:** ![Try2B\_Comprehensive](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/try2b_comprehensive/32/65_2.png) [@Try2B\_Comprehensive](https://boards.straightdope.com/u/Try2B_Comprehensive)\
**Post date:** [March 16, 2016, 4:30pm UTC](https://boards.straightdope.com/t/why-did-poorly-educated-whites-dysfunction-poor-health-and-death-start-rising-in-the-late-90s/749164/7 "2016-03-16T16:30:02Z")

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NAFTA took effect in 1994…

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**Author:** ![SlackerInc](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/slackerinc/32/275_2.png) [@SlackerInc](https://boards.straightdope.com/u/SlackerInc)\
**Post date:** [March 16, 2016, 4:50pm UTC](https://boards.straightdope.com/t/why-did-poorly-educated-whites-dysfunction-poor-health-and-death-start-rising-in-the-late-90s/749164/8 "2016-03-16T16:50:56Z")

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So it’s just a socially spread epidemic of drug and alcohol abuse that doesn’t have any particular cause?

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**Author:** ![Bear\_Nenno](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/bear_nenno/32/3358_2.png) [@Bear\_Nenno](https://boards.straightdope.com/u/Bear_Nenno)\
**Post date:** [March 16, 2016, 5:56pm UTC](https://boards.straightdope.com/t/why-did-poorly-educated-whites-dysfunction-poor-health-and-death-start-rising-in-the-late-90s/749164/9 "2016-03-16T17:56:39Z")

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Jerry Springer

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**Author:** ![SlackerInc](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/slackerinc/32/275_2.png) [@SlackerInc](https://boards.straightdope.com/u/SlackerInc)\
**Post date:** [March 16, 2016, 6:02pm UTC](https://boards.straightdope.com/t/why-did-poorly-educated-whites-dysfunction-poor-health-and-death-start-rising-in-the-late-90s/749164/10 "2016-03-16T18:02:44Z")

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> [@Bear\_Nenno](#):
>
> Jerry Springer

Haha, this FTW.

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**Author:** ![j666](https://avatars.discourse-cdn.com/v4/letter/j/9de0a6/32.png) [@j666](https://boards.straightdope.com/u/j666)\
**Post date:** [March 16, 2016, 9:57pm UTC](https://boards.straightdope.com/t/why-did-poorly-educated-whites-dysfunction-poor-health-and-death-start-rising-in-the-late-90s/749164/11 "2016-03-16T21:57:07Z")

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> [@Try2B\_Comprehensive](#):
>
> NAFTA took effect in 1994…

But the good blue collar jobs were gone long before that.

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**Author:** ![Ruken](https://avatars.discourse-cdn.com/v4/letter/r/f475e1/32.png) [@Ruken](https://boards.straightdope.com/u/Ruken)\
**Post date:** [March 16, 2016, 11:06pm UTC](https://boards.straightdope.com/t/why-did-poorly-educated-whites-dysfunction-poor-health-and-death-start-rising-in-the-late-90s/749164/12 "2016-03-16T23:06:08Z")

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Here’s a graphical representation of the most common jobs by income decile. I wonder how similar historical plots look, especially wrt to “good blue collar jobs”.

> **[The Most Common Jobs For The Rich, Middle Class And Poor](https://www.npr.org/sections/money/2014/10/16/356176018/the-most-popular-jobs-for-the-rich-middle-class-and-poor)**
>
> What do people up and down the income ladder do for work?

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**Author:** ![j666](https://avatars.discourse-cdn.com/v4/letter/j/9de0a6/32.png) [@j666](https://boards.straightdope.com/u/j666)\
**Post date:** [March 17, 2016, 12:19am UTC](https://boards.straightdope.com/t/why-did-poorly-educated-whites-dysfunction-poor-health-and-death-start-rising-in-the-late-90s/749164/13 "2016-03-17T00:19:34Z")

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> [@Ruken](#):
>
> Here’s a graphical representation of the most common jobs by income decile. I wonder how similar historical plots look, especially wrt to “good blue collar jobs”.  
> [The Most Common Jobs For The Rich, Middle Class And Poor : Planet Money : NPR](http://www.npr.org/sections/money/2014/10/16/356176018/the-most-popular-jobs-for-the-rich-middle-class-and-poor)

The only classic “good blue collar job” on that list is truck driver and, maybe, police. There are no manufacturing jobs at all.

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**Author:** ![SlackerInc](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/slackerinc/32/275_2.png) [@SlackerInc](https://boards.straightdope.com/u/SlackerInc)\
**Post date:** [March 17, 2016, 12:19am UTC](https://boards.straightdope.com/t/why-did-poorly-educated-whites-dysfunction-poor-health-and-death-start-rising-in-the-late-90s/749164/14 "2016-03-17T00:19:57Z")

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Great NPR link, thanks.

> [@j666](#):
>
> But the good blue collar jobs were gone long before that.

It’s a good point. But now you have got me thinking that maybe it’s something like what Freakonomics has shown in terms of the effect of Roe v Wade on violent crime. Could it be that the dysfunction is a lagging indicator of as much as a generation after the good blue-collar jobs disappear? Maybe being raised in a home with unemployed parents, or spending one’s twenties and thirties with a struggling situation is required before this kicks in.

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**Author:** ![j666](https://avatars.discourse-cdn.com/v4/letter/j/9de0a6/32.png) [@j666](https://boards.straightdope.com/u/j666)\
**Post date:** [March 17, 2016, 12:49am UTC](https://boards.straightdope.com/t/why-did-poorly-educated-whites-dysfunction-poor-health-and-death-start-rising-in-the-late-90s/749164/15 "2016-03-17T00:49:18Z")

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Doesn’t everyone spending their 20s and 30s struggling?

Still, people who were 45 - 54 in 1998 were poor in 1944 - 1953 - they were the first wave of Boomers, weren’t they? They grew up in the Golden Years for their demographic.

At least until the unions were crushed and the U.S. abandoned a manufacturing base.

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**Author:** ![Ruken](https://avatars.discourse-cdn.com/v4/letter/r/f475e1/32.png) [@Ruken](https://boards.straightdope.com/u/Ruken)\
**Post date:** [March 17, 2016, 12:56am UTC](https://boards.straightdope.com/t/why-did-poorly-educated-whites-dysfunction-poor-health-and-death-start-rising-in-the-late-90s/749164/16 "2016-03-17T00:56:36Z")

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> [@j666](#):
>
> The only classic “good blue collar job” on that list is truck driver and, maybe, police. There are no manufacturing jobs at all.

But is that much different from how it was before the trend in the OP? Goods-producing jobs are only 14% of non-ag wage/salaray (i.e. not self-employed) jobs today. And the number of those jobs has certainly decreased. But not by as much as the increase in service-providing jobs (3 new service jobs for every lost goods job 2004-2014). But I don’t have a good data rundown for the 90s. I’m sure BLS has what we need; I just haven’t found it yet.  
[http://www.bls.gov/emp/ep\_table\_201.htm](http://www.bls.gov/emp/ep_table_201.htm)

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**Author:** ![Ruken](https://avatars.discourse-cdn.com/v4/letter/r/f475e1/32.png) [@Ruken](https://boards.straightdope.com/u/Ruken)\
**Post date:** [March 17, 2016, 1:18am UTC](https://boards.straightdope.com/t/why-did-poorly-educated-whites-dysfunction-poor-health-and-death-start-rising-in-the-late-90s/749164/17 "2016-03-17T01:18:14Z")

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Ok here we go. We need to look at these time series:

[Total nonfarm](http://data.bls.gov/timeseries/CES0000000001)  
[Goods-producing](http://data.bls.gov/timeseries/CES0600000001)  
[Manufacturing](http://data.bls.gov/timeseries/CES3000000001)

I couldn’t find a way to build the year range into the URL.

Plenty of other series here: [http://www.bls.gov/web/empsit/cesseriespub.htm](http://www.bls.gov/web/empsit/cesseriespub.htm)

Nothing really funny going on in the 90s with either manufacturing or all goods-producing jobs. Maybe we need to break it down into smaller industrial subclasses. But then we’re not really talking about a lot of people.

Now, these are just jobs. They don’t count unemployed folks in these tables. So maybe that’s what I’m missing.

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**Author:** ![j666](https://avatars.discourse-cdn.com/v4/letter/j/9de0a6/32.png) [@j666](https://boards.straightdope.com/u/j666)\
**Post date:** [March 17, 2016, 2:21am UTC](https://boards.straightdope.com/t/why-did-poorly-educated-whites-dysfunction-poor-health-and-death-start-rising-in-the-late-90s/749164/18 "2016-03-17T02:21:37Z")

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Just compare the trends of total non-farm to goods producing & manufacturing from 1972 through 2000; non-farm shows a steady increase, nearly doubling in the period while the goods producing rose less than 15% and manufacturing was flat.

Imagine being that age, unemployed, and realizing you are never going to get a good job again, not because of anything you can fix, but because the jobs just aren’t there.

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**Author:** ![Ruken](https://avatars.discourse-cdn.com/v4/letter/r/f475e1/32.png) [@Ruken](https://boards.straightdope.com/u/Ruken)\
**Post date:** [March 17, 2016, 2:39am UTC](https://boards.straightdope.com/t/why-did-poorly-educated-whites-dysfunction-poor-health-and-death-start-rising-in-the-late-90s/749164/19 "2016-03-17T02:39:09Z")

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But why the sudden shift in the 90s that the nytimes article discusses? I’m trying to tie it to something changing, but I don’t know what that something is.

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**Author:** ![Squink](https://avatars.discourse-cdn.com/v4/letter/s/b5e925/32.png) [@Squink](https://boards.straightdope.com/u/Squink)\
**Post date:** [March 17, 2016, 2:56am UTC](https://boards.straightdope.com/t/why-did-poorly-educated-whites-dysfunction-poor-health-and-death-start-rising-in-the-late-90s/749164/20 "2016-03-17T02:56:07Z")

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Here’s a nice graph: [Per capita health care spending 1970-2007](https://www.washingtonpost.com/business/economy/the-history-of-health-care-spending-in-7-graphs/2012/01/09/gIQAFlCCmP_gallery.html)  
Things got steep in the US in the 90’s. Wages did not rise in synchrony.

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