What should be huge medical news is that the mortality rate (the rate at which people die) for white men and women aged 45 to 54 with less than a college education is rising in this country. This despite all the money that is spent on health care. This just does not happen. Why is this? Per the Washington Post:

“Drugs and alcohol, and suicide . . . are clearly the proximate cause,” said Angus Deaton, the 2015 Nobel laureate in economics, who co-authored the paper with his wife, Anne Case. Both are economics professors at Princeton University.


And we are talking about a lot of excess deaths

Based on the findings, Deaton and Case calculated that 488,500 Americans had died during that period who would have been alive if the trend hadn’t reversed.

There is a lot of speculation about the exact why and more studies are certain to follow, It is clear that the economic recovery has left these people behind and it is also clear that the safety net, including mental health but also including meaningful retraining, has not been effective for this group of people. For now, as a physician I need to do a better job of screening for pathological substance use and mental illness, As citizens we all need to advocate for more, not less, support services for this at risk population. As people, we can all say out neighbor “Is there anything I can do to help?”