Public Release: 

Death rates, health problems, rise among middle-aged white Americans

Suicide, drug and alcohol poisoning, liver diseases are top causes of death

NIH/National Institute on Aging

Deaths among white U.S. men and women aged 45-54 rose significantly between 1999 and 2013, according to a new analysis. This change reversed decades of progress in mortality and was unique to non-Hispanic whites in the United States. In parallel, morbidity rates increased as well. The study found self-reported declines in health, mental health, and abilities to conduct activities of daily living, accompanied by increases in reports of chronic pain, inability to work, and deterioration of liver function among this group.

Anne Case, Ph.D., and Angus Deaton, Ph.D., of Princeton University, detail these findings in a study published online on November 2, 2015 in the Proceedings of the National Academy of Sciences. The analysis was funded by the National Institute on Aging (NIA), part of the National Institutes of Health.

The three causes of death that accounted for the change in mortality among non-Hispanic whites were suicide, drug and alcohol poisoning, and chronic liver diseases and cirrhosis. The researchers used data from the Centers for Disease Control and Prevention, the U.S. Census Bureau, individual death records, and other sources for their analysis.

From 1978-1998, the mortality rate for middle-aged white Americans fell by an average of two percent per year. This matched the average rate of decline in France, Germany, Canada, Australia, Sweden, and the United Kingdom, as well as the average over all European Union countries. Other rich countries continued to decline at about two percent per year after 1998. The mortality rate for middle-aged people in the United States began to increase by half a percent a year, starting in 1999.

The authors note that the increase in midlife mortality is only partly understood. Increased availability of opioid prescription drugs, chronic pain (for which opioids are often prescribed), and the economic crisis which began in 2008 may all have contributed to an increase in overdoses, suicide, and increased liver disease associated with alcohol abuse. In their discussion, the researchers also noted that the reversal in health trends indicates that today's middle-aged adults will be entering their senior years and Medicare eligibility in worse health than today's adults age 65 and older.


ARTICLE: "Rising Morbidity and Mortality in Midlife Among White non-Hispanic Americans in the 21st Century" by Anne Case and Angus Deaton. Proceedings of the National Academy of Sciences. Published online on November 2, 2015.

SPOKESPERSONS: John Phillips, Ph.D., chief, Population and Social Processes Branch, and Lis Nielsen, Ph.D., chief, Individual Behavioral Processes Branch, NIA Division of Behavioral and Social Research, are available to discuss the article.

CONTACT: To schedule interviews, contact Barbara Cire in the NIA Office of Communications and Public Liaison, (301) 496-1752,

About the National Institute on Aging: The NIA leads the federal government effort conducting and supporting research on aging and the health and well-being of older people. The Institute's broad scientific program seeks to understand the nature of aging and to extend the healthy, active years of life. For more information on research, aging, and health, go to

About the National Institutes of Health (NIH): NIH, the nation's medical research agency, includes 27 Institutes and Centers and is a component of the U.S. Department of Health and Human Services. NIH is the primary federal agency conducting and supporting basic, clinical, and translational medical research, and is investigating the causes, treatments, and cures for both common and rare diseases. For more information about NIH and its programs, visit

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