Mortality in midlife for subgroups in Germany

Abstract

Case and Deaton (2015) document that, since 1998, midlife mortality rates are increasing for white non-Hispanics in the US. This trend is driven by deaths from drug overdoses, suicides, and alcohol-related diseases, termed as deaths of despair, and by the subgroup of low-educated individuals. In contrast, average mortality for middle-aged men and women continued to decrease in several other high-income countries including Germany. However, average mortality rates can disguise important differences between subgroups and the phenomenon of increasing mortality rates might also be present for subpopulations in these countries. Hence, we analyze how mortality in midlife is changing for several important demographic subgroups in Germany over the 1990 to 2015 period with a focus on deaths of despair. Our results show a very clear pattern: We find that mortality rates declined between 1990 and 2015, with no increases in deaths of despair for any of the subgroups. Thus, our findings starkly contrast with those for the US.

Comparing gender-specific suicide mortality rate trends in the United States and Lithuania, 1990–2019: putting one of the “deaths of despair” into perspective

“…The current findings suggest that the suicide mortality rate trend in the US is not necessarily an indicator of an upcoming global trend and may in fact be atypical, as Case and Deaton [ 3 ] and others [ 24 ] have postulated with respect to the so-called deaths of despair in general. Even though a similar trend could be occurring elsewhere (for example, see [ 7 ]), it appears to be restricted to certain countries.…”

Suicides, drug poisonings, and alcohol-related deaths cluster with health and social disadvantage in 4.1 million citizens from two nations

“…Prior research has detected steeper rises in mortality from suicide, drug and alcohol poisonings, and alcohol-related diseases among working-age adults in the U.S. relative to other Western nations (Case & Deaton, 2015;Haan et al, 2019;National Academies of Sciences, Engineering, & Medicine, 2021). Consistent with these observations, these deaths were not markedly elevated in our NZ and Danish study populations, and they did not increase across the study period.…”

“…Increases in these deaths have since been observed among other racial/ethnic groups (National Academies of Sciences, Engineering, & Medicine, 2021; Shiels et al, , 2020 and younger working-age adults (25-44 years [National Academies of Sciences, Engineering, & Medicine, 2021]). It has been hypothesized that the steep rise in deaths of despair is largely confined to the U.S. due to three factors that differentiate it from other industrialized countries and underlie increasing inequality in economic opportunity and health: its weaker social-safety net and limited provision of communal supports across the lifespan; costly privatized healthcare system, with healthcare costs borne by employers (and by individuals, among those who are unemployed); and failure to implement strong pharmaceutical regulations (Case & Deaton, 2020a, 2020bHaan, Hammerschmid, & Schmieder, 2019;Sterling & Platt, 2022). However, support for this hypothesis-and associated policies to reduce premature mortality-requires information about deaths of despair in industrialized countries that differ in these contextual factors (King, Scheiring, & Nosrati, 2022).…”

Understanding the Rise in Life Expectancy Inequality

“…We decompose changes in life expectancy inequality into four broad categories: cardiovascular, cancer, miscellaneous lifestyle (smoking, alcohol, and obesity related deaths not classified as cardiovascular or cancer), and other causes. 11 The separation into these four categories is motivated by cardiovascular disease and cancer being leading causes of death, and because what we label as "miscellaneous lifestyle" has been the focus of influential research and the debate on deaths of despair (Fuchs, 1974;Cutler et al, 2011;Ruhm, 2018;Haan et al, 2019).…”