While we're on the subject of declining life expectancies for high school dropouts, here's another look at things:
This is for people with low incomes, which is not the same thing as dropouts. Still, it's in the same ballpark, so this chart tells us a few things:
- Income for the poor has gone up fairly steadily over the past 40 years.
- Poor people have consistently augmented their incomes by about 20% through means-tested government programs.
- Use of Medicaid and CHIP has increased very substantially.
So the answer to stagnant life expectancies probably isn't shrinking incomes. It's not related to the receipt of welfare benefits, either positively or negatively. And it's probably not due to collapsing medical care.
So what is it? Remember, we're looking for something that changed around 1998, and it has to be something that changed a lot more for the poor than the well-off.
If I had to guess, it's something related to diet. But what?
The Atkins diet first became a major fad roughly 1998, but somehow I doubt that this is the causal influence you're looking for.
Did the age profile of deaths change at that time? I'm wondering if we're seeing more deaths younger from opioid abuse or maybe gun suicide.
It could have started before 1998. It might have taken a years before it built up enough to show up.
Fair enough. If we go back 40 years, to 1958, we see the introduction of Rice-a-Roni, the San Francisco treat. Although I suspect we should go back another 4 years, to 1954, when Marshmallow Peeps were first mass-produced.
😄😄😄
C'mon, Kev! This is too easy! Burger King introduced "Cini Minis" in 1998. Of course, Go-Gurt was introduced the following year, and the McFlurry was introduced in 1997, so you can take your pick. Or maybe it's all three!
(If you subscribe to the theory that it takes 20 years for something to have an impact, you can always blame Ben and Jerry, who introduced their ice cream in 1978.)
A steady diet of Fox News? Haha. In reality, this type of analysis requires more distillation. For example we know opioid overdoses have surge dramatically and are now close to 100,000 persons a year. And most of these people are poor and young. How does this affect the averages? And how does the fact that a quarter million young black individuals have been shot to death this century in the drug wars further affect the averages? A back of the hand calculation tells me that these two factors alone have reduced life expectancy on the poor by a few years.
Again, it's meth.
Production moved to rural (poor) areas in the late 90's because the labs stink and are easily detected. Production ramped up around 1998, and escalated rapidly for next 18 years.
Unless you've worked closely with meth users, it's difficult to appreciate the awesome power it has over their lives. Not only is it directly toxic, it causes other behaviors that lead to early death.
I had to evict a "Tweeker". He first complained that "bugs" were in the house. I had a bug guy check out house. No bugs found. Then he complained bugs were coming out of the walls and started tearing holes in the walls to find them. After he was out I had to have the house checked to see if he was cooking.
In 25 years as an evil landlord I never had a "good" tenant.
Lucky for me house prices in San Jose exploded.
Increased varieties of artificial sweeteners?
1) Diet. Ultraprocessed foods.
2) Opioids.
3) Guns.
And I have a question about the chart: is it individual incomes or household incomes? If it's households then that $10k/yr in Medicaid isn't going to do much.
Is it guns combined with increased anxiety cultivated by wingnut propaganda?
just because medicaid spending has gone up doesn't mean usage has risen at the same rate
if co-pays for medicine/office visits/etc. have gone up, people could be avoiding treatment
Corresponds roughly to when oxycontin came on the market (~2 year lag)
Fox News. Hit the cable systems in Oct. 1996.
+1
I'll go with despair. (BTW despair.com is a great website full of demotivating posters and the like. Check it out.) This is the blue collar end game. There used to be a lot more blue collar jobs that offered a lot more than just scraping by, and you didn't have to have a lot in the way of smarts. Not everyone is born with smarts. American industry was imploding in the 1970s and the unions went with it, but the impact didn't really hit for a few decades. First, industry moved to the south. Then it moved to Mexico and then China. Then China joined the WTO.
It wasn't all China. Computers simplified a lot of design and more modern equipment eliminated jobs by the tens of thousands. A modern automobile has maybe 5-10 labor hours in it as opposed to around 100 a century ago. This kind of thing took a while to ripple through. I remember when NYC was an industrial power. I even had a high school summer job in a machine shop in Sunnyside. Into this century, there was still a factory making anti-icing boots for small planes above the Film Forum on Houston Street in NYC. An entire class of jobs and a way of life has vanished. You have to go to Wikipedia to find out what "table money" was.
Look at what happened when the USSR collapsed. The male death rate soared. The drug of choice was vodka, but it could have been meth or heroine or driving too fast or waving one's gun while arguing with friends. The female death rate rose as well, just not as dramatically. Women have other survival strategies. (When the Viking Greenland colony collapsed, the women left and lived with the locals.) The entire economic system people were used to was gone, and there was nothing to replace it. It was a form of mass suicide, and it happened in the US, just ten years later and slightly more gradually.
Indeed. When I was in high school, I had a summer job working in a small print shop, in Great Neck, NY. It was a small company, and as a summer worker, I wasn't trusted to operate the presses, just do manual collation of the final results.
I'd bet that computerization of the printing industry took out that place, and its half-dozen jobs non-college degree jobs.
I had one other normal job before I started working as a student programmer writing an OS at MIT. I was working for a freight forwarder in the WTC, doing a repetitive office job that's almost certainly been automated away, watching for the arrival of ships in NY by reading the Journal of Commerce, scanning for certain ship names, and dispatching trucks to pick up our containers, or partial containers. That office probably had 50 people working in it, and I bet almost all of those jobs are just functions provided by shipping companies' software these days.
That was all in the mid-to-late 1970s. It's really a different economy these days.
I suspect that the underlying drivers include cigarette smoking. Smoking rates started diverging by class in the 1970's, but that divergence continued over time. It's hard to get good numbers, because smoking doesn't cause many deaths in the short-run, but I suspect that by the late 1990's the difference in lifetime smoking among 60-year-olds starts to impact life expectancy.
One rather has to suspect that this is a subject area where single cause analysis is never going to result in a clear causal linkage for a single cause. Drum has a strong tendency to have a mono-causal lens.
In this sense one probably needs to have - and that is of course challenging - to have a multi-factor analysis where in some socio-economic classes and geographies (together) several single factors work together.
Sometimes the data fit multi-factor causation, and sometimes not. Drum claims that the life expectancy divergence impacting high school dropouts appears quite suddenly and rather dramatically around 1998. To my mind that suggests a single, dominant cause is more likely than several.
My guess is opioids. Oxycontin was approved for use in the US in 1996.
Poverty!!
Clinton gutted welfare in 1996, imposing a work requirement and putting in a five-year lifetime cap for welfare assistance (now TANF) … the work requirement flooded the labor market with low-wage, unskilled labor, allowing employers to demand more and give less in return for labor. You get fired? You lose welfare.
The floor dropped out from under the poor. As of 2015 there were 4.5 million Americans living on just $2 a day, including all welfare businesses. The answer is clearly poverty.
Well, if you look at the stats -- https://www.statista.com/statistics/200463/us-poverty-rate-since-1990/ -- you can see that poverty rates were dropping throughout the 1990s, and the downward slope only got steeper starting in 1996.
IIRC, Clinton also greatly increased the EITC, which is probably a more useful anti-poverty program than welfare. Politically, Clinton took the wind out of Republicans' attacks on Democrats, as well.
Note that replacing AFDC with TANF got rid of one of the most pernicious parts of AFDC -- that only single mothers could receive AFDC. And if you look at the growth rate of Black single mothers (who were at the time the poorest single mothers being tracked, and thus most likely to be on AFDC), the rate abruptly levels off from its steep growth path around, you guessed it, 1996. So, you could argue, and I am arguing, that Clinton's welfare reform was a force for stability in poor families.
The EITC only applies to those who have an income to earn credit against. There are a lot of people with no income or income outside of the tax system.
Additionally one of these charts points to data saying poverty increases starting in 1998, and another indicates the steep rise in extreme poverty that welfare used to mitigate against.
https://www.washingtonpost.com/news/wonk/wp/2016/08/22/the-enduring-legacy-of-welfare-reform-20-years-later/#
I'd say lack of emergency care in rural areas. The number of hospitals in rural and poor areas shrank much more than the population.
But suddenly, starting about 1998?
Computers. More low wage jobs that are totally sedentary leads to the rise in obesity and thus affects low-skilled workers dependent on these jobs. Cheapest entertainment is a large screen TV completes the cycle of lower life expectancy for those who can’t escape a sedentary lifestyle.
Higher paid, more highly educated workers tend to have sit down jobs in much greater proportion than poorer people and high school dropouts. I really doubt that's it. And TV has been around since the 1950s.
I have a problem with statistics that use means or medians because they hide the details. A cursory look at the news tells me that Medicaid access remains a battle ground in red states. So the fact that Medicaid is helping the poor get medical care ON THE AVERAGE tells me nothing about exactly whom among that group actually get medical care versus those with more traditional insurance. It also tells me nothing about the effectiveness of care received via Medicaid in areas with few-to-no doctors.
The late 1990's is when there was a major shift in health insurance, and we went from policies that paid for. whatever care you wanted to managed care, where a primary care doctor needed to approve care. Perhaps that gatekeeping caused part of the problem.
Another part is that primary care doctors began to prescribe more pain killers and less physical therapy because it was cheaper to provide a pill than a session with a living person.
And of course there were increases in meth, the shift in gun advertising from hunting to protection and the advent of Fox News.
But lest we get to sidetracked in things ordinary, lower-income folk might be able to control, lets not forget the food supply; most particularly Monsanto and the spraying of nearly all our nations wheat crops with glyphosate to desiccate the stalks so that the whole crop can be harvested at the same time, and there's less loss to the natural ripening pattern from bottom to top of the stem.
Opioids. Nothing explains a sudden divergence in the late 90s Oxycontin was approved in 1996. You'd expect a divergence affecting the most poorly paid workers because they're the kind of folks most likely to get injured on the job (warehouse workers, cleaners, retail, hotels, factories, etc), and thus prescribed painkillers. They're also far less likely than more affluent workers to lack the kind of health insurance that covers addiction treatment.
Maybe it was the on again-off again of McRibs on the Mickey D menu.
I have excellent teeth and on the two occasions I tried them I ended up having to take them out of the bun and cutting them with a knife. My teeth literally bounced off them.
Then again, it might be whatever on God’s green earth they used to make the fake BBQ sauce.
Maybe it was the on again-off again of McRibs on the Mickey D menu.
I have excellent teeth and on the two occasions I tried them I ended up having to take them out of the bun and cutting them with a knife. My teeth literally bounced off them.
Then again, it might be whatever on God’s green earth they used to make the fake BBQ sauce.