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Researchers stumble on middle-age mental health crisis

November 9, 2015
by H. Steven Moffic
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The authors of a new publication speculate that there may be a "lost generation" in our midst. In a study1 published in the Proceedings of the National Academy of Sciences, the authors note a big spike in the death rate for middle-aged "white, non-Hispanic Americans" in the United States.

The research indicates that the mortality rate for whites between the ages of 45 and 54 rose dramatically between 1999 and 2013. It had been going in the other direction and falling for the two decades before that period. The authors were surprised, stumbling on these findings by accident.

I suppose we shouldn't be surprised by the finding, given the rightful attention to health disparities among minorities, not whites.

What accounts for these increased deaths? It is not the medical illnesses that one might suspect, like cardiovascular or cancer or diabetes. No, according to the authors, the increase can be attributed to behavioral health disorders—our area of expertise.

There has been a surge in overdose deaths related to prescription opioids and heroin. Moreover, opioids seem to be prescribed more to whites than blacks or Hispanics, perhaps a paradoxical benefit of discrimination in healthcare. There is increased alcohol abuse and addiction, with the consequent increase in related liver disease. And there is the general increase in suicide by any means.

The question, then, is what is the underlying social issue? Is it that the least-educated whites in the United States had the most financial loss and stress? Perhaps for years, an increase in two working parents in a family helped mask the problem of financial troubles, but in time, the solution of working more simply proved ineffective at reducing financial loss and stress.

Is it the pressures of the so-called "sandwich generation," who often care for their children and their aging parents at the same time?

Perhaps the American Dream has been becoming more of a nightmare.

Of course, we in behavioral healthcare can not directly fix these social problems. However, we can pay special attention to this middle-aged, white, socio-cultural group in our systems of care and in our outreach, now that we know they are of high risk. This means special attention to substance abuse and suicidal ideation. It means whatever help we can give for their economic well-being and job retraining.

A "lost generation" would have tragic effects not only on themselves, but also the generations of their children and their parents.

1 Anne Case and Angus Deaton: Rising morbidity and mortality in midlife among white non-Hispanic Americans in the 21st century. PNAS Early Edition, September 17, 2015.

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H. Steven Moffic

H. Steven Moffic

H. Steven Moffic, M.D. retired from the clinical practice of psychiatry and his tenured...