Are America’s whites really dying faster?

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Image caption,
Miners have been a focus of Donald Trump's presidency

America may be one of the richest countries in the world, but the travails of the white working class have captured the nation's imagination - and one struggle in particular.

According to a pair of studies published by two Princeton economists, Anne Case and Sir Angus Deaton, middle-aged white Americans are dying at a higher rate than black and Hispanic Americans.

The research has fed a narrative that white Americans are being left behind - a feeling which has intensified with the growing popularity of Donald Trump.

Case and Deaton were looking at mortality rates – the rate at which people die – for Americans between the age of 45 and 54.

In most countries there has been a strong trend for people to live longer over the past 50 years. But in the case of white Americans aged 45-54, mortality appears to have gone the other way.

Andrew Gelman, a Columbia University statistician, says: "The story of white men not having a place in the world - the loss of blue-collar jobs - that's a very popular story.

"It's a story I've been hearing for most of my life."

But the story this data tells is more complicated.

The headline statistic is about 45-54 year-olds, but the average age within that group has changed over the past 15 years.

There was a baby boom in the years following the Second World War, and the people born in that period are now older.

This means that in the early 2000s more 45-54 year-olds were in their mid-40s, while by 2015 more were in their late 40s and early 50s.

Andrew Gelman explained that "during that period your chance of dying increases by about 8% per year".

"The headline-grabbing statistic is that [white middle-aged mortality] went up. After you adjust for age, it's pretty flat," he said.

And when the results are broken down by gender, what has actually happened is that white middle-aged mortality has increased for women rather than for men.

So while it is the plight of the working-class man that tends to get the attention, the mortality data points to women being more important to the overall trend.

There is clearly something important going on, despite the criticisms of Case and Deaton's work. But what is behind this alarming development in American mortality?

Dr Nan Astone is a senior fellow at the Urban Institute, who has studied the rising mortality of middle-aged white American women.

"We found that about 50% of the increase is due to opioid drug use... for overdose deaths. The other half is really due to an increase in cardiovascular disease and also due to an increase in diseases related to smoking and overeating and drinking," she said.

Although death rates for white Americans are lower than for minorities overall, why some groups of white Americans should be increasingly prone to these unhealthy behaviours remains a mystery.

On average, African-Americans are poorer and have less access to healthcare than white Americans, and yet their death rates are not going up. "It's hard for me to accept the fact that these things which are actually lower for whites are accounting for their increase in death rates," says Nan Astone.