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Am J Public Health. 2018 Dec;108(12):1626-1631. doi: 10.2105/AJPH.2018.304585. Epub 2018 Sep 25.

America's Declining Well-Being, Health, and Life Expectancy: Not Just a White Problem.

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Peter A. Muennig is with the Department of Health Policy and Management, Mailman School of Public Health, Columbia University, New York, NY. Peter A. Muennig and Zafar Zafari are with the Global Research Analytics for Population Health Center, Mailman School of Public Health. Megan Reynolds is with the Department of Sociology, University of Utah, Salt Lake City. David S. Fink is with the Department of Epidemiology, Mailman School of Public Health. Arline T. Geronimus is with Health Behavior and Health Education, School of Public Health and the Population Studies Center, Institute for Social Research, University of Michigan, Ann Arbor.


Although recent declines in life expectancy among non-Hispanic Whites, coined "deaths of despair," grabbed the headlines of most major media outlets, this is neither a recent problem nor is it confined to Whites. The decline in America's health has been described in the public health literature for decades and has long been hypothesized to be attributable to an array of worsening psychosocial problems that are not specific to Whites. To test some of the dominant hypotheses, we show how various measures of despair have been increasing in the United States since 1980 and how these trends relate to changes in health and longevity. We show that mortality increases among Whites caused by the opioid epidemic come on the heels of the crack and HIV syndemic among Blacks. Both occurred on top of already higher mortality rates among all Americans relative to people in other nations, and both occurred among declines in measures of well-being. We believe that the attention given to Whites is distracting researchers and policymakers from much more serious, longer-term structural problems that affect all Americans.

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