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What’s killing some Virginians who should be in the prime of their working lives?
It’s complicated.
While overall life expectancy for whites in Virginia has increased by 16 percent from the mid-1990s through 2014, death rates in those aged 25 to 54 skyrocketed in several stress-related categories, according to a study released today by Virginia Commonwealth University’s Center on Society and Health.
Deaths from drug overdoses, suicides, alcohol poisoning and alcoholic liver disease accounted for most of the rise and were grouped as a composite measure in the study called Stress-Related Conditions. They accounted for an 83 percent increase in deaths in white Virginians from 1995 to 2014, and were responsible for 2,300 more deaths than would otherwise have occurred. About 66 percent of the excess deaths stem from unintentional drug overdoses.
Overall, there was a 331 percent rise in drug overdose deaths over the two decades. Alcohol poisoning accounted for a 37 percent increase in fatalities, and suicides rose 29 percent in the study period.
Mortality increases were especially prevalent in rural, more remote areas of the commonwealth, especially in south and southeast Virginia and in east Virginia. The higher the unemployment rate, the higher the death rate. Lower education levels and less access to mental health and primary health are also major factors adversely affecting longevity in the population.
The study, “Why Are Death Rates Rising in Virginia’s White Population?” follows similar projects that were conducted in California and Missouri. Those studies found that the stress-related conditions were affecting people living in rural areas and that major urban areas were mostly bypassed, but in Virginia, the white population across the state was affected, according to Steven Woolf, a physician and director of the center.
Around metro Richmond, whites in the city itself did not experience a higher mortality rate, but there were spikes reported in Chesterfield, Hanover and Henrico counties. Drug overdose deaths in the study period surged 319 percent in Chesterfield County and by 134 percent in Henrico County, according to the report. Overall in Central Virginia, drug overdoses increased 214 percent, and the suicide rate rose by 24 percent since 1995.
The researchers call for “focusing upstream” in finding a solution, not addressing problems piecemeal. Various policies seek to improve the economy and add jobs, improve health care, and battle drug abuse, but “it’s a matter of connecting the dots” to tie them together, says Woolf.
Policy makers need to be mindful that people facing economic challenges of low income and high unemployment may also face less access to mental health care and to primary health care as well. They face more stress and have less of a safety net on which to fall back.
“It’s really a bad time to weaken access to health care,” says Woolf.
As the study notes, “Addressing the economy and alleviating the hardships responsible for the chronic stress experienced by children and adults may do more to alleviate desperation and may save more lives than focusing exclusively on symptoms.”
The study also calls for additional research to untangle the various factors behind the rise in deaths. Researchers cite one vein of thought that contends adverse health among the groups seeing greater mortality stems from greater stresses and unmet expectations. In the decades after World War II, their parents had enjoyed economic stability, had jobs that were secure throughout their careers and were more affluent than previous generations. That stability no longer exists, and current generations are facing hardships to which they are unaccustomed. That can result in unhealthy coping mechanisms such as increased use of tobacco, alcohol and drugs, stress eating, less exercise, and violence.
The increased mortality rates seen in whites are not occurring in people of color, according to the study. Researchers note that people of color already face higher mortality rates than whites overall. The death rate of blacks in Virginia is about 1.2 times higher than in whites.
Researchers note that the study “does not, and should not, distract attention from addressing the causes, historic and otherwise, of the inequities that have undermined the health of other racial groups. However, understanding the factors responsible for recent mortality trends in the white population is also important — not only to address the public health crisis in that population but also to signal disturbing health trends that could be affecting other groups.”
