the people who are affected. >> people need to demand reform... >> ali velshi on target. >> one solid assumption that you could makeover time was that americans werelistic longer and longer. improvements in healthcare, in infant mortality, in science, and the viper. it was thought, pushing the numbers, and why people were the primary beneficiaries. new research from a nobel prize-winning economist turned up numbers glowing them out of his seat. white, middle-aged americans, have seen their death rates surge from a variety of causes since 1999. what does this tell us about today? the miles per hour way of

death. it's the "inside story." welcome to "inside story," i'm ray suarez. the new numbers, published in the proceedings of the national academy of sciences turn what you think you know about this country upside down. in 1850, an american's life expectancy at birth was barely 40 years, and 100 years later, 65. and half a century later, another decade had been added on. most of the increase was due to increase in infant mortality. but even allowing for that, you might assume that the progress would go on and on. and for sure, conversation busy medicine, retirement and aging are all premised on the idea that the trend line would

simply go higher and higher. that's why a surge showing a startling increase in the death rate of middle-aged white americans is surprising. more middle-aged americans are dying than before. specifically those without higher education. those are the findings by princeton economists, who won the noble prize last month, and his wife. they were studying statistics on happiness and suicide when they noticed unprecedented numbers. a spike in the suicide rate among the american white hen and women between the ages of 45 and 54 with no more than a high school dippa. that led them to uncover a surge in the overall death rate of that group. by 134 deaths per 100,000

people. more than 32%. at the same time, nearly every other race and ethnicity, every other age group, in every other developed nation, saw a decrease in the death rate. however, the findings indicate that suicide alone does not account for the jump. substance abuse is also playing a significant role. role afflictions like overdoses and opioid are contributors. death fell among middle-aged americans with a college degree, bull the increase was so large with those with a high school education or less. it's not clear why other groups are being spared, though researchers have several theories, including racial differences in the use and misuse of prescription drugs,

and a more pessimistic financial outlook among whites. still, it provides new evidence in a dommography that they have been looking at for years, declining health of poorly educated white americans. ellen mira, associate professor at the dartmouth institute, and david weir, the director of health and retirement study on the demography of ages. professor mira, has there ever been anything like this in history? such a large group of people in such a short amount of style, seeing such a change in their fortunes? >> well, i think that we haven't seen anything like this in repeat periods. it's really unprecedented, particularly as you look at the least educated. and you look at that rise of

134 deaths per 100,000. and it starts to make you think about other settings, like the rise in mortality for russian men straddling the collapse of the soviet union. that was a little bit larger, but still, the magnitudes are in the same ballpark. >> and just to be sure, when numbers of people look over something like this, 132 per 100,000 is not a small number. >> no, that's not a small number. the numbers are really quite large by historical standards, and as was pointed out, in all of the other groups, these numbers are falling, and not rising. they're actually falling. so anything positive is big, but 134 is quite large. >> david weir, the concentration, as we mentioned before, in a certain segment of americans.

white americans, 35-54, is so heavy that even though other people in that same age group is experiencing increases, it's bending the curve down. that places the distress really in one part of the population, doesn't it? >> well, it does seem to. two things about that. one of course, you mentioned african-americans, their mortality rates are still quite a bit higher than those of whites, and they have not seen the increase. but we found for whites in this age group, i would say though, that things are not that rosie for american health in other age groups either. america is falling behind other countries in the world at the

same level of income at a pretty rapid pace. so what they have found in this paper is really two things i think. one, the phenomenon that we focused on, about increasing mortality and problems, specific to the white population and middle age, and secondly, a more general phenomenal, lagging health in the u.s. >> david, where you mentioned health as a general category, but isn't it significant that these are preventable causes of death that have been identified by case? >> so absolutely right. so the things that they focus on, largely external causes, things that we think could be prevented in some way, though i wouldn't say that we're ready to hand solutions for them either. but the other age groups, and indeed a large part of the fact

that this age group did not improve over the last 15 years, that's spread over a much wider range of causes, and it's not just specific to suicide and poisoning. >> doctor chiny, you have won awards for your data driven journalism, so you look at a variety of sources, and when this crossed your desk, what did you make of it. >> i was surprised as everybody was surprised. but i've been out on the road to a lot of places in the country where there's not a lot of hope. and you've been there too. and some of this isn't completely surprising. the american communities project, one thing that i looked at three distinct parts of the country. county types, one is evangelical centers, the bible belt. and appalacha, and then graying america, elderly, north and the west. and all of these places share a couple of common traits.

the large non-hispanic white population, up over 780%. a lot of rural population, low education levels, and the higher than average unemployment rates. now, the higher than average unemployment rates, only half a percentage point higher, and still significant, but not enormous, where you really see the differences when you look at workforce participation rates in these places. extremely high for those not participating. 44%, 45%. and almost half of the population 60 and over not in the work force. these are older populations, retirees, and maybe people who want to stay home and not work. but when you compare those numbers to metropolitan areas, the numbers are a lot higher. it does suggest that [ audio difficulties ] it's right in front of your face, you can see it. >> we'll talk more about that

as the show continues, and guests, stand by. we turn our attention to life in america for the 21st tre. for a large group of americans, middle-aged whites, are there reports coming across the country about the losses, the economic devastation x. the despair in middle class communities, not just the temporary set back to be endured, but the american disaster, the way of death. it's "inside story." >> tough that the country gave up on me. >> look at the trauma... every day is torture. >> this is our home. >> nobody should have to live like this. >> we made a promise to these heroes... this is one promise americans need to keep.

>> new research, published in the proceedings of science, showing why middle aged americans are dying at not unusually high and growing rate and dying of preventible causes. what's going on in working class white communities that's pushing these numbers?

and as we talk about the stress factors, chronic pain, drug addiction and losses, why aren't the latino communities suffering the same fate? david, we're inside of a community that once had a factory that was the main employer, and that's gone. in a place where you have high concentrations of lightly educated people, what's the health profile? are people likely not to see doctors as often? are people more likely not to get treatment for the things that are bothering them? and let's face it, at an age where you start to have more aches and pains, into your 50s. >> well, i'm talking to you from southeastern michigan, close to detroit. so we know something about economic deterioration and stress. i think it's pretty clear that a lot of the health problems that we see are not manufactured in the doctor's office.

they come in to be, and these conditions, that's a problem with american health. and i think specifically with poor health of less educated people in less well off communities. so i think that's the place to look, more so than the healthcare system itself. >> doctor chiny, you were talking in the last segment about life in these opportunities that you categorized in your research. has there been a sort of bifurcation or trifur case of society more than places like orlando have? >> i grew up outside of detroit. and the other community that i think we're going to see affected, we need to do a

geographic cut of the state, but i think that the other thing you'll see, the places around the big cities, in detroit, the important thing, with the education, go out and get another job. the employer isn't there to employ you, and i spent time in ohio, you talk to people there, and the place has been chronically depressed for the past 34 years, and they're talking about how they're going to fix everything and make it better, but the bottom line, it's not that simple. when you talk to the politicians about what you're going to do, we're going to unleash the entrepreneurial spirit. and that's a great idea. but these people spent their lives working on assembly lines, and they're not just going to make apps tomorrow. they have a set of skills in

the economy, and it's hard for them to make it work. >> professor mira, the research projects took a stab at trying to identify some is of the sort of paths that people were taking to an early grave. and talked a little bit about for instance, after a while, moving on to how they take the depression to a hard and fast data to understand? >> to see the rise in overdose deaths related to prescription drugs, see the rise in overdose that's related to heroin, as well as household surveys,

which do bear out that folks who starting treated with prescription opioids will often switch to heroin, and that's also born out in treating those population, they're saying that the dep graphic has changed in who they're treating, and they're seeing more people who have problems of abuse, opioids, both legal and illegal. and so i think that you can look to these numbers and think about how these are changing. to look at how that plays into it. but i would follow up on david weir's comment and there's more here than just opioids at hand. you're seeing the stagnation around mortality and other causes as well. >> yes, stay with us. when political reporters come back from the field, with stories of white anger and

alienation and loss and painful yearning, does it mesh with what we're seeing in the numbers? the american way of death. stay with us, it's "inside story." inside story."

>> welcome do "inside story," i'm ray suarez. the mortality rate for middle-aged whites fell, and fell substantially from 1978 to 1998. starting in 1999, something curious happened, those gains changed direction for whites with a high school diploma or less. for the first does years in the new century, their mortality rates rose by a shocking 22%. yes, we had a terribly destructive recession, and whites with less education suffered worse than their peers

with education, but hispanics and blacks didn't see similar increases in death rates. my guests are still with me, and dr. chinni, when you see a lot of journalism, and there has been a ton of it in the last ten years, about the alienation and anger and loss, i read that story, the first draft of it on the research, about. >> yes, i spent a lot of my time and the question we have all had, what's going on? there's something different going on this year. on the republican side in particular, the democratic side, more on the republican side, but there's an under current of populist anger, and there's always some of it, but if you look at the people leading in the polls now, donald trump and ben carson, these people are not politicians in any way, shape or form, and a lot of their

message is i'm going to go to washington and blow things up, change the way things are, seriously, because i don't have any political experience. and people are longing. and trump's slogan is make america great again. remember how it used to be, and we can have that again. and for this segment of the population, that's a very appealing message, we need to get back what it used to be for my parents and their parents, and i want that life too. >> prefer mira, i know that you're not a political scientist, blue as you with familiar with the findings, is it consistent with the sense of powerlessness? that you hear loud and clear in a lot of the voices from these communities? that people don't care about my lot in life, and the people in power don't care about me? >> i think that it is consistent with these sorts of views. i think that there's a puzzle here, when you think about the

contrast between what happened with white non-hispanics and the other groups, and let me give you an exactly. during the great recession, unpolite rates doubled for middle-aged americans in all of these groups, and because they were starting out at a higher place for blacks and hardships, they had a higher unemployment rate. but yet survey data that asks people, how do you feel about your financial situation in the future found out that blacks were much more optimistic than whites. so you see this pessimism in this group that seems to have mortality. >> and is it overreading the data to see that? see a corollary for it, and higher suicide rates and higher drug addiction, and that sort of thing? >> well, i think that all of these things are consistent. we saw higher reports of pain, and higher

reports of psychological distress, and you've seen over the past decade a rise in disability awards for musculoskeletal disorders, and also for psychiatric disorders, and so all of the trends are consistent. >> david weir. i think a lot of the people in that group and feeling that anger also don't feel that it's going to be responded to, that it's being heard or understood that the politicians going to washington are going to make programmatic responses to their pain. >> i think you're right. i think that does explain, you connected the dots there between the political attitudes and the expressions and the economic dislocation that people are feeling. the paper did not really connect the dots from those experiences to the mortality increase, but you don't have to connect very many dots to get from one to the other. so i think that there definitely is something there. i guess my concern would be

that in seeking some kind of political recognition of their condition, they're actually embracing policies that are not in fact going to help with their situation. >> more is going to come out. dante chinni, 30 seconds left, and what do you hope to see out of these numbers that will help you in your research in understanding the coming year? >> i would love to see the geographic slice. we're talking when we have a lot of speculation of what we think is going on, and i would like to know, at least get a sense of where this is going, because then we can tie more closely to what we're seeing. >> i would like to thank my guests, ellen meara, dante chinni, a partnership with the wall street journal, and news hour, and david weir, director of health and retirement study

on the michigan center for the demography of aging. i'll be back in a moment with a final thought on expectations. stay with us, it's "inside story" and send us your thoughts on twitter@aj inside the reef am. or follow me and get in touch at ray suarez news, or follow us on facebook to tell us what you think is affecting the mortality rate among white americans. we would love to hear from you.

>> people have had a hard time seeing their economic circumstances as something more than temporary. whereas factors that can shape the life chances of your children and shape your own life and death. and yet, there have been plenty of cries of pain from men and women who see the american dream eluding their grasp. even as they conclude their own children won't be able to do better than their own parents, once thought of as an american birthright. the work brings rigor and data to what might have seen as a depression before. that large numbers of people, long since left behind by changes in the american economy are sinking in despair. despair that leds to alcoholism

and drug addiction and suicide, but it's bending the curve of one of the most reliable trends in american life, that people always live longer than those that came before. the black and brown communities have long wrestled with economic setbacks. daunted and stop bid substance abuse. but in this case, they haven't collapsed on their knees in the same way. latinos are shockingly optimistic about their futures, given everything that america has dished out in the past decade. maybe if you lower your expect stations to begin with, the shock might be easier to handle. i'm ray suarez, and that's the "inside story," the news continues right now.