Advertisement

The US Mortality Crisis: An Examination of Non-Hispanic White Mortality and Morbidity in Yavapai County, Arizona

  • Michelle Anne ParsonsEmail author
  • Steven D. Barger
Original Paper
  • 8 Downloads

Abstract

Midlife non-Hispanic white mortality in the United States is rising, particularly in small metro and rural counties. This article responds to calls for county-level studies. We examine social determinants of morbidity and mortality among adult non-Hispanic whites in Yavapai County, Arizona, as part of an integrative study. We report overall mortality trends in Yavapai County using CDC Wonder data and then examine social determinants of reported physical health and mental distress in Yavapai County data using 6 years (2011–2016) of the Arizona Behavioral Risk Factor Surveillance System (BRFSS). The BRFSS includes 1,024 non-Hispanic white respondents aged 25–64. We also present data from the recently established Yavapai County Overdose Fatality Review Board (YCOFRB). Mortality trends indicate that suicide and drug and alcohol-related mortality have all increased since 1999. These increases affect all 5-year age groups from 25 to 64 and both men and women. BRFSS data show that low education and unemployment, but not number of children or home ownership, are significantly associated with worse reported health and frequent mental distress in multivariate analyses. The YCOFRB point to the importance of homelessness and mental health. The mortality crisis in Yavapai County is not restricted to midlife or to drug-related deaths. The unemployed and those with low levels of education are particularly at risk. There is a need for integrative approaches that use local data to elucidate social determinants of morbidity and mortality and to reveal structural determinants.

Keywords

Mortality US Health behavior Social factors Mental health 

Notes

Funding

MA Parsons was supported in this research by the National Science Foundation Cultural Anthropology Program and Sociology Program (#1658528). SD Barger was funded in part by the Southwest Health Equity Research Collaborative NIH U54MD012388. The views expressed in this article do not represent those of the National Science Foundation or the National Institutes of Health.

Compliance with Ethical Standards

Conflict of interest

We have no conflicts of interest or financial conflicts to report.

References

  1. 1.
    Case, A., & Deaton, A. (2017). Mortality and morbidity in the 21st century. Brookings Papers on Economic Activity, pp. 397–476.Google Scholar
  2. 2.
    Schmid, C. H. (2016). Increased mortality for white middle-aged Americans not fully explained by causes suggested. Proceedings of the National Academy of Sciences of the USA, 113(7), 2912.CrossRefGoogle Scholar
  3. 3.
    Zajacova, A., & Karas, J. (2017). Physical functioning trends among US women and men age 45–64 by education level. Biodemography and Social Biology, 63(1), 21–30.CrossRefPubMedPubMedCentralGoogle Scholar
  4. 4.
    Manchikanti, L., et al. (2012). Opioid epidemic in the United States. Pain Physician, 15, ES9–ES38.PubMedGoogle Scholar
  5. 5.
    Muennig, P. A., Reynolds, M., Fink, D. S., Zafari, Z., & Geronimus, A. T. (2018). America’s declining well-being, health, and life expectancy: Not just a white problem. American Journal of Public Health, 108(12), 1626–1631.CrossRefPubMedPubMedCentralGoogle Scholar
  6. 6.
    Notzon, F. C., Komarov, Y. M., Ermakov, S. P., Sempos, C. T., Marks, J. S., & Sempos, E. V. (1998). Causes of declining life expectancy in Russia. Journal of the American Medical Association, 279(10), 793–800.CrossRefPubMedGoogle Scholar
  7. 7.
    Parsons, M. (2014). Dying unneeded: The cultural context of the Russian mortality crisis. Nashville: Vanderbilt University Press.Google Scholar
  8. 8.
    Montez, J. K., & Zajacova, A. (2014). Why is life expectancy declining among women in the United States ? American Journal of Public Health, 104(10), 5–7.CrossRefGoogle Scholar
  9. 9.
    Case, A., & Deaton, A. (2015). Rising morbidity and mortality in midlife among white non-Hispanic Americans in the 21st century. Proceedings of the National Academy of Sciences of the USA, 112(49), 15078–15083.CrossRefPubMedGoogle Scholar
  10. 10.
    Diez Roux, A. V. (2017). Despair as a cause of death: More complex than it first appears. American Journal of Public Health, 107(10), 1566–1567.CrossRefPubMedPubMedCentralGoogle Scholar
  11. 11.
    Masters, R. K., Tilstra, A. M., & Simon, D. H. (2017). Mortality from suicide, chronic liver disease, and drug poisonings among middle-aged U.S. white men and women, 1980–2013. Biodemography and Social Biology, 63(1), 31–37.CrossRefPubMedPubMedCentralGoogle Scholar
  12. 12.
    Montez, J. K., & Berkman, L. F. (2014). Trends in the educational gradient of mortality among US adults aged 45 to 84 years: Bringing regional context into the explanation. American Journal of Public Health, 104(1), 82–90.CrossRefGoogle Scholar
  13. 13.
    US Census Bureau. American FactFinder. [Online]. Retrieved from https://factfinder.census.gov/faces/nav/jsf/pages/community_facts.xhtml.
  14. 14.
    CDC and NCHS. (2018). Underlying cause of death 1999–2016 on CDC WONDER Online Database, released December, 2018. [Online]. Retrieved from http://wonder.cdc.gov/ucd-icd10.html.
  15. 15.
    Klein, R. J., Proctor, S. E., Boudreault, M. A., & Turczyn, K. M. (2002). Healthy people 2010 criteria for data suppression. Statistical Notes, 24, 1–12.Google Scholar
  16. 16.
    Korn, E. L., & Graubard, B. I. (2011). Analysis of health surveys. New York: Wiley.Google Scholar
  17. 17.
    Idler, E. L., & Benyamini, Y. (1997). Self-rated health and mortality: A review of twenty-seven community studies. Journal of Health and Social Behavior, 38(1), 21–37.CrossRefPubMedGoogle Scholar
  18. 18.
    Barger, S. D., Cribbet, M. R., & Muldoon, M. F. (2016). Participant-reported health status predicts cardiovascular and all-cause mortality independent of established and nontraditional biomarkers: Evidence from a representative US sample. Journal of the American Heart Association, 5, 1–9.CrossRefGoogle Scholar
  19. 19.
    Benjamins, M. R., Hummer, R. A., Eberstein, I. W., & Nam, C. B. (2004). Self-reported health and adult mortality risk: An analysis of cause-specific mortality. Social Science and Medicine, 59, 1297–1306.CrossRefPubMedGoogle Scholar
  20. 20.
    Cook, J., et al. (1998). Self-reported frequent mental distress among adults—United States, 1993–1996. Morbidity and Mortality Weekly Report, 47(16), 325–331.Google Scholar
  21. 21.
    Barros, A. J. D., & Hirakata, V. N. (2003). Alternatives for logistic regression in cross-sectional studies: An empirical comparison of models that directly estimate the prevalence ratio. BMC Medical Research Methodology, 3, 21.CrossRefPubMedPubMedCentralGoogle Scholar
  22. 22.
    Minton, J., Green, M., McCartney, G., Shaw, R., Vanderbloemen, L., & Pickett, K. (2017). Two cheers for a small giant? Why we need better ways of seeing data: A commentary on: ‘Rising morbidity and mortality in midlife among White non-Hispanic Americans in the 21st century’. International Journal of Epidemiology, 46(1), 356–361.PubMedGoogle Scholar
  23. 23.
    Macintyre, S., Hunt, K., & Sweeting, H. (1996). Gender differences in health: Are things really as simple as they seem? Social Science and Medicine, 42(4), 617–624.CrossRefPubMedGoogle Scholar
  24. 24.
    Seedat, S., et al. (2009) Cross-national associations between gender and mental disorders in the World Health Organization World Mental Health Surveys. Archives of General Psychiatry, 66(7), 785–795.CrossRefPubMedPubMedCentralGoogle Scholar
  25. 25.
    Krueger, P. M., Tran, M. K., Hummer, R. A., & Chang, V. W. (2015). Mortality attributable to low levels of education in the United States. PLoS ONE, 10(7), 1–13.Google Scholar
  26. 26.
    Montez, J. K., Hummer, R. A., Hayward, M. D., Woo, H., & Rogers, R. G. (2011). Trends in the educational gradient of U.S. adult mortality from 1986 to 2006 by race, gender, and age group. Research on Aging, 33(2), 145–171.CrossRefPubMedPubMedCentralGoogle Scholar
  27. 27.
    Schwartz, C. R., & Mare, R. D. (2005). Trends in educational assortative marriage from 1940 to 2003. Demography, 42(4), 621–646.CrossRefPubMedGoogle Scholar
  28. 28.
    McPherson, M., Smith-Lovin, L., & Brashears, M. E. (2006). Social isolation in America: Changes in core discussion networks over two decades. American Sociological Review, 71, 353–375.CrossRefGoogle Scholar
  29. 29.
    Stone, W. (2016). Residents Call for Regulation of Sober Living Homes in Arizona. National Public Radio, 2016. [Online]. Retrieved from https://www.npr.org/2016/08/22/490969839/residents-call-for-regulation-of-sober-living-homes-in-arizona.
  30. 30.
    Basta, K. L., & Bridge, D. (2018). Arizona balance of state continuum of care sheltered & unsheltered point in time report, 2018.Google Scholar
  31. 31.
    Zoorob, M. J., & Salemi, J. L. (2017). Bowling alone, dying together: The role of social capital in mitigating the drug overdose epidemic in the United States. Drug and Alcohol Dependence, 173, 1–9.CrossRefPubMedGoogle Scholar
  32. 32.
    Pierce, J. R., & Schott, P. K. (2016). Trade liberalization and mortality: Evidence from U.S. counties. NBER Working Paper Series, 22849, 1–66.Google Scholar
  33. 33.
    Monnat, S. M. (2018). Factors associated with county-level differences in U.S. drug-related mortality rates. American Journal of Preventive Medicine, 54(5), 611–619.CrossRefPubMedPubMedCentralGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Anthropology, College of Social and Behavioral SciencesNorthern Arizona UniversityFlagstaffUSA
  2. 2.Department of Psychological SciencesNorthern Arizona UniversityFlagstaffUSA

Personalised recommendations