For the past 15 years, death rates in the U.S. among white women have mysteriously soared. New research seems to have found a culprit: prescription painkillers.
Demographers recently uncovered a startling trend: In 42.8 percent of U.S. counties, mortality rates for women rose between 1992 and 2006. Male rates, meanwhile, increased in a mere 3.4 percent of counties. Between 1999 and 2011, death rates climbed substantially among only white women, ages 15 to 54. A study from the Urban Institute, published Thursday, attributed half the rise to “accidental poisoning,” or drug overdoses.
Americans’ life expectancy has steadily increased for decades. So, as medicine and technology have advanced, why is women’s health apparently deteriorating nationwide?
Death rates among black women, meanwhile — although they remain higher — largely decreased over the same period.
“A lot of theories out there suggest stress has major effects on our health,” said co-author Nan Astone, a senior research fellow at the Urban Institute’s Labor, Human Services and Population Center. “We know that white women are single parents more often than they ever have been before. They’re more often the breadwinner. They’re juggling a lot of roles.”
Prescription painkillers, or opioids, have become increasingly easy to find over the past two decades. Prescriptions have increased tenfold since 1990, according to a Harvard Medical School report. Medical providers wrote 259 million prescriptions in 2012, “enough for every American adult to have a bottle of pills,” the CDC estimates.
Only 3.3 per 100,000 white women died from opioid-related complications in 1999, according to the Urban Institute report. That number surged to 15.9 per 100,000 white women in 2011. (Future research will examine Hispanic and other racial populations, Astone said.)
“If death rates for a group are rising, it is highly likely that the health of that population is worsening, thus affecting a much larger group of people than those who die,” researchers wrote. “Moreover, the social context of health and survival is integrally related to the health outcomes of adult women, who are crucial to the social fabric of their families, communities and local economies.”
Wide use and abuse of the addictive drugs is now known as “the opioid epidemic.” Deaths from painkiller overdoses among women have increased more than 400 percent since 1999, the CDC reports, compared with 265 percent among men. Nearly 48,000 women died of overdoses between 1999 and 2010.
Heartbreak aside, it’s an expensive problem. Opioid abuse costs in the United States totaled $55.7 billion in 2007, according to the CDC. That’s measuring decreased workplace productivity, health-care costs and criminal justice expenses.
Curbing opioid-related deaths is more complicated than simply arresting people who illegally peddle or buy the drugs. Lawmakers should also address the social determinants of health, Astone said. Housing and access to medical care, for example, are high on the list.
The highest concentration of counties with rising female death rates clustered in historically impoverished regions of the Southwest, where doctors and clinics are known to write more opioid prescriptions.
Previous research shows a strong correlation between income and lifespan.
People whose family income in 1980 was greater than $50,000, putting them in the top 5 percent of incomes, had a life expectancy at all ages that was about 25 percent longer than those in the bottom 5 percent, whose family income was less than $5,000, according to the National Longitudinal Mortality Survey.
Disease associated with obesity and smoking also added to the recently higher mortality rates among white women, Astone said. The death rate for respiratory complications, for example, increased from 5.6 deaths per 100,000 women in 1999 to 7.2 deaths per 100,000 women.