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  #401  
Old 12-15-2019, 09:20 PM
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Originally Posted by Neutral Omen View Post
Yes, this is old. I just wanted to copy over the article.

Quote:
Why So Many U.S. Men Die at Age 62
Spoiler:
If you're approaching age 62, thoughts about retirement and collecting Social Security may be on your mind. Here's something else to think about as well.

A significant increase in mortality starts at 62, according to a new study. The escalation is much more dramatic for men than for women. And the fatal catalyst, the study's authors believe, might be the availability of Social Security.

Maria D. Fitzpatrick, an associate professor of economics at Cornell University, and her co-author, Timothy J. Moore, a senior lecturer in economics at the University of Melbourne, reviewed mortality data from the National Center for Health Statistics' Multiple Cause of Death files for 1979 to 2012. Their working paper was published by the National Bureau of Economic Research in December and in the peer-reviewed Journal of Public Economics last month.

The Wall Street Journal spoke with Dr. Fitzpatrick about the research. Edited excerpts follow.

WSJ: Why did you study this?

DR. FITZPATRICK: There is a lot of work about the financial health of Americans as they retire. It is a big change in people's lives. We were hypothesizing that it could have effects not just on their financial health but on their physical and psychological health.

WSJ: What's going on at age 62?

DR. FITZPATRICK: A lot happens in our early 60s. Some change jobs, scale back working hours or retire. Our health-care coverage may shift. We may have fewer financial resources, or we may begin collecting Social Security. About one-third of Americans immediately claim Social Security at 62. Ten percent of men retire in the month they turn 62.

WSJ: What do the numbers show?

DR. FITZPATRICK: There's a sizable, 2% increase in male mortality at age 62 in the U.S. That 2% is of the whole male population. But we really think this estimate is about the 10% of men who retire. So the increase in the probability of death for men who retire [at 62] could be as high as 20%. I think that is a pretty big deal.

WSJ: What is really happening?

DR. FITZPATRICK: Retirement could have positive long-run benefits for your health because you're taking better care of yourself. Or it could be that, in the long run, retirement has a negative effect. You can think of how a retiree slowly withdraws from the world because he no longer has any reason to engage.

What we find in the short-run are negative consequences. For example, many deaths come from traffic accidents. If you don't go to work, you have more hours of the day to be driving around. Medical literature suggests when older men are more sedentary, they're more likely to be at risk for infection. When they lose their jobs, they increase their smoking rate.

People who retire at 62 are more likely to have worked as physical laborers. They could be retiring because they're in poor health. More broadly, there could be negative consequences because this is a difficult time for people.

WSJ: So what is the bottom line?

DR. FITZPATRICK: The takeaway is retirement may be bad for the health of men, particularly for men who retire at the relatively early age of 62. That is the leading explanation.

WSJ: What can be done about it?

DR. FITZPATRICK: We aren't necessarily saying people shouldn't retire. But if you're thinking about retirement, particularly if you're 62 and if your health is poor to start with, think about preventive health measures. Stay healthy, see a physician, don't just sit on the couch, but don't overdo it either. Be careful about driving. Just be careful. It is a tricky time.



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  #402  
Old 12-16-2019, 11:23 AM
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https://khn.org/news/among-u-s-state...est-hows-that/
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Among U.S. States, New York’s Suicide Rate Is The Lowest. How’s That?

Spoiler:
“I just snapped” is how Jessica Lioy describes her attempt in April to kill herself.

After a tough year in which she’d moved back to her parents’ Syracuse, N.Y., home and changed colleges, the crumbling of her relationship with her boyfriend pushed the 22-year-old over the edge. She impulsively swallowed a handful of sleeping pills. Her mom happened to walk into her bedroom, saw the pills scattered on the floor and called 911.

In 2017, 1.4 million adults attempted suicide, while more than 47,000 others did kill themselves, making suicide the 10th-leading cause of death in the United States, according to the federal Centers for Disease Control and Prevention. And the rate has been rising for 20 years.


New York’s efforts to prevent suicides include testing a brief intervention program for people who have attempted suicide — because they are at risk for trying again. “They steal you for an hour from the universe and make you focus on the worst thing in your life and then coach you through it,” Jessica Lioy says.(COURTESY OF JESSICA LIOY)

Like other states, Jessica Lioy’s home state of New York has seen its rate increase. But New York has consistently reported rates well below those of the U.S. overall. Compared with the national rate of 14 suicides per 100,000 people in 2017, New York’s was just 8.1, the lowest suicide rate in the nation.

What gives? At first glance, the state doesn’t seem like an obvious candidate for the lowest rank. There’s New York City, all hustle and stress, tiny apartments and crowds of strangers. And upstate New York, often portrayed as bleak and cold, is famously disparaged in the Broadway musical “A Chorus Line” with the comment that “to commit suicide in Buffalo is redundant.”

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Experts say there’s no easy explanation for the state’s lowest-in-the-nation rate. “I can’t tell you why,” said Dr. Jay Carruthers, a psychiatrist who is the director of suicide prevention at the New York State Office of Mental Health.

Guns And Urbanization Are Likely Factors

There’s no single answer, but a number of factors probably play a role, according to Carruthers and other experts on suicide.

Low rates of gun ownership are likely key. Guns are used in about half of suicide deaths, and having access to a gun triples the risk that someone will die by suicide, according to a study in the Annals of Internal Medicine. Because guns are so deadly, someone who attempts suicide with a gun will succeed about 85% of the time, compared with a 2% fatality rate if someone opts for pills, according to a study by researchers at the Harvard Injury Control Research Center.

“The scientific evidence is pretty darn good that having easy access to guns makes the difference whether a suicidal crisis ends up being a fatal or a nonfatal event,” said Catherine Barber, who co-authored the study and is a senior researcher at the Harvard center.

New York has some of the strongest gun laws in the country. In 2013 — after the mass shooting at Sandy Hook Elementary School in Newtown, Conn. — the state broadened its ban on assault weapons, required recertification of pistols and assault weapons every five years, closed a private sale loophole on background checks and increased criminal penalties for the use of illegal guns.

This year, the state enacted laws that, among other things, established a 30-day waiting period for gun purchases for people who don’t immediately pass a background check, and prevented people who show signs of being a threat to themselves or others from buying guns, sometimes referred to as a “red flag” or “extreme risk” law.

The population is also heavily concentrated in urban areas, including more than 8 million people living in New York City. According to the Census Bureau, nearly 88% of the state’s population lived in urban areas in the 2010 census, while the national figure is about 81%.

Suicide rates are typically lower in cities. In 2017, the suicide rate nationwide for the most rural counties — 20 per 100,000 people — was almost twice as high as the 11.1 rate for the most urban counties, according to the CDC. The trend is accelerating. While the suicide rate in the most urban counties increased by 16% from 1999 to 2017, it grew by a whopping 53% in the most rural counties.

Loneliness, isolation and access to lethal weapons can be a potent combination that leads to suicide, said Jerry Reed, who directs the suicide, violence and injury prevention efforts at the Education Development Center. The center runs the federally funded Suicide Prevention Resource Center, among other suicide prevention projects.

People in rural areas may live many miles from the nearest mental health facility, therapist or even their own neighbors.

“If your spouse passes away or you come down with a chronic condition and no one is checking on you and you have access to firearms,” Reed said, “life may not seem like worth living.”

Intervention Helps ‘Force You’ To Move Forward

New York’s efforts to prevent suicides include conducting a randomized controlled trial to test the effectiveness of a brief intervention program developed in Switzerland for people who have attempted suicide — because they are at risk for trying again.

The trial has yet to get underway, but clinicians at the Hutchings Psychiatric Center in Syracuse were trained in the Attempted Suicide Short Intervention Program, as it’s called. They began testing it with some patients last year.

Jessica Lioy was one of them. After her suicide attempt, she spent a week at the inpatient psychiatric unit at Upstate University Hospital in Syracuse. A social worker approached her about signing up for that outpatient therapy program.

The program is simple. It has just four elements:

In the first session, patients sit down with a therapist for an hourlong videotaped discussion about why they tried to kill themselves.
At their second meeting, they watch the video to reconstruct how the patient moved from experiencing something painful to attempting suicide.
During the third session, the therapist helps the patient list long-term goals, warning signs and safety strategies, along with the phone numbers of people to call during a crisis. The patient carries the information with them at all times.
Finally, during the next two years, the therapist writes periodic “caring letters” to the patient to check in and remind them about their risks and safety strategies.
In the Swiss trial, about 27% of the patients in the control group attempted suicide again during the next two years. Only 8% of those who went through the intervention program re-attempted suicide during that time.

“The difference with ASSIP is the patient involvement. It’s very patient-centered,” said Dr. Seetha Ramanathan, the Hutchings psychiatrist overseeing the program. It’s also very focused on the suicide attempt, not on other issues like depression or PTSD, she said.

Lioy said that, at the beginning, she didn’t have high hopes for the program. She had already told her story to many doctors and mental health therapists. But this felt different, she recalled.

“They steal you for an hour from the universe and make you focus on the worst thing in your life and then coach you through it,” Lioy said. “They force you to feel something, and they force you to just reflect on that one situation and how to move forward to not end up back in that place. It’s very immediate.”

It hasn’t all been smooth sailing. Shortly after returning home, Lioy felt depressed and couldn’t get out of bed. But she had learned the importance of asking for help, and she reached out to her parents.

“I was able to talk with them, and it felt amazing,” she said. “I’d never done that before.”

There have been other changes. Since returning home, Lioy finished her bachelor’s degree in molecular genetics and is working as a pharmacy technician. She’s applying to doctoral programs and she has a new boyfriend, although she said she no longer needs a boyfriend to feel OK about herself.

“It’s been a really big journey,” Lioy said.


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  #403  
Old 12-23-2019, 12:07 PM
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https://www.nytimes.com/2019/12/22/u...yCEPYDx7Lfxx4U

Quote:
Another Benefit to Going to Museums? You May Live Longer
Researchers in Britain found that people who go to museums, the theater and the opera were less likely to die in the study period than those who didn’t.
Spoiler:
Numerous studies have shown that art and music can help soothe chronic pain, stave off symptoms of dementia and Alzheimer’s disease and accelerate brain development in young children.

Now, there is evidence that simply being exposed to the arts may help people live longer.

Researchers in London who followed thousands of people 50 and older over a 14-year period discovered that those who went to a museum or attended a concert just once or twice a year were 14 percent less likely to die during that period than those who did n’t.

The chances of living longer only went up the more frequently people engaged with the arts, according to the study, which was published this month in The BMJ, formerly The British Medical Journal. People who went to a museum or the theater once a month or even every few months had a 31 percent reduced risk of dying in that period, according to the study.

The study controlled for socioeconomic factors like a participant’s income, education level and mobility, said Andrew Steptoe, a co-author of the study and the head of University College London’s research department of behavioral science and health.

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“Even if you take those things into account, we still found that there is a difference in the survival of people who are involved in the arts,” Professor Steptoe said in an interview on Friday.

The study did not examine what kind of music, art or theater led to a longer life, he said.

In other words, it’s not clear whether your chances of living longer are improved by choosing “Die Walküre” over “The Phantom of the Opera.”

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But Professor Steptoe said researchers theorized that people who expose themselves to the arts are likely to be more engaged in the world.

“We know that a sense of purpose in life is important,” he said. “Being involved and excited by the arts keeps and maintains your purpose in life.”

The study also noted that engaging in the arts can reduce loneliness, promote empathy and emotional intelligence, and keep people from becoming sedentary — all factors that contribute to a longer life.

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Many studies have examined the positive effects of the arts on older people.

Americans over 55 who did not create art or go to concerts, museums or plays reported higher rates of hypertension and cognitive decline than those who did, according to a study of nearly 1,500 participants released by the National Endowment for the Arts in 2017.

Similar studies have shown the benefits of exposing children and adolescents to art.

University of Arkansas researchers found that children who were taken on field trips to museums performed better in school and scored higher on standardized tests than those whose schools did not take students on field trips.

The London study is believed to be the first comprehensive examination of the effects of art on mortality, Professor Steptoe said.

From 2004 to 2005, researchers collected data from 6,710 people who responded to questionnaires about how often they went to concerts, museums, galleries, the theater or the opera. (Professor Steptoe said the effect of moviegoing had already been examined elsewhere and was not considered in the study.)

In addition to providing personal information such as age, gender, ethnicity, marital status, educational background, profession and income, participants also answered questions about their physical and mental health, how often they smoked or drank, and how much exercise they got.

Over the next 14 years, about 2,000 participants died — a vast majority of them from illnesses related to cancer, cardiovascular disease, respiratory problems and other natural causes, according to the study. (The tiny fraction of participants who died of unnatural causes was still included in the study, Professor Steptoe said.)

The researchers combed through the data they had collected to search for patterns. They said their findings suggested, but did not prove, that participating in the arts could lead to a longer life span.

“This study raises a number of future research questions,” the authors wrote.

For example, future studies could consider how engagement in the arts from a young age might affect a person’s life span.

The study also did not examine whether there was any overlap with participants who actively participated in art, as by playing music, dancing or painting.

Still, the results of the study excited art and theater advocates who said they hoped the research would motivate a push to restore arts and music programs that have been cut from schools in New York and around the country over the years.

“So much of that has been destroyed,” said Heather A. Hitchens, chief executive of the American Theater Wing, which funds a wide range of productions and programs.

“Too often, the arts are seen as this frill, but they really do play an essential role in our lives,” Ms. Hitchens said. “Now we have a study telling us it helps us live longer. It’s just yet the latest example of how powerful the arts are.”

Advocates said the study was also a reminder of how critical it is for the arts to be more accessible to Americans of all incomes.

Gabriella Souza, a spokeswoman for the Walters Art Museum in Baltimore, said the study’s results were not surprising.

“In terms of finding peace and tranquillity in galleries, that is one of the reasons people come to our museums,” she said.

The museum, which offers free admission and gets about 160,000 visitors a year, recently surveyed visitors about why they come. Twenty percent of them said for “peace and rejuvenation,” Ms. Souza said.

“It’s a real testament to how important exposure really is,” she said. “You need to be able to access art to be able to appreciate it.”


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  #404  
Old 12-26-2019, 02:43 PM
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https://www.npr.org/sections/health-...ou-live-longer

Quote:
Optimists For The Win: Finding The Bright Side Might Help You Live Longer

Spoiler:
Good news for the cheery: A Boston study published this month suggests people who tend to be optimistic are likelier than others to live to be 85 years old or more.

That finding was independent of other factors thought to influence life's length — such as "socioeconomic status, health conditions, depression, social integration, and health behaviors," the researchers from Boston University School of Medicine and the Harvard T.H. Chan School of Public Health say. Their work appears in a recent issue of the science journal PNAS.

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This story comes from Life Kit, NPR's family of podcasts for making life better — everything from exercise to raising kids to making friends. For more, sign up for the newsletter and follow @NPRLifeKit on Twitter.

A Brighter Outlook Could Translate To A Longer Life
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"We wanted to consider, in the current issue, benefits of psychological resources like optimism as possible new targets for promoting healthy aging," says Lewina Lee, who headed the study. She's a clinical research psychologist at Boston University. "The more we know about ways to promote healthy aging the better."

Researchers already knew from previous work that optimistic individuals tend to have a reduced risk of depression, heart disease and other chronic diseases. But might optimism also be linked to exceptional longevity? Lee looked at medical records from two long term research studies — one involving female nurses and the other involving men, mostly veterans.

The study included 69,744 women and 1,429 men. Both groups completed survey measures to assess their level of optimism, as well as their overall health and health habits such as diet, smoking and alcohol use. In the survey, study participants were asked if they agreed with statements such as "in uncertain times I usually expect the best" or "I usually expect to succeed in things that I do."

Health outcomes from women in the study were tracked for 10 years, while the men's health was followed for 30 years. Researchers found that the most optimistic men and women demonstrated, on average, an 11-15% longer lifespan, and had far greater odds of reaching 85 years old, compared to the least optimistic group.

Now, researchers say they can't tell from this study how optimism might affect longevity. Optimistic people might be more motivated to try to maintain good health — such as maintaining a decent diet, engaging in regular exercise and not smoking.

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They may also be better at regulating stress, Lee says.The burden of unrelieved stress is well known to have negative effects on health, including an increase in heart disease, liver disease and gastrointestinal problems.

Clinical health psychologist Natalie Dattilo, with Brigham and Women's Hospital in Boston, says even if it doesn't come naturally, optimism can be taught. In her practice she works mostly with adults who struggle with depression and anxiety — "a lot of folks who worry," she says. Many are pessimistic and "tend to see things through a half empty glass and typically expect negative outcomes."

In treatment, Dattilo works to expand their world view, so their set of assumptions about the world and themselves are more uplifting and empowering.

"We examine their thinking under a psychological microscope," Dattilo says, discussing why they anticipate a particular negative outcome. "If we can look at that together, we can begin to uncover systems of beliefs and assumptions people are making about themselves in their lives and we can begin to change those."

Dattilo challenges patients to pay attention when a negative outlook kicks in, and consciously shift it. "Just try it on, try on a different thought, attitude or mindset and play that out and just see what happens," she advises.

Also, she emphasizes, optimism isn't simply the absence of depression or sadness or stress.

"People who think in optimistic ways are still prone to stress," she says. "They are functioning in our society, meeting demands, prone to burn out. And it's not like negative events won't happen."

But the way they cope with problems makes a difference, she says. Difficulties don't tend to cause them distress for extended periods of time.

"Resilience is our ability to bounce back, to recover," she says. "And what this study shows is that optimism actually plays a very big role in our ability to bounce — even if we experience setbacks."

So, are gloomy curmudgeons doomed to short, brutish lives, even if they are content to be pessimistic? Some people find eternal optimists insufferable.

From Gloom To Gratitude: 8 Skills To Cultivate Joy
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From Gloom To Gratitude: 8 Skills To Cultivate Joy
Lewina Lee says she treats pessimistic patients "all the time." While some seem satisfied with their outlook, others are more open to lightening up, once they know how, in order to achieve goals that are important to them.

"I would try to challenge their negativity and shake it loose," she says, and get rid of some of the patients' more rigidly held beliefs for their own benefit.

Pessimists who try this will likely end up happier, she suggests. And they might even extend their lives.


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  #405  
Old 01-07-2020, 10:10 PM
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https://www.nytimes.com/2020/01/06/o...ng-people.html

Quote:
Why Are Young Americans Killing Themselves?
Suicide is now their second-leading cause of death.


Spoiler:
Teenagers and young adults in the United States are being ravaged by a mental health crisis — and we are doing nothing about it. As of 2017, statistics show that an alarming number of them are suffering from depression and dying by suicide. In fact, suicide is now the second leading cause of death among young people, surpassed only by accidents.

After declining for nearly two decades, the suicide rate among Americans ages 10 to 24 jumped 56 percent between 2007 and 2017, according to data from the Centers for Disease Control and Prevention. And for the first time the gender gap in suicide has narrowed: Though the numbers of suicides are greater in males, the rates of suicide for female youths increased by 12.7 percent each year, compared with 7.1 percent for male youths.

At the same time, the rate of teen depression shot up 63 percent, an alarming but not surprising trend given the link between suicide and depression: In 2017, 13 percent of teens reported at least one episode of depression in the past year, compared with 8 percent of teens in 2007, according to the National Survey on Drug Use and Health.

How is it possible that so many of our young people are suffering from depression and killing themselves when we know perfectly well how to treat this illness? If thousands of teens were dying from a new infectious disease or a heart ailment, there would be a public outcry and a national call to action.

While young people are generally physically healthy, they are psychiatrically vulnerable. Three-quarters of all the mental illness that we see in adults has already occurred by age 25. Our collective failure to act in the face of this epidemic is all the more puzzling since we are living at a time when people are generally more accepting of mental illness and stigma is on the wane.

You’d think it would be no big deal to see your family doctor or a therapist and get your depression treated like any other medical problem. But the data suggest otherwise: Only 45 percent of teenage girls who had an episode of depression in 2019 received any treatment, and just 33 percent of teenage boys with depression did. In contrast, two-thirds of adults with a recent episode of depression received treatment.

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What explains the epidemic of teen depression and suicide? There are lots of theories but few definitive answers.

Some researchers emphasize the potential role of social media exposure and use of smartphones. There is some evidence that girls, who have shown greater rates of increase in depression than boys, experience more cyberbullying because of their greater use of mobile phones and texting. But most studies of digital technology and mental health are correlational and can’t prove causation.

Drugs and alcohol are always a popular culprit, but in this case they are an unlikely explanation, as the studies cited above controlled for drug use. In addition, there is no evidence of a significant increase in the use of drugs or alcohol in young people during the study period.

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It is legitimate (though controversial) to ask whether the Food and Drug Administration’s “black box” warning for antidepressants back in 2004 — which said the drugs could cause suicidal thoughts and actions in some children and teenagers — discouraged the use of these drugs and unwittingly helped fuel the rise in teen depression. Within two years of the F.D.A. advisory, antidepressant use dropped by 31 percent in teens and 24 percent in young adults. Although antidepressant use recovered somewhat after 2008, it has remained below levels that would have been expected based on prescribing patterns before the warnings appeared.

The good news is that we don’t have to wait for all the answers to know what to do. We know that various psychotherapies and medication are highly effective in treating depression. We just need to do a better job of identifying, reaching out to and providing resources for at-risk youths.

To start, we need a major public campaign to educate parents and teachers to recognize depression in young people and to learn about the warning signs of suicide — like a sudden change in behavior, talking or writing about suicide, and giving away prized possessions. We should have universal screening of teenagers at school, with parental consent, to identify those who are suffering from depression and who are at risk of suicide. And we have to provide adequate funding and resources to match the mental health needs of our young people.

Every day, 16 young people die from suicide. What are we waiting for?


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Old 01-13-2020, 06:01 AM
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https://www.economist.com/finance-an...ican-mortality

Quote:
Economists grapple with rising American mortality
Understanding “deaths of despair” will require fresh thinking


Spoiler:
Five years ago Anne Case and Angus Deaton of Princeton University introduced the world to the phenomenon of “deaths of despair”. A growing share of middle-aged white Americans, especially those without college degrees, are dying from suicide and drug and alcohol use. At first it seemed possible to hope that the troubling rise in death rates would reverse as the economy recovered from the financial crisis. Instead, mortality has risen further—a standing indictment of American society. Several books on the subject, and discussions at the meeting of the American Economic Association (aea) earlier this month in San Diego, do not quite provide an explanation. But they make significant contributions, while posing a substantial challenge to economics.

America’s mortality crisis actually predates the financial crisis: mortality rates for white Americans without a degree have been rising since at least the early 1990s. But it seems to be worsening. Life expectancy in America fell for three consecutive years between 2014 and 2017 (the most recent year for which data are available). That has not happened since the 1910s, when Americans were brought low by war and Spanish flu. Rising death rates are caused in large part by the opioid epidemic, which began with prescription painkillers and expanded to street drugs such as heroin and fentanyl. But suicide and alcohol-related mortality have also risen precipitously. Opioids, reckon Ms Case and Mr Deaton, were fuel on a fire already burning.

The crisis resists simple explanations. There is no simple causal link between rising unemployment or inequality, for instance, and rising mortality. In a forthcoming book Ms Case and Mr Deaton offer a more nuanced argument. They reckon that a fundamental unfairness in the American economy contributes to indicators of economic dysfunction, such as high inequality, and also creates the conditions for the mortality crisis. They point to a health-care system that, enabled by dysfunctional markets and pliant regulators, plied Americans with prescription painkillers.

The health-care industry has also redistributed income upwards. Doctors represent 16% of the top 1%, and 6% of the top 0.1%, of the American income distribution. Costs are much higher than in other countries, and outcomes are worse. Employer-provided health benefits soak up an ever-greater share of worker compensation, which might otherwise be paid as higher wages. The burden of benefits encourages firms to outsource jobs, leading to more insecure, dead-end sorts of employment. Not all of the American economy functions this way. But enough of it does to leave many less-skilled Americans stuck in jobs of low quality and potential, even as the rich and well-educated prosper mightily.

Left unidentified are the reasons why American capitalism was able to become more predatory. The roots of the problem could be intellectual. Raghuram Rajan, an economist at the University of Chicago who participated in the aea discussions, suggests that troubles in America's left-behind places were enabled by economic misunderstandings. His book, "The Third Pillar", develops the point. Economists and policymakers, he argues, have focused excessively on the respective roles of the market and the state, while ignoring policies' effects on cities and neighbourhoods. But these provide practical and social support to their members, helping them manage setbacks and shaping their identities. As economists failed to take seriously the localised harms caused by trade and technological change, weakened communities fell into a cycle of economic and social regression, and became vulnerable to pathologies such as addiction and suicide.

It is possible, though, that the answer to the mortality question lies beyond the normal scope of economics. Ms Case and Mr Deaton note that rising mortality among white Americans has occurred alongside other, potentially related trends. These include not only worsening economic prospects, but also falling rates of marriage, church attendance and membership in community organisations. In citing these factors they take a leaf from Robert Putnam's book, "Bowling Alone", published in 2000, which argued that America was undergoing a long, steady decline in "social capital"-the strength of civic and community connections.

Mr Putnam, a political scientist at Harvard University, updates and extends this argument in a forthcoming book, the thesis of which he outlined at the aea meeting. Zoom out, he said, and deaths of despair fit into a longer American cultural narrative. For a range of variables, including income equality, cross-party political collaboration, labour-union membership, community involvement and marriage rates, there was a rise from the beginning of the 20th century into the 1960s, followed by a plateau and decline. (The same arc is found for the use of the word "we" relative to "I" in books published in American English.) It seems possible, Mr Putnam said, that the challenges of the first half of the century, from the power of industrial monopolies to depression and war, prompted a cultural response in which Americans thought and acted more as a group. Over the past half-century, however, they seem to have reverted to a more atomised condition.

The death of culture

Mr Putnam's analysis is suggestive rather than conclusive. Although some social pathologies, such as a turn toward nationalism and xenophobia, have spread globally, nothing like America's mortality crisis can be found in other rich countries. If he is right, they must not have experienced the same weakening of collective institutions and sentiments.

But if culture is a vague and as-yet-unsatisfying answer to the question posed by deaths of despair, it serves as a proxy for forces that social scientists desperately need to understand. America's mortality crisis is a sign of serious institutional weakness. To grapple with it, economists will need to venture beyond their field's traditional boundaries.


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Top 50 ways to die in America. Or something like that.
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https://www.cnbc.com/2020/01/23/us-s...cdc-finds.html
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Quote:
US suicide rate rises 40% over 17 years, with blue-collar workers at highest risk, CDC finds
PUBLISHED THU, JAN 23 20203:16 PM ESTUPDATED THU, JAN 23 20205:24 PM EST
Hannah Miller
KEY POINTS
Adults working in construction are at a significantly higher risk for suicide, a new CDC study says.
The study used data from 20,975 deaths recorded in the 2016 National Violent Death Reporting system.
In 2017, nearly 38,000 people of working age died by suicide in the U.S., which represents a 40% rate increase in less than two decades, according to the CDC.


Spoiler:
The suicide rate has surged 40% in the U.S. over less than two decades, with blue-collar workers — particularly mining, oilfield, construction and auto-repair workers — at a significantly higher risk, according to new research from the Centers for Disease Control and Prevention.

The CDC analyzed suicide rates by industry and occupational groups by gender using data from the 32 states that participated in the 2016 National Violent Death Reporting system. Researchers examined the suicide rates by profession for 20,975 people between the ages of 16 and 64. For both men and women, construction and “extraction” workers, mostly in the mining or oil and gas fields, had the highest suicide rates, the CDC found in research published Thursday.

“Previous research indicates suicide risk is associated with low-skilled work, lower education, lower absolute and relative socioeconomic status, work-related access to lethal means, and job stress, including poor supervisory and colleague support, low job control, and job insecurity, the CDC wrote.

The total suicide rate among all men was 27.4 individuals per 100,000 people, but the rate among those in the construction field was 49.4 per 100,000. For women, the suicide rate for the total population studied was 7.7 per 100,000 individuals. The suicide rate for women in construction and extraction, however, was 25.5 per 100,000 individuals — the highest among any profession.

Among industry groups, mining, quarrying and oil and gas workers had the highest suicide rate for men at 54.2 per 100,000.

In 2017, nearly 38,000 people between the ages of 16 and 64 died by suicide in the U.S., according to the CDC. The overall suicide rate rose by 40% from 12.9 per 100,000 people in 2000 to 18 per 100,000 people in 2017. In response to the rising rate, the public health institute launched the industry and occupation study to help inform suicide prevention.

“These findings highlight opportunities for targeted prevention strategies and further investigation of work-related factors that might increase risk of suicide,” the study’s authors wrote in a discussion note.


https://www.cdc.gov/mmwr/volumes/69/...cid=mm6903a1_w
Quote:
Suicide Rates by Industry and Occupation — National Violent Death Reporting System, 32 States, 2016
Weekly / January 24, 2020 / 69(3);57–62

Cora Peterson, PhD1; Aaron Sussell, PhD2; Jia Li, MS3; Pamela K. Schumacher3; Kristin Yeoman, MD2; Deborah M. Stone, ScD1 (View author affiliations)

View suggested citation
Summary
What is already known about this topic?

Suicide among the U.S. working-age population (ages 16–64 years) is increasing; in 2017, nearly 38,000 persons died by suicide.

What is added by this report?

National Violent Death Reporting System data from 32 states were used to calculate suicide rates for major industry and occupational groups and detailed occupational groups. Five industry groups and six major occupational groups had higher suicide rates than did the overall study population. Suicide rates for detailed occupational groups provide insight into subcategories within major groups.

What are the implications for public health practice?

Opportunities exist for targeted and broadscale prevention. CDC’s Preventing Suicide: A Technical Package of Policy, Programs, and Practices provides strategies to prevent suicide and can serve as a resource for communities and employers.


Spoiler:
In 2017, nearly 38,000 persons of working age (16–64 years) in the United States died by suicide, which represents a 40% rate increase (12.9 per 100,000 population in 2000 to 18.0 in 2017) in less than 2 decades.* To inform suicide prevention, CDC analyzed suicide data by industry and occupation among working-age decedents presumed to be employed at the time of death from the 32 states participating in the 2016 National Violent Death Reporting System (NVDRS).†,§ Compared with rates in the total study population, suicide rates were significantly higher in five major industry groups: 1) Mining, Quarrying, and Oil and Gas Extraction (males); 2) Construction (males); 3) Other Services (e.g., automotive repair) (males); 4) Agriculture, Forestry, Fishing, and Hunting (males); and 5) Transportation and Warehousing (males and females). Rates were also significantly higher in six major occupational groups: 1) Construction and Extraction (males and females); 2) Installation, Maintenance, and Repair (males); 3) Arts, Design, Entertainment, Sports, and Media (males); 4) Transportation and Material Moving (males and females); 5) Protective Service (females); and 6) Healthcare Support (females). Rates for detailed occupational groups (e.g., Electricians or Carpenters within the Construction and Extraction major group) are presented and provide insight into the differences in suicide rates within major occupational groups. CDC’s Preventing Suicide: A Technical Package of Policy, Programs, and Practices (1) contains strategies to prevent suicide and is a resource for communities, including workplace settings.

NVDRS combines data on violent deaths, including suicide, from death certificates, coroner/medical examiner reports, and law enforcement reports. Industry and occupation coding experts used CDC’s National Institute for Occupational Safety and Health Industry and Occupation Computerized Coding System (NIOCCS 3.0)¶ to assign 2010 U.S. Census civilian industry and occupation codes for 20,975 suicide decedents aged 16–64 years from the 32 states participating in the 2016 NVDRS, using decedents’ usual industry and occupation as reported on death certificates. Industry (the business activity of a person’s employer or, if self-employed, their own business) and occupation (a person’s job or the type of work they do) are distinct ways to categorize employment (2).

Suicide rates were analyzed for industry and occupational groups by sex. Population counts by occupation for rate denominators were states’ civilian, noninstitutionalized current job population counts (for persons aged 16–64 years) from the 2016 American Community Survey Public Use Microdata Sample.** Replicate weight standard errors for those counts were used to calculate 95% confidence intervals (CIs) for suicide rates (3). Rates were calculated by U.S. Census code for major industry groups, major occupational groups, and detailed occupational groups with ≥20 decedents; detailed occupational groups are typically more homogenous in terms of employee income, work environment, and peer group. Rates were not calculated for detailed industry groups because many decedents’ industry was classifiable only by major group. The following decedents were excluded from rate calculations: military workers (327); unpaid workers (2,863); those whose other NVDRS data sources (e.g., law enforcement reports) indicated no employment at time of death (i.e., unemployed, disabled, incarcerated, homemaker, or student) (4) (1,783); and those not residing in the analysis states (223). A total of 15,779 decedents, including 12,505 (79%) males and 3,274 (21%) females, were included in the analysis. The analysis was conducted using Stata (version 15, StataCorp) and SAS (version 9.4, SAS Institute) statistical software.

Industry and occupational groups with suicide rates significantly (α = 0.05) higher than the study population (i.e., all industries or occupations: 27.4 males [95% CI = 26.9–27.9] and 7.7 females [95% CI = 7.5–8.0] per 100,000 population) were identified when the group’s 95% CI exceeded the study population rate point estimate. Treating the population rate as a constant is reasonable when variance is small and is required for one-sample inference that recognizes the nonindependence of individual industry and occupation groups relative to the study population.

The five major industry groups with suicide rates higher than the study population by sex included 1) Mining, Quarrying, and Oil and Gas Extraction (males: 54.2 per 100,000 civilian noninstitutionalized working population, 95% CI = 44.0–64.3); 2) Construction (males: 45.3, 95% CI = 43.4–47.2); 3) Other Services (e.g., automotive repair; males: 39.1, 95% CI = 36.1–42.0); 4) Agriculture, Forestry, Fishing, and Hunting (males: 36.1, 95% CI = 31.7–40.5); and 5) Transportation and Warehousing (males: 29.8, 95% CI = 27.8–31.9; females: 10.1, 95% CI = 7.9–12.8) (Table 1) (Supplementary Table 1, https://stacks.cdc.gov/view/cdc/84274). The six major occupational groups with higher rates included 1) Construction and Extraction (males: 49.4, 95% CI = 47.2–51.6; females: 25.5, 95% CI = 15.7–39.4); 2) Installation, Maintenance, and Repair (males: 36.9, 95% CI = 34.6–39.3); 3) Arts, Design, Entertainment, Sports, and Media (males: 32.0, 95% CI = 28.2–35.8); 4) Transportation and Material Moving (males: 30.4, 95% CI = 28.8–32.0; females: 12.5, 95% CI = 10.2–14.7); 5) Protective Service (females: 14.0, 95% CI = 9.9–19.2); and 6) Healthcare Support (females: 10.6, 95% CI = 9.2–12.1).

Rates could be calculated for 118 detailed occupational groups for males and 32 for females (Supplementary Table 2, https://stacks.cdc.gov/view/cdc/84275). Some occupational groups with suicide rates significantly higher than those of the study population were only identifiable through observation at the detailed group level (Table 2). Among males, these detailed groups included the following seven groups: 1) Fishing and hunting workers (part of the Farming, Fishing, and Forestry major occupational group); 2) Machinists (Production major group); 3) Welding, soldering, and brazing workers (Production major group); 4) Chefs and head cooks (Food Preparation and Serving Related major group); 5) Construction managers (Management major group); 6) Farmers, ranchers, and other agricultural managers (Management major group); and 7) Retail salespersons (Sales and Related major group). Among females, these detailed groups included the following five groups: 1) Artists and related workers (Arts, Design, Entertainment, Sports, and Media major group); 2) Personal care aides (Personal Care and Service major group); 3) Retail salespersons (Sales and Related major group); 4) Waiters and waitresses (Food Preparation and Serving Related major group); and 5) Registered nurses (Healthcare Practitioners and Technical major group). Groups with highest rate point estimates (e.g., female Artists and related workers and male Fishing and hunting workers) also had wide 95% CIs (Table 2), based on relatively low numbers of decedents and relatively small working populations (Supplementary Table 2, https://stacks.cdc.gov/view/cdc/84275).

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Discussion
This report used data from 32 states to provide updated population-level suicide rates for major occupational groups and new information on suicide rates for major industry groups and detailed occupational groups. Estimates for most major occupational groups are similar, although not directly comparable, to previous estimates that were based on 2015 NVDRS data from 17 states (4). Recent NVDRS expansion to 50 states might facilitate direct comparisons over time by industry and occupation nationwide. These findings highlight opportunities for targeted prevention strategies and further investigation of work-related factors that might increase risk of suicide. Previous research indicates suicide risk is associated with low-skilled work (5), lower education (6), lower absolute and relative socioeconomic status (7), work-related access to lethal means (8), and job stress, including poor supervisory and colleague support, low job control, and job insecurity (9). Industry, labor, and professional associations, as well as employers, and state and local health departments can use this information to focus attention and resources on suicide prevention. Future research might examine these and other risk factors among the industries and occupations identified in this report as having high suicide rates.

This report estimated suicide rates comprehensively for industry and occupational groups meeting sample size criteria and identified groups with rates higher than the study’s population rate. Although relative comparisons of suicide rates in this manner are useful for prevention purposes, these results should not overshadow the essential fact that the suicide rate in the U.S. working-age population overall has increased by 40% in less than 2 decades. Therefore, all industry sectors and occupational groups can contribute to reducing suicide incidence.

The findings in this report are subject to at least five limitations. First, this study did not address confounding factors that might account for different suicide rates among and within industry or occupational groups. Second, it did not address suicide among unemployed decedents, military or unpaid workers, or those aged >64 years (9). Third, the numerator and denominator data were not a direct match for calculating rates; death certificates reflect decedents’ usual industry and occupation, and available population size data refer to the number of persons by current job. Fourth, the results are based on data from 32 states and are therefore not nationally representative. Finally, three states contributing to the 2016 NVDRS did not collect data on all violent deaths. Other limitations of NVDRS analysis using death certificate industry and occupation data have been described previously (4).

All industries and occupations can benefit from a comprehensive approach to suicide prevention. CDC’s Preventing Suicide: A Technical Package of Policy, Programs, and Practices (1) provides strategies with the best available evidence to prevent suicide and can serve as a resource for communities and employers. Workplace-specific strategies include 1) promoting help-seeking; 2) integrating workplace safety and health and wellness programs to advance the overall well-being of workers; 3) referring workers to financial and other helping services; 4) facilitating time off and benefits to cover supportive services; 5) training personnel to detect and appropriately respond to suicide risk; 6) creating opportunities for employee social connectedness; 7) reducing access to lethal means among persons at risk; and 8) creating a crisis response plan sensitive to the needs of coworkers, friends, family, and others who might themselves be at risk (1,10). Other community-based strategies include strengthening economic supports, strengthening access and delivery of care, teaching coping and problem-solving skills, and responsibly reporting suicide (e.g., not providing details) (1). Further workplace prevention resources are available at https://workplacesuicideprevention.com/external icon and https://theactionalliance.org/commun...kplaceexternal icon and help is available at 1-800-273-TALK (8255).

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There is occupational-level info at the end of the report
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Old 02-02-2020, 12:51 PM
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https://www.wsj.com/articles/life-ex...rs-11580398277
Quote:
Life Expectancy Rises in U.S. for First Time in Four Years
Lower mortality from cancer, accidents and unintentional injuries; drug overdose deaths fell 4%

Spoiler:
U.S. life expectancy increased in 2018 for the first time in four years as deaths from drug overdoses dropped, according to government figures released Thursday.

Lower mortality from cancer, accidents and unintentional injuries were the main reasons life expectancy ticked up in 2018, according to a report from the Centers for Disease Control and Prevention's National Center for Health Statistics. The center also said that drug overdose deaths among U.S. residents fell 4% that year, the first such decline in 28 years.

Life expectancy at birth was 78.7 years in the country in 2018, an increase of one-tenth of a year from 2017. The age-adjusted death rate for the population fell 1.1%. Women are expected to live five years longer than men, to the ages of 81.2 and 76.2, respectively, according to the 2018 figures.

Public-health experts said the figures were a step in the right direction but cautioned that the improvements are small, and still leave the U.S. behind its recent longevity peak. Life expectancy in the U.S. had fallen in two of the past three years before 2018 after hitting 78.9 years in 2014. The latest figure is the same as life expectancy was in 2010.

"This is potentially good news, although we would need to see if this is the beginning of a new trend," said Elizabeth Arias, a demographer at NCHS who co-wrote the report.

The death rate decreased the most among people 15 to 24 years old, with a decline of 5.1%. It fell for all other age groups but the declines were minimal for those ages 35 to 44 and 55 to 64.

Among the top 10 causes of death in the U.S., only two increased in 2018: suicide and influenza/pneumonia. Lower mortality from heart disease -- the nation's top killer -- chronic lower respiratory diseases and homicides helped drive down mortality during the period.

The infant mortality rate decreased 2.3% in 2018 because of drops in unintentional injuries and certain gestational complications, the CDC report said.

The decline in drug deaths suggests that the greater focus on combating deadly opioids is starting to have some impact. The rate of drug overdose deaths involving heroin, natural and semisynthetic opioids and methadone were lower in 2018 than the previous year. But for synthetic opioids including fentanyl, that death rate increased slightly during the period.

Georges C. Benjamin, the executive director of the American Public Health Association, said that a decline in physicians prescribing opioids and wider availability of the opioid-reversal drug Narcan are beginning to show success.

Senior White House adviser Kellyanne Conway on Thursday credited the administration's drug policy for the increase in life expectancy, citing the decrease in drug overdose deaths.

"We will continue to fight this every single day, and we will continue to make the investments of money, of time, of education," she said of the opioid epidemic. Jim Carroll, director of the Office of National Drug Control Policy, said the administration's work with foreign countries, particularly China, had helped reduce the flow of fentanyl into the U.S.

Dr. Benjamin said that America still lags behind its peers in advancing life expectancy despite spending far more money on health care.

"The United States should not celebrate because we are spending twice as much money as the other developed nations and getting worse outcomes," he said.
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