Post: #1

The paper can be found here:
Rising morbidity and mortality in midlife among white non-Hispanic Americans in the 21st century

I´ll quote the New York Times article, it´s a short but informative read:

Quote:Something startling is happening to middle-aged white Americans. Unlike every other age group, unlike every other racial and ethnic group, unlike their counterparts in other rich countries, death rates in this group have been rising, not falling.

That finding was reported Monday by two Princeton economists, Angus Deaton, who last month won the 2015 Nobel Memorial Prize in Economic Science, and Anne Case. Analyzing health and mortality data from the Centers for Disease Control and Prevention and from other sources, they concluded that rising annual death rates among this group are being driven not by the big killers like heart disease and diabetes but by an epidemic of suicides and afflictions stemming from substance abuse: alcoholic liver disease and overdoses of heroin and prescription opioids.

The analysis by Dr. Deaton and Dr. Case may offer the most rigorous evidence to date of both the causes and implications of a development that has been puzzling demographers in recent years: the declining health and fortunes of poorly educated American whites. In middle age, they are dying at such a high rate that they are increasing the death rate for the entire group of middle-aged white Americans, Dr. Deaton and Dr. Case found.

The mortality rate for whites 45 to 54 years old with no more than a high school education increased by 134 deaths per 100,000 people from 1999 to 2014.

“It is difficult to find modern settings with survival losses of this magnitude,” wrote two Dartmouth economists, Ellen Meara and Jonathan S. Skinner, in a commentary to the Deaton-Case analysis that was published in Proceedings of the National Academy of Sciences.

“Wow,” said Samuel Preston, a professor of sociology at the University of Pennsylvania and an expert on mortality trends and the health of populations, who was not involved in the research. “This is a vivid indication that something is awry in these American households.”

Dr. Deaton had but one parallel. “Only H.I.V./AIDS in contemporary times has done anything like this,” he said.

In contrast, the death rate for middle-aged blacks and Hispanics continued to decline during the same period, as did death rates for younger and older people of all races and ethnic groups.

Middle-aged blacks still have a higher mortality rate than whites — 581 per 100,000, compared with 415 for whites — but the gap is closing, and the rate for middle-aged Hispanics is far lower than for middle-aged whites at 262 per 100,000.

David M. Cutler, a Harvard health care economist, said that although it was known that people were dying from causes like opioid addiction, the thought was that those deaths were just blips in the health care statistics and that over all everyone’s health was improving. The new paper, he said, “shows those blips are more like incoming missiles.”

Dr. Deaton and Dr. Case (who are husband and wife) say they stumbled on their finding by accident, looking at a variety of national data sets on mortality rates and federal surveys that asked people about their levels of pain, disability and general ill health.

Dr. Deaton was looking at statistics on suicide and happiness, skeptical about whether states with a high happiness level have a low suicide rate. (They do not, he discovered; in fact, the opposite is true.) Dr. Case was interested in poor health, including chronic pain because she has suffered for 12 years from disabling and untreatable lower back pain.

Dr. Deaton noticed in national data sets that middle-aged whites were committing suicide at an unprecedented rate and that the all-cause mortality in this group was rising. But suicides alone, he and Dr. Case realized, were not enough to push up overall death rates, so they began looking at other causes of death. That led them to the discovery that deaths from drug and alcohol poisoning also increased in this group.

The people who are, slowly or quickly, killing themselves are the people who thought, in the 60s and 70s, that if they did what their parents did they too would get job security, pensions, and a decent lifestyle.

They concluded that taken together, suicides, drugs and alcohol explained the overall increase in deaths. The effect was largely confined to people with a high school education or less. In that group, death rates rose by 22 percent while they actually fell for those with a college education.

It is not clear why only middle-aged whites had such a rise in their mortality rates. Dr. Meara and Dr. Skinner, in their commentary, considered a variety of explanations — including a pronounced racial difference in the prescription of opioid drugs and their misuse, and a more pessimistic outlook among whites about their financial futures — but say they cannot fully account for the effect.

Dr. Case, investigating indicators of poor health, discovered that middle-aged people, unlike the young and unlike the elderly, were reporting more pain in recent years than in the past. A third in this group reported they had chronic joint pain over the years 2011 to 2013, and one in seven said they had sciatica. Those with the least education reported the most pain and the worst general health.

The least educated also had the most financial distress, Dr. Meara and Dr. Skinner noted in their commentary. In the period examined by Dr. Deaton and Dr. Case, the inflation-adjusted income for households headed by a high school graduate fell by 19 percent.

Dr. Case found that the number of whites with mental illnesses and the number reporting they had difficulty socializing increased in tandem. Along with that, increasing numbers of middle-aged whites said they were unable to work. She also saw matching increases in the numbers reporting pain and the numbers reporting difficulty socializing, difficulty shopping, difficulty walking for two blocks.

With the pain and mental distress data, Dr. Deaton said, “we had the two halves of the story.” Increases in mortality rates in middle-aged whites rose in parallel with their increasing reports of pain, poor health and distress, he explained. They provided a rationale for the increase in deaths from substance abuse and suicides.

Dr. Preston of the University of Pennsylvania noted that the National Academy of Sciences had published two monographs reporting that the United States had fallen behind other rich countries in improvements in life expectancy. One was on mortality below age 50 and the other on mortality above age 50. He coedited one of those reports. But, he said, because of the age divisions, the researchers analyzing the data missed what Dr. Deaton and Dr. Case found hiding in plain sight.

“We didn’t pick it up,” Dr. Preston said, referring to the increasing mortality rates among middle-aged whites.

Ronald D. Lee, professor of economics, professor of demography and director of the Center on Economics and Demography of Aging at the University of California, Berkeley, was among those taken aback by what Dr. Deaton and Dr. Case discovered.

“Seldom have I felt as affected by a paper,” he said. “It seems so sad.”

   

The findings of this study are quite shocking.

What do the members of RVF think about this?

Do you notice those developments on the ground?

Did the destruction of Middle Class America also destroy its will to live?

Could it be that White Americans couldn´t bear the burden of their privilege anymore?

Let´s discuss.

Post: #2

Sounds more like a lot of fat and feckless boomers and Gen Xers shitty lifestyles are finally coming to nip them in their butts.

Whether by design or not, the cultural legacy of the boomers is quickly coming to an end.

Post: #3

I read this paper last night. It's an interesting one.

I believe that the authors have correctly identified the cause of this increase in mortality amount lower class uneducated American whites aged 45-54: it is the epidemic of painkiller pill addiction, all over the country but particularly in certain regions like Appalachia. The causes of death that are contributing to this increase in mortality are poisonings, overdoses and suicides, all the direct result of painkiller abuse. They don't break out the results by state, but I believe that if they looked at the Appalachian region (eastern Kentucky, eastern Tennessee, West Virginia and parts of Ohio and Pennsylvania) the results would be truly eye-popping.

I recently encountered this phenomenon in someone I know (not well, but a friend of a friend). He is not, technically speaking, in the uneducated group -- in fact, he is a college professor -- but he comes from an extreme low class Eastern Kentucky trailer trash background so he is an honorary member of the uneducated classes.

In this exact age bracket of 45-54 he developed a painkiller addiction; at one point he "threw out his back" and was prescribed Percocet. He found that he liked this a great deal, and eventually he graduated to Vicodin, and at last to the great King of painkillers, Oxycontin. Soon enough he was at times living on the street, and he traveled out to West Virginia and eventually all the way back to his hometown in Kentucky because he could get Oxy in all these places much cheaper and more readily than he could in the city where he worked. When a man of around 50 returns to the town of his childhood, not for a sentimental journey into the past but because that is a place where he can score cheap Oxy, that is a reality that should give one some pause, LOL.

Something this guy spoke about is the obsessive and inescapable suicidal ideation that appears at some stage of Oxy addiction. He'd had a reasonably hard life and thought that he had been suicidal before, but he realized that he really hadn't -- not until this time, when he found himself thinking about ways of killing himself at all times, a persistent thought that seemed urgent and unavoidable. And I believe he came very close -- but something allowed him to eventually come out of it. But many many other lower class whites, both men and women, of that exact age group who have lain in the velvety bed of Oxy were never able to rise from it; and I (like the authors) believe that the numbers in the study testify to the spread and potency of this American white lower class epidemic.

Post: #4

The graph above shows that only American white male deaths are increasing, while other Western countries show decreases across the board. Cultural decline can't explain that. What can?

Post: #5

(11-03-2015 09:32 AM)CleanSlate Wrote:  The graph above shows that only American white male deaths are increasing, while other Western countries show decreases across the board. Cultural decline can't explain that. What can?

The American lifestyle really is much more toxic than that of many other Western countries. We have deathfats in Europe but I very, very rarely see anyone under the age of 55 use a scootypuff for example.

And I don't know about other European countries but unless you've just been split in half by a freak sawmill accident you're not getting the "doze off to fairyland" horse tranquilizer dose of painkillers that seem quite common in the US.

Post: #6

My guess is that it's a combination of hopelessness and idleness given that secure, good-paying jobs for white Americans in the Midwest have completely dried up for the most part. Rural communities are being decimated by alcoholism, opioid-use and poverty. The intelligent whites leave their communities behind and make it in a big city, thereby lowering stock of the remaining populace.

I'm from Upstate NY, and the communities that have thrived there for centuries are dying by the dozens. Beautiful old main streets completely deserted, with the only tenant a pizza shop and OTB. Boarded up Victorians that go for a song. When my wife accompanies me to visit my family, she is shocked by the bombed-out look of these towns.

Unfortunately I think the genie is out of the bottle on this one. You'd have to redistribute quite a bit of money to the interior while concurrently throttling free-trade agreements.

The Republican Party is the party that best represents these downtrodden folk and has almost completely abandoned them. That's why Trump has become so popular in my opinion; his populism is speaking directly to these disenfranchised people.

Post: #7

I have noticed this trend in Canada for awhile now.

Many of my (white) friends have lost one of their parents or both to Cancer primarily.

I think stress, eating habits and inactive lifestyles contribute to this. I also feel there is something else at play here, which I cannot put my finger on.

Being older as well, I really feel the high consumption of meat and alcohol takes a toll eventually.

Post: #8

(11-03-2015 10:20 AM)PUA_Rachacha Wrote:  Unfortunately I think the genie is out of the bottle on this one. You'd have to redistribute quite a bit of money to the interior while concurrently throttling free-trade agreements.

The Republican Party is the party that best represents these downtrodden folk and has almost completely abandoned them. That's why Trump has become so popular in my opinion; his populism is speaking directly to these disenfranchised people.

Good post.

This resonates with the experience I gained from traveling all over the USA for my work. I do a lot of hands on field work in the middle of nowhere, usually a several hours drive away from the big cities. I've spent enough time in the small towns scattered about in the fly over country to really see what you are talking about.

Many of these small towns are a sad sight to see. Jobs are scarce. Houses are run down. Pothole laden streets. Brick-and-mortar businesses one weather-related mishap away from bankruptcy.

Rampant obesity. Hopelessness in people's eyes. Hardly any hot chicks, as they've undoubtedly fled to the big cities in pursuit of "opportunities".

You'd think you're in a third world country if you suddenly teleported to those places without knowing exactly where you are.

But it's not just the lack of opportunity or finances that had been dragging these towns down. I think it's something else.

These depressed communities lack self-sufficiency. I don't have any proof to back it up, and it is all conjecture on my part, but I believe this may play a part into increasing middle-age male deaths in America.

Let me explain.

One time I went to rural Montana, again on a work trip, and I met with a dude who was dressed like a colonist. He took me to his colony and gave me a tour. Everyone - men, women, and children - were dressed the same way. Strict dress code. I felt like I went back in time to the 17th century. The amazing part was that they had their own farm, grew their own food, hunted their own game, sourced their homes with both water and electricity on their own, and even had their own school!

They were completely self-sufficient. If all levels of our government completely vanished overnight along with the infrastructure we've become accustomed to, they would be completely unaffected while cities would drown in their own chaos and crime.

All the colonists were too busy living their lives to turn to drugs, co-miser about their sorry existence, and they had purpose in their eyes. Everyone understood their roles clearly, and went about each day fulfilling their roles.

There was teamwork and a sense of synergy in their community that has been sorely lacking in cities and suburbs all over America.

Remembering this experience as I read your post leads me to believe that self-sufficiency is lacking, or has been taken away by the ever-expanding government. This lack of self-sufficiency leaves the men with not much else to do. They've forgotten how to build a community from scratch.

So they languish.

Of course, I don't know how I would explain the divergence of male death rates between America and other Western countries. Perhaps it has something to do with the size of the country and population. France, Sweden, etc, are relatively small, while the the US is a very big country, and the government has spread themselves so thin that they cannot possibly govern all the communities across 3.8 million square miles. Some communities HAVE to pick up the slack themselves, but they don't.

Post: #9

Well, what do you expect from a group that has seen the following:

1. Divorce raped into the next dimension

2. Jobs shipped overseas / benefits destroyed.

3. Vibrant communities now ghost towns.

4. Constantly reminded by the media and society that your problems don’t matter because you’re white and well, you have it easy. Say anything un-PC and have your life destroyed.

5. Multiple stupid fuckin wars (Vietnam and Iraq) that have claimed the lives of many of your relatives and/or friends. Those severely injured are left to deal with the inefficient VA that barely can do anything right for years on end; despite the fact politicians have time to appease and bend over backwards for stupid bullshit SJW causes and illegal immigrants.

6. Watched illegal immigrants be given preferential status in many instances; including in the labor market, welfare benefits, and culturally.

7. Once feminine thin women turn into fat disgusting slobs who abuse the court system to extract every cent of child support possible. No one cares that you can’t pay or see your kids frequently.

Some people are simply going to be overwhelmed with all the aforementioned and give up. For those left, sadness will eventually turn to anger. There is a reason someone like Trump is doing as well as he is in the polls. A storm several decades in the making is coming.

Post: #10

This thread could end up being insightful or end up in a ball of flames...

The OP, with no prescript, I get the vibe, is putting cheese out in a very subtle way and I hope nobody tries to bite.

This isn't some white America problem. To much, to soon, this group scream and moans instead of sitting down and looking at the big picture.

What is being displayed here with the data is nothing new. It is nothing new if you are African American that is.

Ask yourself why the NYT left out African Americans from the graphs? This is because there has been a reverse in middle age African American death rates and they have stabilized.

They leave this out because they don't want to bring up the factors that lead to the initial dip in the first place...

For years now many of us have been telling people that the canary in the coal mine for the downgrade of general culture and well being in the west was from indicators from the African-American community and their experience of efforts to destroy them in decades past. Nothing that is happening to White America is anything new, the same script that was used to destroy the African-American community is being used on Whites.

From members such as Excelsior who much more eloquently then me put this out on blast on ROK years ago.

How come nobody remembers the 1970s? 20 years into a target effort to destroy Black African-American males they saw a historic rise in death rates. Literally only much better than war torn places in Africa or EE the Average African American male was more likley to be in jail or dead by 50 years old.

When you take away a mans means to provide he falls into despair. You ruin his home and community and what else does a man live for? Broken and beat down the man reaches for anything to help him escape teh hell that is cast in front of him.

I just encourage anybody to go read up on the past. Anything happening now isn't exclusive or unique. Generations of Black American men were put through a meat grinder and a whole community was destroyed in the process and it was all intentionally done.

Post: #11

Well considering Britain and Australia have the opposite trend, it's likely to be health related rather then societal.

I've haven't been to America yet, but people I know who have always remark on the numbers of fat people in so many numerous places (and even this is coming from British people, and we have a high rate of obesity).

I've heard that loads of your food has the shittiest additives you could think of in them. Also in Britain/Oz, drinking culture revolves round team sports, I don't know if it's like that in the US.

Post: #12

CleanSlate and Kosko, well said.

While I have not been first hand to witness the gutting of this demographic, I have seen glimpses of the ingredients that you mention.

Taking away a mans family, community and perceived purpose is the easiest way to kill his soul. Most men are not going to directly put a gun in their mouth -though certainly a good portion will- but instead will go the romantic route and pop pills and drink their days away. We even see this silly fantasy in successful people, artists especially, where this type of escape is seen as tragic and sad.

These small rural towns that were once gems of communities and had a self sufficient economy are now wasted. The men that could find a family and a job, even a simple non skilled job, and be happy now have too much information to compete with. And going to the city to compete with urban men at that age is going to be too much.

Post: #13

Kosko, let me clarify a few things:

Quote:This thread could end up being insightful or end up in a ball of flames...

The OP, with no prescript, I get the vibe, is putting cheese out in a very subtle way and I hope nobody tries to bite.

If I put some cheese out, it was certainly not intentional. I actually first read about this in an Austrian newspaper today, found it to be interesting and valuable news, and thus proceeded to read the original paper at PNAS. That one group of people has such a disastrous change in life expextancy in a rather short time period is quite unusual (it reminds me a bit of the drop in male life expectancy in post-Soviet Russia), especially in a developed first world country like the US is. The fact that this year´s Nobel Prize for Economics winner takes an interest in this and that it makes international news should attest to that.

I thought it would be nice to have a dicussion about this topic on the forum, as there are lots of knowledgable posters from America who I recon would also like to know more about this. I haven´t been to the States since I was a child, so I have no idea what things are like on the ground. Thus I wanted to know how or if such a staggering development could have gone unnoticed for so long.

Did I hesitate to start this thread as it undeniably bears potential to descend into one of those infamous race threads? Of course.
But I figured since the article is about hard statistical findings, not putting various racial groups against each other, but specifically deals with one group and its problems, and taking into account that the majority of regular posters here are rational and responsible men, we should be able to have a serious discussion on a high level.

Quote:This isn't some white America problem. To much, to soon, this group scream and moans instead of sitting down and looking at the big picture.

I disagree on the first statement.
This specific case talks about a white American problem, the drop in life expectancy in a distinctive age group of White Americans.
This is not an opinion piece, but a peer reviewed study from a very reputable source. Nobody is moaning or screaming.
That other groups might have experienced the same thing earlier, is very possible and I believe that too, but it´s not the topic of the study.

Should we also look at the big picture and try to find out why this phenomenon occurs in more and more parts of American society?
Of course, that´s what this forum is for.
This study is just a further piece of the puzzle that helps us to see the big picture, nothing more, nothing less.

Quote:What is being displayed here with the data is nothing new. It is nothing new if you are African American that is.

Ask yourself why the NYT left out African Americans from the graphs? This is because there has been a reverse in middle age African American death rates and they have stabilized.

Indeed I was also curious as to why the graph doesn´t mention African Americans. The article does mention something however:
"Middle-aged blacks still have a higher mortality rate than whites — 581 per 100,000, compared with 415 for whites — but the gap is closing"
So yes, there is the elephant in the room and it is a huge problem, nobody denies it, but again, not the topic of the study.

Quote:They leave this out because they don't want to bring up the factors that lead to the initial dip in the first place...

An interpretation I´m inclined to agree with.

Quote:For years now many of us have been telling people that the canary in the coal mine for the downgrade of general culture and well being in the west was from indicators from the African-American community and their experience of efforts to destroy them in decades past. Nothing that is happening to White America is anything new, the same script that was used to destroy the African-American community is being used on Whites.

From members such as Excelsior who much more eloquently then me put this out on blast on ROK years ago.

How come nobody remembers the 1970s? 20 years into a target effort to destroy Black African-American males they saw a historic rise in death rates. Literally only much better than war torn places in Africa or EE the Average African American male was more likley to be in jail or dead by 50 years old.

When you take away a mans means to provide he falls into despair. You ruin his home and community and what else does a man live for? Broken and beat down the man reaches for anything to help him escape teh hell that is cast in front of him.

I very much like this theory.
As someone who´s been reading the forum for a long time, I remember that At...Excelsior in particular posted some very eloquent, convincing and frankly mind blowing essays about that, which at least to someone like me, who´s not American and only has a superficial understanding about what´s going on in the US, offered a completely new perspective, as I´ve never heard about things like the (systematic?) destruction of the African American family and community in European mainstream media before.

You say nothing that is happening to White America is new, alright, but I´d say that it is happening to White America is new.
And that´s the news.

Quote:I just encourage anybody to go read up on the past. Anything happening now isn't exclusive or unique. Generations of Black American men were put through a meat grinder and a whole community was destroyed in the process and it was all intentionally done.

This advice never gets old. Everyone should read about history and learn from it, to avoid making the same mistakes our predecessors made.

Could you further elaborate on why you think it was intentional?
Who did it and why. I´m curious.

Post: #14

I'm going to throw out some anecdotal observations on this. I agree with Kosko that the 1970s factors that broke the black population are not coming to the whites.

Part of this can be seen through divorce. When I lived in Wisconsin, I checked out a 'father's rights' group meeting and holy hell it was depressing. The guys that were in their 45-55 range looked like ghosts. They all had brutal stories and just had an air about them that they had given up.

My theory is that middle aged white men were on the first wave of the decline, both economically and socially. Their disconnect with the expectations presented to them in their youth vs. today's reality is the strongest and so they are damaged the most psychologically. Compare that to people in their 30s like myself that sort of expect divorce rape and economic turmoil...its not so shocking when it happens.

The same thing goes for middle aged, single men that I see at my church. The ones with wives seem to be ok, but the ones by themselves look like wraiths...just sort of barely there and dragging themselves in on sunday.

The future effect of this, as kosko mentioned, can already be seen in history.

Post: #15

(11-03-2015 11:08 AM)The Black Knight Wrote:  Well, what do you expect from a group that has seen the following:

1. Divorce raped into the next dimension

2. Jobs shipped overseas / benefits destroyed.

3. Vibrant communities now ghost towns.

4. Constantly reminded by the media and society that your problems don’t matter because you’re white and well, you have it easy. Say anything un-PC and have your life destroyed.

5. Multiple stupid fuckin wars (Vietnam and Iraq) that have claimed the lives of many of your relatives and/or friends. Those severely injured are left to deal with the inefficient VA that barely can do anything right for years on end; despite the fact politicians have time to appease and bend over backwards for stupid bullshit SJW causes and illegal immigrants.

6. Watched illegal immigrants be given preferential status in many instances; including in the labor market, welfare benefits, and culturally.

7. Once feminine thin women turn into fat disgusting slobs who abuse the court system to extract every cent of child support possible. No one cares that you can’t pay or see your kids frequently.

Some people are simply going to be overwhelmed with all the aforementioned and give up. For those left, sadness will eventually turn to anger. There is a reason someone like Trump is doing as well as he is in the polls. A storm several decades in the making is coming.

   

Post: #16

This is my fathers generation as he just turned 55, so I can see what this kind of decline would do to a man like him.

These guys, in their early 20's had all sorts of opportunity. Women, work and pleasure were all there for the taking. But one thing I hear from all these guys is that money was tight. They started out their married lives in their early 20's living mostly paycheck to paycheck. They saved for things, because credit cards were barely there. And while their home lives were mostly good with thin wives, no divorce and a good relationships between men and women, the good times were only about to ramp up.

Imagine the wealth these guys started to feel when their mortgage rates hit bottom, credit was thrown around for free, and real estate always went up. 10 years ago when my dad was mid 40's he was worth a lot of money from saving, his family home was worth 6x what he paid for it, and he had a loving wife and good family.

Imagine what a bored early to mid 40's woman was thinking after 25 years of nagging the balls off her husband. Cash the fuck out. Why not? Its her right after all.

Marriage has always been a struggle, but when we started getting blasted with the idea that men are basically evil and responsible for the worlds woes, women took this at face value and sucked what they could out of the system.

I know for a fact that if my mom left my dad now, he would not do well, even though he spent his whole life as one of the "red pill alpha males". He has too much time, love, money and faith in the system now that to be raked over the coals just might kill him.

Its what Dr Howard says, guys like us can mentally prepare for the reality of the world, but when the world changes so suddenly right in the middle of the game its going to be nearly impossible for some men to adapt, and this is likely what happened here.

Post: #17

I think one big driver is obesity - In Europe it's very rare to see a 300lb+ man. In the US there are 300lb+ women walking around.

Another thing may be the marketing of prescription drugs.

From 2013:

Consumer Drug Advertising Should Be Banned

Quote:Consumer advertising of prescription drugs is a massive public health experiment in which billions of dollars are spent each year. But this advertising is a blunt instrument where a sharp edge is needed.

Drugs have harms as well as benefits, and the harms are greater when drugs are indiscriminately prescribed. Consumer advertising, delivered to the masses as a shotgun blast, rather than as specific information to concerned patients or caregivers, results in more prescriptions and less appropriate prescribing

There is no evidence that consumer ads improve treatment quality or result in earlier provision of needed care. Research has shown that the ads convey an unbalanced picture, with benefits and emotional appeals given far greater weight than risks. Clinicians can work to override these miscues, but this steals precious time from activities that can provide real benefit to patients. In the packed agenda of the patient visit, in which so many real concerns and evidence-based care are available to make a difference in people's lives, the intrusion of marketing risks harm.

Advertising also provokes a subtle shift in our culture -- toward seeking a pill for every ill. While there are many for whom stimulants and other medications can be a godsend, the case of attention deficit hyperactivity disorder is a prime example of how, too often, a pill substitutes for more human responses to distress. U.S. clinicians prescribe stimulant medication for A.D.H.D. at a rate 25 times that of their European counterparts. The complex decision to start a long-term medication should be motivated by the observations of teachers and parents and children, in the context of a relationship with a caring clinician − not stimulated by rosy ads.

Consumer drug advertising is banned in most of the world, although pharmaceutical companies are making a full-court press on the European Union, even while violating the limited guidelines for that advertising in the United States.

In the information age, in which more balanced sources of information on drugs should be widely available, biased pill-pushing messages are a public health menace. To advance the health of the public, the United States should follow the lead of the vast majority of countries, and ban direct-to-consumer pharmaceutical advertising.

Direct-to-consumer drug marketing is a scandal. Can the FDA fix it?

Quote:September 18, 2015, 2:19 PM

Two nations in the world allow drug companies to market prescription medicines directly to consumers: New Zealand and the United States. In the U.S. at least, the lack of effective regulation of what drugmakers say, and how, leaves consumers utterly at a loss when trying to understand the uses and risks of these intensely marketed products.

That's the conclusion of Jeremy A. Greene of Johns Hopkins and Elizabeth S. Watkins of UC San Francisco, who write in the New England Journal of Medicine that discussions of side effects and contraindications are typically provided to consumers in package inserts whose "medical terminology, dense verbiage, and tiny fonts ... have made them inscrutable to the average consumer and virtually useless as information sources."

The print and broadcast ads for the same products are even worse — colorful images of individuals happily liberated from the burdens of disease, accompanied by hastily babbled rosters of side effects or "one or two pages of dry text providing ... required disclosures," often just repeating language intended for doctors prescribing the drugs, says University of Arizona law professor Christopher Robertson in a companion piece.

Now, the Food and Drug Administration is preparing to step in. The FDA has circulated a draft regulation that would require consumer information to be communicated in plain language and in (horrors!) a readable format.

The FDA is frowning on the usual impenetrable jargon of drug inserts and advertised warnings. The regulation aims to replace it with "a conversational tone or language designed to engage the reader." Instead of the term "contraindications," for example, the warnings should say, "do not use if you have... ." Instead of "somnolence," use "drowsiness." Not "syncope," but "fainting." No more small print, but fonts "selected or designed for readability;" double-spacing between paragraphs and more white space to draw the reader in.


This is all important because studies have shown that more than 40% of drug consumers don't usually look at the warning summaries in prescription drug ads, and of those who tried, 55% find them hard to read.

Any television viewer knows that the list of side effects can be over in a flash or easily overlooked, even if they're horrific. In a commercial for the prescription sleeping pill Lunesta, for example, such possible side effects as aggressiveness, agitation, hallucinations, and "deepening of depression, including risk of suicide" are reeled off in the same soothing, soporific voiceover that mentions the drug's virtuous ability to deliver a good night's sleep.

This isn't the FDA's first effort to regulate consumer information, according to Greene and Watkins' report. The last effort started with the birth control pill, which was shown in the 1960s to have potentially fatal safety risks years after it became widely prescribed.

The FDA ordered disclosure of the pill's safety risks in clear language, but doctors and drugmakers fought back; the proposed disclosures became progressively more "anemic," the authors observe, until the final version removed all references to any adverse symptoms at all. In 1979, the FDA proposed plain-language disclosures for all prescription drugs, but that effort died under pressure from the anti-regulation Reagan Administration.

What was left was a "voluntary approach," which remained in place even after 1985, when the FDA started to allow drug companies to advertise in newspapers and magazines.

Will the FDA rules work, once they're implemented? Robertson is skeptical. He calls the rules "modest" and points out that by encouraging drugmakers to limit their disclosures to the most serious or common side effects in the interest of reducing consumer confusion, the draft rules may give manufacturers too much discretion about what to leave out.

Robertson says the FDA could have proposed greater restrictions, "perhaps cracking down on industry's use of noncognitive persuasion (think bathtubs in a field of flowers to suggest the romance made possible by an erectile-dysfunction drug), which may undermine rational decision making by patients." He acknowledges, however, that such rules might run afoul of the Supreme Court's favoring of free-speech rights for commercial entities.

Greene and Watkins see some direct-to-consumer marketing as a positive in treating consumers as stakeholders entitled to more information about their own healthcare. But they caution that 30 years of such marketing leaves room for doubt that "advertising is the best medium for communicating risk information." The drug companies, they say, "should at least be required to try to communicate risk information as effectively as they do their promotional messages."

Post: #18

A few follow-up comments:

First, most posters in this thread have implicitly assumed that the increase in mortality in the 45-54 age bracket is specifically a problem of white American men. That is not the case. The authors have looked at men and women separately, and both men and women show equal increases in mortality for this cohort (again, the cohort is white Americans of ages 45-54).

As a consequence of this, any explanations that apply to men only (which various posters have offered) cannot possibly explain why this is happening.

Second, it is possible to break down the particular causes of death that are leading to this increase in mortality. These are mainly suicides and alcohol and drug poisonings/overdoses. If the cause was obesity (for example) you would expect to see increasing mortality from obesity-linked diseases such as diabetes. But this is not happening, so obesity can be ruled out as an explanation.

Third, this increase is occurring in the US only, so phenomena that apply across the board to both the US and other western countries are not possible explanations, either.

Fourth, the increase is limited to this racial group (whites) and this specific age bracket. For older whites (55 and above) mortality rates continue to decrease.

Fifth, within this cohort, the increase in mortality is coming exclusively from people with little education (no college degree). Educated members of this cohort are still seeing stable or improving mortality rates.

Putting all of these together, a putative cause of this phenomenon would have to:

1. Affect primarily white Americans, but not residents of other countries or Americans of other races
2. Affect men and women equally
3. Be prevalent in the 45-54 age bracket
4. Only affect people in the lower classes / little education
5. Cause deaths from suicide and alcohol and drug poisoning and overdose.

In my opinion, the only explanation that satisfies all these conditions is the one that the authors themselves offer in the paper, and which I outlined in my previous post in this thread. Namely, it is the epidemic of prescription painkiller addiction among middle aged white Americans. This epidemic is a uniquely American phenomenon (indeed, it's regional within the US); it is concentrated among white lower class Americans; it has equal prevalence among men and women; it is particularly rife in this middle aged cohort; and it leads to a very high rate of suicides and drug and alcohol poisonings (also due to adverse interactions between alcohol and painkillers). There is really no other conclusion that is consistent with all the data, and this one fits the data perfectly. Therefore, it should be accepted as the correct explanation.

Post: #19

They call Oxycotin "Hillbilly Heroin" because it's use is so prevalent in this demographic (especially in Appalachia).

Post: #20

(11-03-2015 08:38 PM)WalterBlack Wrote:  I think one big driver is obesity - In Europe it's very rare to see a 300lb+ man. In the US there are 300lb+ women walking around.

Another thing may be the marketing of prescription drugs.

but if it was obesity, wouldn't you expect to see multiple age brackets, races and genders increasing in mortality rates?

Post: #21

(11-03-2015 09:34 PM)Dusty Wrote:  They call Oxycotin "Hillbilly Heroin" because it's use is so prevalent in this demographic (especially in Appalachia).

I live in appalachia and I see plenty of young oxy and meth users as well. It certainly isn't just middle aged white men using it.

Post: #22

So. The Celtic Austrian who's country is getting ass fucked needs to post some lame ass study SJW style for what reason?

Did you do a state by state study? What are your sources? Facebook click bait?

I'm getting real sick of euro-clowns posting USA stuff here. Go buy some guns and handle your business.

Post: #23

I think Lizard has the right of it. One difference between America and the rest of the west, even other Anglosphere countries like the UK and Australia, is the rampant over-use of prescription medication. Middle-aged white people talk about "my meds" like it's a normal part of life to be taking a bunch of little white pills every day at age 50.

Post: #24

(11-03-2015 10:31 PM)RawGod Wrote:  I think Lizard has the right of it. One difference between America and the rest of the west, even other Anglosphere countries like the UK and Australia, is the rampant over-use of prescription medication. Middle-aged white people talk about "my meds" like it's a normal part of life to be taking a bunch of little white pills every day at age 50.

We do talk about guns and Muslims also.

Post: #25

Just putting Samseau's addiction thread here...

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