For more than a century, we’ve taken it for granted that life expectancy will continue to increase with no end in sight.
But a study at Princeton University has questioned that assumption for one age group. Among Canadians 50 to 54, the mortality rate from suicide, alcoholism and illicit drugs has jumped 25 per cent since 1990.
That more or less wiped out all of the health-care gains from improved medical treatment over the period, and might have reduced the life expectancy of this group. The question is, what is causing these “deaths from despair”?
Stagnating incomes among working-class families might be part of the reason. So, I suspect, is the age of the population segment we’re talking about.
Younger people tend to be more resilient. And folks in their 60s have retirement to look forward to.
But middle-aged men and women whose lives haven’t worked out can be trapped in a darker mentality. If their marriage broke down or they can’t provide for their kids, guilt and self-blame are a natural reaction.
Some of this crisis might have played a part in Donald Trump’s victory south of the border, where deaths from despair have also soared. The so-called “rust belt states” that gave Trump the presidency have seen traditional industries all but wiped out.
Yet the study’s authors mainly discount an economic explanation. Instead, they point to the weakening of support structures, such as marriage, religion, trade unions and service clubs. They argue the decline of these institutions has made middle age far more lonely and comfortless than once it was.
That would explain, in part, why more than half the drug-overdose deaths in B.C. occur among people aged 40 to 59. You might expect that young people fleeing dysfunctional homes, or kids willing to try whatever concoction comes along, would be the principal victims.
But fentanyl is not, primarily, a plague that kills teenagers (or seniors), though there are deaths in both groups. It is a plague that affects the middle aged and, overwhelmingly, men more than women.
This latter point — that men are disproportionately the victims of drug fatalities — hints at another factor. The sectors of B.C.’s economy that have been hardest hit of late — resource extraction, mining, forestry — are largely male-dominated.
Most middle-aged men grew up in an era when it was expected they would be the family’s main breadwinner. In 1960, the ratio of males to females in the workforce was roughly two to one.
Today, the numbers are nearly even. The ascent of women, while desirable both from an equity perspective and for the contribution it has made to the economy, has been matched — to an extent — by the descent of working-class men.
This is a difficult narrative to get right. There is no causality between the greater participation of women in the workforce and the plight of some men.
And yet it might be possible to trace here at least some of the roots of despair.
The hard truth is, we really don’t understand what is going on. No one explanation covers all the bases, as the authors of the study admit.
This feels like the early days of the HIV/AIDS epidemic.
People were dying of opportunistic infections such as pneumonia and tuberculosis, but no underlying cause had been found.
Likewise, the symptoms of death from despair are well-known — opioid fatalities, homelessness, suicide — but we haven’t tied down the social malfunction behind them.
Instead, we point to mental illness, or the high cost of housing, or childhood abuse, all of which are real, but cannot be the whole story.
We need a public discussion of this crisis, before it gets worse.
