According to a study released by the Center on Society and Health, in partnership with the Graduate School of Public Health at the University of Pittsburgh, “deaths of despair”—those related to drugs and alcohol and other causes of death linked to stress—are skyrocketing among young and middle-aged whites in rural Missouri.

The study, funded by the Missouri Foundation for Health, shows that while death rates have generally been decreasing in the United States and other industrialized countries, death rates in most Missouri counties increased for young and middle-aged whites (ages 25-59 years) since 2000. This trend is consistent with findings from national studies, which also report rising death rates among certain groups of whites, especially those who are middle-aged, have less education, and women.

It is important to note that, while rising death rates—in this case, among whites—are startling and warrant investigation, death rates in certain minority populations continue to be persistently and alarmingly higher than their white counterparts. Even as mortality rates among African Americans in Missouri continue to fall, for example, in 2010-2014 they remained 1.2 times as high as mortality rates for whites. Continued efforts are needed to understand and reduce unnecessarily high death rates among people of color.

The increase in mortality among whites has been attributed to the opioid epidemic, but this study found that it reflects increased death rates from multiple causes, including drug and alcohol overdoses, suicides, and accidents. The research found that the increase in death rates among whites was isolated to 79 of the 114 counties in Missouri, most located in largely white, rural counties in northwestern and southern Missouri, with the Ozarks and Bootheel regions experiencing the largest increases in mortality. In contrast, whites in major metropolitan areas, such as Kansas City and St. Louis, and along the I-70 corridor were largely spared this trend; their mortality rates decreased over this same time period.

Overall, the leading causes of rising death rates among whites in Missouri were substance abuse (e.g., drug, alcohol, and tobacco) and suicides. An estimated 68 percent of these excess deaths were due to accidental drug overdoses, suicides, alcoholic liver disease, and chronic lower respiratory disease (caused mainly by smoking).

• Death rates from drug overdoses between 1995 and 2014 increased by 585 percent among young and middle-aged whites in Missouri.
• Death rates from alcohol poisoning (e.g., binge drinking) increased by 763 percent.
• The rate of suicides among young and middle-aged whites increased by 30 percent after 2000. Hanging, strangulation, or suffocation were the most common forms of non-firearm suicide, increased by 156 percent after 1995.

For more information on our Missouri Mortality Study, and details regarding our other projects in Virginia, Minnesota, California, and Kansas, visit https://societyhealth.vcu.edu/work/the-projects/mortality-studies.html.