“The opioid crisis is the tip of the iceberg,” states a new report from Virginia Commonwealth University’s Center on Society and Health, which includes alarming information about rising death rates in Virginia. Stress-related conditions, including not only unintentional drug overdoses, but also suicides, alcoholic liver disease, and alcohol poisonings, are killing white Virginians aged 25-to-54 years at increasing rates. The report, which also highlights increases in deaths from organ diseases possibly linked to substance abuse and trauma, found that stress-related deaths among white people ages 25-to-54 years increased 83 percent between 1995 and 2014. The study examined eight regions of Virginia, including all 95 counties and 38 independent cities.
“The alarming rise in death rates from drug overdoses, alcoholism, and suicides demands action,” said Center on Society and Health Director Steven Woolf, M.D., who is a professor at VCU School of Medicine. “The need for policies to improve living conditions and economic opportunity for the most vulnerable populations in Virginia could not be more urgent.”
The rise in stress-related deaths in Virginia mirrors a nationwide trend – what some call “deaths of despair.” The report also discusses increasing death rates from liver cancer, viral hepatitis, and some forms of heart disease.
Between 1995 and 2014, the increase in the death rate due to stress related conditions caused nearly 2,300 excess deaths among whites ages 25-to-54 years—lives that would have been spared if mortality rates had not increased. The increase in death rates from unintentional drug overdoses, an increase of 331 percent, was startling, but there were also increases in alcoholic liver disease (37 percent) and suicides (29 percent) among young and middle aged whites.
The report found that the highest increases in death rates due to stress-related conditions occurred in Southwest, Southside, and West Central Virginia, areas that have endured persistently high poverty rates over many years. Across Virginia, those areas with the largest increases in death rates tended to be rural and less diverse, have higher percentages of adults without bachelor’s degrees, and have a shortage of mental health professionals. “This is a crisis of our household economies and our communities,” Woolf said. “It will not be solved simply by changing how painkillers are prescribed.”
Increases in mortality due to stress related conditions did not solely affect rural localities, however. Areas of Northern Virginia and Hampton Roads also saw increases from these same causes of death. As the authors expressed in the report, “Hardship exists not only in rural Virginia but, increasingly, in pockets of disadvantage in metropolitan areas. More nuanced explanations for these health trends must also be considered.”
The report, which emphasizes that populations of color often experience higher death rates than whites, theorized why middle-aged white people were disproportionately impacted by stress-related mortality. “This age group is experiencing life conditions that differ starkly from past expectations and may lack the resilience to endure the cumulative stress that comes with prolonged social and economic hardships,” the authors said, noting that during the two decades examined in the report, young and middle-class white people experienced economic and social instability unlike that of their parents and grandparents.
The report authors also noted that, while rising death rates among white people are startling and warrant investigation, death rates in certain minority populations continue to be persistently and alarmingly higher than their white counterparts. From 2010 to 2014, the death rate among African Americans in Virginia was still 1.2 times higher than that of the white population.
“This crisis underscores the urgent need for policy action to reduce health inequities for all Virginians,” Woolf said.