New Study Finds More Whites And American Indians/Alaska Natives Are Dying Young

It seems to be linked to a drastic increase in accidental deaths from drug overdoses, suicides, and liver disease.

In an alarming new study, researchers found that deaths among 25–64-year-olds have increased the most among whites and American Indians/Alaska Natives, when compared to other racial and ethnic groups.

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The study findings, published yesterday in The Lancet, were based on US death certificates from 1999 to 2014 collected by the National Center for Health Statistics.

"We wanted to give a comprehensive picture of premature mortality in the US among major racial and ethnic groups," Meredith Shiels, PhD, an investigator at the National Cancer Institute and lead author of the study, told BuzzFeed News.

Researchers looked at the change in death rates (not the absolute death rate) among 25–64-year-olds, which is known as the "premature mortality rate." They compared this across the following racial and ethnic groups: American Indian/Alaska Natives, Hispanics, blacks, whites, and Asian/Pacific Islanders. They also identified the specific causes of death to better understand trends among different groups.

There were an estimated 111,000 excess premature deaths among whites and 6,000 among American Indians/Alaska Natives from 2000 to 2014.

The highest increase in premature death rate was specifically among women aged 25–30 in both racial groups. When they examined the annual mortality rates among 30-year-olds, they found a 2.3% increase in white women, a 0.6% increase in white men, a 4.3% increase for American Indian/Alaska Native women, and a 1.9% increase among American Indian/Alaska Native men.

Still, the absolute premature mortality rate is highest for American Indians/Alaska Natives and blacks.

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"To give some context, American Indians/Alaska Natives have the highest absolute or total rate of premature deaths each year, followed by blacks, whites, Hispanics, then Asian and Pacific Islanders," Shiels said. This study examined how much the rate changed among different racial and ethnic groups, which is different from the total number of premature deaths each year.

According to the study, the change in rates for these groups can be attributed to a drastic increase in suicides, liver disease, and accidental deaths from drug overdoses.

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The study did not explore the type of drug overdoses, but Shiels said recent research from the CDC found that a large portion of overdose deaths are from opioid drugs, which include prescription painkillers and heroin, including heroin laced with fentanyl. Specifically, from 2000–2014 there was a 200% increase in the rate of deaths from opioid overdoses in the US, which the CDC called "an epidemic."

According to Shiels, there were increases in premature death due to accident in all 50 states for women and in 48 states for men. "We also found striking regional differences, with the highest rates of all-cause and accidental deaths between ages 25 and 49 in the Appalachian region of the South," Shiels said.

In contrast, the premature death rate has declined substantially among Hispanics, blacks, and Asian/Pacific Islanders.

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The study found that there were an estimated 112, 000 fewer deaths in Hispanic individuals, 311,000 fewer deaths in black individuals, and 34 ,000 fewer deaths in Asian/Pacific Islanders. "The decline in premature mortality among these racial groups are consistent with trends in Canada and the UK," Shiels said.

The decrease in premature mortality among these groups from 1999 to 2014 is mainly due to declines in death from cancer, heart disease, and HIV. Researchers attribute this to successful public health efforts, Shiels said, such as ones cutting smoking, improving diagnosing disease, detecting and treating cancer earlier, and increasing access to HIV treatment.

Overall, the increase in premature death rates in the US is still "extremely unusual" for high-income countries.

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"We usually see improvement in mortality in high-income countries, but the US is a complete outlier in this regard," Shiels said. Reduction of premature mortality is a UN Sustainable Development Goal, because they are largely preventable with access to medical care. It's expected and inevitable to die of older age, but premature death can mostly be prevented through targeted public health efforts.

"The lack of progress in whites and American Indians/Alaska Natives is primarily due to potentially avoidable causes," Shiels said.

"Although we've seen success in reducing mortality, we need to continue these public health efforts to lower absolute premature mortality," Shiels said. For example, the biggest decline in premature mortality was seen in black men and women, but their absolute premature death rate is still 50% higher than whites.

"In addition to continued efforts against cancer, heart disease, and HIV, we need to target these emerging causes of death, namely drug overdoses, suicide, and liver disease," Shiels said.

The NIH reported that it hopes to use these findings to target prevention and surveillance efforts and help those groups in greatest need.

"There's a need for aggressive public health efforts to prevent premature mortality and expand medical care, especially for substance use disorders and mental illness," Shiels said.