Deaths from Despair: Part 1A

Predicting the future outcomes using data from the past has its limits. If the future is "written in stone," then the stones are rarely if ever available when one is doing prognostication. This is especially true when one is attempting to prognosticate what humans will do in the future. 

Scientists creating models of climate change have it somewhat "easier" than psychologist and sociologist when it comes to creating more accurate predictive models. Their models are based on more knowable things such as physics and chemistry. And even they have gotten things wrong although over the decades their models have become much more precise as more data has been collected enabling them to adjust their models and also adding more variables to their models. Finally, the addition of greater and greater super computing power hasn't hurt either. There are times that I envy them. But then I take a look at what they're predicting, knowing that their predictions are firmly based, and my blood runs cold. I haven't yet broken into a cold sweat, but I've come close. These models are flashing red warning signals. 

And here's something more to consider, one area where these models have not quite been matching up with the actual data is in the timing of events. It appears that the predicted changes are coming at a much faster rate than originally predicted. This seems even to be the case with the more recent models.

But I digress ... 

Allow me to get the points I wanted to share. 

A Clarification

I wrote what I did above in order to point out an apparent discrepancy between the drug overdose deaths model and the deaths from despair in their predictions for the crude rates and number of deaths from 2017 to 2025. As it turns out the prediction crude rate and number of deaths from drug overdoses are larger in 2025 than the deaths from despair. 

Predicted Deaths from Drug Overdoses

Predicted Deaths from Despair

What is clear is the drug overdoses has comprised the major portion of deaths from despair. Nevertheless, why does the model for drug overdoses predict a higher number of deaths than the model for deaths of despair.

The problem falls largely with trying to fit a model to the existing data that best explains and enables one to predict the future. Clearly the best model for the drug overdose deaths was the fourth order model that showed greater acceleration than the third order model for the deaths from despair. Deaths from despair include two components suicides and alcohol related deaths that have not been increasing at the rate of drug overdose deaths. Thus when it comes to the actual data, deaths from despair is shifted upwards overall from 1999 to 2017 as you can see, but not accelerating as quickly as drug overdose deaths. Thus the seeming impossibility between the predictions for drug overdoses greater than deaths from despair for 2018 to 2025.

Nevertheless, what is more important is the clarity of the message that both curves are accelerating, meaning that the rate of change is expected to increase year to year. And the rate of change of the curves does not bode well for the future. The hope is that the 1) the rate of change will stop increasing and 2) that soon an inflection point will occur and the curves will begin to point downward. These curves provide a warning namely that based on current data predicting that the future doesn't look promising. I believe that is the major takeaway. Let's hope that these predictions are wrong.

As a side note, I wish the predictions regarding climate change are wrong ... but they're not. And we need to do something about it. But I digress ...

Deaths from Despair Part 1

I became interested in deaths from despair as a result of two articles published in the New York Times in 2018 of summaries of the research from Case and Deaton on the raising rate of deaths from despair particularly among US Whites. Here are links to those articles:

• https://www.nytimes.com/2015/11/03/insider/more-white-men-die-from-suicide-and-substance-abuse-why.html?searchResultPosition=2
• https://www.nytimes.com/2015/11/03/health/death-rates-rising-for-middle-aged-white-americans-study-finds.html?searchResultPosition=3

My interest has been rekindled largely by the recent reports that US life expectancy had dropped over a three year period. Here's a link to one of those articles from the Washington Post: https://www.washingtonpost.com/health/theres-something-terribly-wrong-americans-are-dying-young-at-alarming-rates/2019/11/25/d88b28ec-0d6a-11ea-8397-a955cd542d00_story.html

I've already analyzed data obtained from CDC's Wonder (https://wonder.cdc.gov) database on suicides and drug overdose deaths. I've discussed them in this blog. In addition, I've collected from Wonder on alcohol-related deaths. Combined, these three categories have been defined as deaths resulting from despair as defined by Case and Deaton of Princeton University (Mortality and Morbidity in the 21st Century, 2017) and by a follow-up study to Case and Deaton's research by the Senate Joint Economic Committee (Long-Term Trends in Deaths of Despair). The Senate Report defined alcohol related deaths somewhat differently than Case and Deaton, nevertheless, the numbers from both studies tell the same story. 

A Series on Deaths from Despair

I've decided to do a series of articles focusing on different aspects of Deaths from Despair. All indications are that the US is in trouble and deaths from despair provide strong indications of the level of that trouble. 

My interest in this area has additionally been motivated by my curiosity of those who follow and revere Donald Trump. It seems that so many of them see Trump as a kind of savior, someone who will magically lift them out of their perils. What I have also found in my analysis of suicides and drug overdose deaths, that those people who seem to cling most strongly to Trump are the ones most likely to die an untimely death by suicide or a drug overdose. The sad part is that these people are clearly in need, clearly hurting but as anyone who has been paying attention: Trump like all con-men will promise them anything and everything, but takes everything he can for himself, his family members and his cronies. Yet Trump's followers continue to revere him, remain enthralled and part of his cult of personality in spite of the fact that Trump has given them nothing but his vitriol to cling to. 

(As a side note, my late cousin was the leader of a cult, the Living Word Fellowship, so I have some understanding how cult leaders operate: how they gather and hold on to their membership while finding every way possible to exploit them. I have been completely amazed that so many of these abused people have continued to remain in the cult. Even the so many of the ones who have left continue to focus much of their energy and attention on the cult and the cult leaders. Somehow the cult fulfills a need or needs in its followers that locks them in. 

Since I'm related to the cult leader, I understand the viewpoint of the leader of the cult. I don't have a clear understanding of those who comprise the membership, but I have seen, heard and read snippets from followers and former followers. I don't like what I've learned. These are people who have been exploited and brutalized, yet they come back from more. I don't believe I'll ever understand them.)

In this article, I'll focus on one or two areas related to deaths from despair. Later articles on this topic will focus on one or two areas of interest with deep dives into the data and what current data can project for the future.

Overview: Deaths from Despair 1999 to 2017 

The figure below shows the number of deaths from despair (combined: suicides, drug overdoses and alcohol related) from 1999 to 2017 obtained from Wonder. 

The best fit trend line can be found in upper left of the chart. Note that this is a 3rd order increasing curve. This is the equation used to predict future outcomes.

As mentioned in an earlier article, CDC announced that drug overdose deaths for 2018 dropped from 2017. However, 2018 data has not been loaded on to Wonder. As I have noted in an earlier article, the number of deaths can change from the announcement to their inclusion into Wonder. For now, I'll use only that data currently available in Wonder. When the numbers from 2018 have been included into Wonder, I'll include that data and make any necessary revisions to my analysis.

One of the things I noted in both studies, is that both studies use normalized data such as crude rates (number per 100,000 population) and percentages. And this makes complete sense when you're comparing one year to the next and in studies such as these. However, when you look at the raw numbers of deaths from despair, the scale of the problem (or problems) we're confronting hits home as shown in the figure below. 

From 1999 to 2017 the number of deaths has risen from nearly 68,000 to nearly 157,000 people living in the US. And over the last 10 year, the number of deaths from despair totals over 1.2 million people. The US crossed into over 100,000 deaths from despair per year in 2009. The world was in the middle of the financial crisis in 2009 and the economy was in downward spiral. An high number of deaths from despair would not be unexpected, but one would hope that as the economy got better, the number of deaths from despair would start to drop. Instead they continued to rise and at an accelerating rate due largely to the opioid addiction crisis in which the US has found itself locked in battle. However, having said this, suicides and alcohol related deaths have also continued to rise, although at a lower rate of increase than drug overdose deaths. (Interestingly enough, drug overdoses as the manner of death in suicides has decreased over the last several years while death by firearm and suffocation/strangulation have continued to increase.)

Projections to 2025

The figure below shows a projects a continuing increase in the crude rate of deaths from despair to 2025. 

The projection of the number of deaths to 2025 puts the problem in clear and stark terms as shown in the figure below.

One can only hope that somehow the staggering rate of increase will be at least slowed, if not stopped. The death rate and numbers for 2017 are unacceptable and suggest that the US has a serious social problem in its midst that needs to be addressed. But a country the size of the US with over 300,000 deaths from despair in a single year with 2.2 million deaths in the last 10 years could only be described as catastrophic.