Trump's Election and the Health of Middle-Aged White Workers

Back in June, soon after it became evident that Donald Trump would be the Republican nominee for President, we wrote an article discussing one significant aspect of his candidacy: his possible appeal to working class voters who are exasperated by stagnant wages and income inequality.  We didn’t advocate for him, but we did see how he would appeal to those workers, which put his candidacy in a realistic light.  See the piece here:  http://ways-of-the-world.blogspot.com/2016/06/why-workers-might-favor-businessman-for.html.

This general notion indeed played out in the actual election results.  Exit poll results showed that Mr. Trump had relatively strong support from low-income voters, middle-aged and older voters, and those with less education.[1]  He received a larger percentage than Mitt Romney did in 2012 of votes cast by people 45-64 years old, of people with incomes under $30,000, of people with high school or less and college less than bachelor’s degrees, and in particular, white people with no college degree.   In fact, Trump scored 67% of those votes compared with just 42% for Romney.  Thus, Trump’s mantra about bringing jobs back to this country would speak to this group, who would be looking for consistent employment opportunities in production, construction and mining especially, sectors which have been experiencing major disruptions that Trump hopes to mitigate.

This situation of uncertainty for middle-aged people in particular has another, deeply serious component.  In a Wall Street Journal discussion of the election result on November 10 [2], Arthur Brooks, president of the American Enterprise Institute, expresses concern for middle-aged workers, especially men and for white, middle-aged people.  He calls our attention in turn to a paper published last December in the Proceedings of the National Academy of Sciences in which Angus Deaton, the Nobel Laureate in economics in 2015 and professor at Princeton, and Anne Case, also at Princeton, describe the astounding development that the mortality rate of white 45-54 year-olds in this country actually rose from 1999 to 2013.  This is in clear contrast to the mortality rates for all other age groups, which declined, an obvious result of advances in medicine.[3] 

What happened to those middle-aged white people is dramatic.  Mortality rates for diseases in that age range did decline.  But rates for externally caused deaths went up: suicide, drug poisoning and alcohol abuse.  Those specific rates went up for other age groups too, but for the 45-54 year-olds, the increases were so large that the pushed overall mortality higher.  Subsequent release of data by the U.S. Center for Disease Control for 2014 show the overall uptrend continued that year as well.  In addition, Deaton and Case discuss “morbidity”:  the proportion of the population reporting good health and the proportion reporting poor health, including various symptoms of pain and the frequency of difficulty performing simple “activities of daily living” (ADLs).  For this population group between 1997-99 and 2011-13, government data show a smaller proportion reported good health, a larger proportion poor health.  More people had trouble with various ADLs and more people consumed excessive amounts of  alcohol.  There was a significant increase in the share of these middle-aged white persons who were unable to work, which, Deaton and Case point out, may correspond to the unusual decline in labor force participation rates, a phenomenon we have discussed here before.

Deaton and Case suggest that economic insecurity might play into 45-54-year-olds’ increased use of drugs, dependence on alcohol and suicides.  They mention the same economic factors we have been talking about: tepid movement of median wages and income inequality.  They point out that these are especially important for people with just a high-school education.  In addition, they discuss the shift in many employers’ pension arrangements from defined benefit plans to defined contribution plans.  So now it’s up to many employees to see to the adequacy of their own retirement savings, since there’s no guarantee of a specific payout during their elder years, as would be the case with defined benefit plans.  The pressure on these people is thus increased.  They have another reason to be concerned: will they have a steady income through consistent employment and will the economy grow so that their financial assets can grow?

This economic pressure on middle-aged white Americans is obviously not the only reason Donald Trump won and Hillary Clinton did not.  There is a general unease with governments and bureaucracies.  We saw it earlier this year in the U.K., where, also, ordinary people surprised their government leaders as they voted that that nation should withdraw from the European Union, the development known as “Brexit”.  The work to do so is in process now.  The factor of importance in that issue is similar to what Mr. Trump advocates, the reduction in regulation of business and other government intrusion into everyday life.  Brexit highlights people’s frustration with the bureaucratic nature of the EU organization.  In the U.S., Trump is concerned that regulation of business, along with the relatively high U.S. business tax rates, contributes to companies’ moving their headquarters and some operations to other countries, even as they continue to sell their products here.  He wants to change the government setting for business so those companies will stay here and keep jobs here.  It’s a good idea, if it can be implemented in a prompt and orderly way.  That’s a big “if”.  Further, it will go the wrong way if there are trade wars and too much anti-immigration push.  Tough questions.

Overall, the numbers we have discussed here describe considerable unease among a core group of Americans, a population group that rarely gets much attention.  But this election has made us look at them.  Perhaps there’s no genuine link between the pressure they feel and the election of Mr. Trump, but it seems there might well be.

In church yesterday during the Intercessory Prayer, I heard myself offer petitions for “all those who are afraid in the wake of the Election” and for “the new President, that he might govern carefully and wisely”.  We indeed hope Mr. Trump rises to the occasion and we hope our many friends and acquaintances who are upset and distressed will find there is reason they can relax.

--------------

[1] “Election 2016: Exit Poll Results.”  The New York Times.  November 8, 2016 and subsequent updates.  The Exit Poll is conducted by Edison Research and is sponsored by a consortium of ABC News, The Associated Press, CBSNews, CNN, Fox News and NBC News.  The data were collected from  24,537 voters leaving 350 voting places throughout the United States on Election Day including 4,398 telephone interviews with early and absentee voters.  http://www.nytimes.com/interactive/2016/11/08/us/politics/election-exit-polls.html. 

[2] Arthur Brooks.  “How Trump Filled the Dignity Deficit,“ The Wall Street Journal.  November 10, 2016, page A23.  http://www.wsj.com/articles/how-donald-trump-filled-the-dignity-deficit-1478734436

[3] Anne Case and Angus Deaton.  “Rising morbidity and mortality in midlife among white non-Hispanic Americans in the 21^st century,” Proceedings of the National Academy of Sciences, December 8, 2015.  Pages 15078-15083.   http://www.pnas.org/content/112/49/15078 .  You may have seen this referenced in The New York Times as well.  A number of professional health policy publications also contain references.