Weaving together many of the themes described in the research projects below is an interest in the demography of the white working class. This population gained renewed attention following a 2015 PNAS article by Case and Deaton, "Rising
morbidity and mortality in midlife among white non-Hispanic Americans in the 21st century", in which it was shown that life expectancy among working-class whites appeared to have reversed a roughly century-long increase. Analysis of the cause of death registries showed that much of the decline was due to substance use overdose, alcohol-related harms, and suicide among middle-aged, low SES, non-Hispanic whites. The fast-emerging narrative is that profound economic hardship and fundamental changes in the labor market have left an especially deep mark on this population, contributing to a sense of despair about the present and future. Emerging scholarship makes clear that these causes of death are not isolated to the white working class, but are part of a larger, national trend in which the deaths of more people, from more places, are attributable to these causes, including firearm deaths. Unfortunately, the trend only accelerated with COVID, setting the US apart as a significant outlier among advanced economies. https://dceg.cancer.gov/news-events/news/2020/deaths-of-despair
Much of this work to
date focuses on the risk factors and characteristics of individuals and groups where mortality rates due to substance use, alcohol, and suicide have increased, with heavy reliance on quantitative data such as Vital Statistics registries and counties as the central geography of interest. Far less is known about the lived experiences, personal narratives, and community contexts of this distinctive demographic group. The community context is especially significant, given the substantial spatial clustering of mortality and its risk factors. This research program aims to document the social, cultural, and community contexts that protect against, and enhance, mortality risk among white working-class Americans. Our research team is developing and testing a neighborhood-level, community-wide, near-real-time public health surveillance system that enables spatio-temporal outbreak detection and rapid intervention. We believe this system can save lives.