Ever since Hillary Clinton and the Democrats failed to hold the White House last November, some members of the party and friendly elements in the media have suggested that the Dems have to renew their focus on white working-class men if they want to win. In this view, liberals have become distracted by so-called “identity” issues like feminism, Black Lives Matter, transgender bathroom access, and the musical Hamilton, thus alienating the underserved voters Donald Trump was then able to nab. Underlying this argument is a series of reports on the immiseration of the white working class and its members’ increasing tendency to die. But while these papers have garnered a lot of attention, there’s good evidence that their conclusions go too far.
The latest version come from the all-star Princeton University economics couple Anne Case and Angus Deaton, writing under the auspices of the Brookings Institution, a centrist think tank. “Mortality and Morbidity in the 21st Century” might sound like a dull title, but the report has inspired breathless headlines, such as: “Why the White Middle Class Is Dying Faster, Explained in 6 Charts” and “Deaths of Despair: The White American Working Class Is Dying Young.” Brookings got in on the hype game themselves with a blog post titled “Working Class White Americans Are Now Dying in Middle Age at Faster Rates Than Minority Groups.” Those headlines are what “Mortality and Morbidity” was designed to elicit; the paper’s leading graphic has served as the peg for most of these stories. Unfortunately, Case and Deaton’s leading graphic is also one of their most misleading.
Figure 1.1 plots all-cause mortality for Americans age 50–54 by race since 1999; it shows the rates for white and black non-hispanics crossing in 2008, with the former now suffering higher rates by a serious margin. Except it’s not exactly an apples-to-apples comparison: The white group in question only includes those with a high school education or less, while the black group comprises all levels of education — everyone.
Much of the media has been reporting that these findings apply to the “white working class,” but that’s not quite right. Although higher education is associated with class, Case and Deaton chose to use educational attainment instead of income or homeownership, and no one really thinks you cease being a worker when you step on a college campus — that would make most Americans members of the capitalist class, which we are not. To call their subject the “working class” is sloppy labeling, but there is a much bigger problem with the Case and Deaton methodology.
In these graphs, white lives literally count more, and black lives less.
That problem is called “lagged selection bias,” and this is how it works: If you’re measuring long-term phenomena, there’s a risk that the pool of people you’re looking at will change while you’re looking at them, owing to a separate trend. For example, if you were looking at the relation between 12th-grade cigarette smoking and income 10 years later, I’m sure that you’d find a serious drop during the past decade. But that wouldn’t necessarily mean the salaries of former teenage smokers are actually going down. Rather, smoking in the 12th grade has become a much rarer phenomenon — falling from 25 percent in 1997 down to 6 percent today — and it’s negatively associated with socioeconomic status. The 19 percent of high school seniors who would have smoked in the 1990s but wouldn’t think of it in 2017 throws off your analysis. What you’d actually end up detecting is not so much the relationship between teen smoking and future income, but changes in youth smoking behavior over time. The (ex-)smokers’ salaries could be increasing normally and you’d never know it by that method.
It’s easy to see how lagged selection bias could apply to a mortality study that breaks down by educational attainment. In fact, the term was created to address this exact case. In 2012, a paper (usually referred to by its lead author S. Jay Olshansky’s last name) led to similar headlines as the new Case and Deaton one, but a few public-health researchers thought something looked off about the findings, which included rapidly increasing mortality for whites without high school degrees.
In the International Journal of Epidemiology, researchers Jennifer B. Dowd and Amar Hamoudisuggested the Olshansky results could reflect increasing high school graduation rates more than increasing mortality. As a greater proportion of Americans finish 12th grade, lagged selection bias (a term that Dowd and Hamoudi coined) means the demographic of non-completers shrinks over time, and the longitudinal comparison gets less valid. “In terms of mortality risk, those excluded from high school in the early part of the 20th century are not comparable with those excluded from high school a generation later,” they write, “because those left behind by the high school expansions in mid-century likely had childhoods that were more disadvantaged along many dimensions, and so were at higher mortality risk all along.”
There are ways to guard against lagged selection bias if you’re conscious about it. A group of researchers based out of the Population Studies Center at the University of Michigan has been working with some of the same material, and they took up Dowd and Hamoudi’s challenge and the Olshansky data sets. The Michigan group was able to reproduce the Olshansky results, but they then tried to account for the effect of lagged selection bias. They used percentile of educational attainment rather than simple attainment — based on Census data, a white American in the 25th percentile would have a 10th-grade education if they were born in 1935, but a high school diploma if they were born after 1950.
It’s a smart way to account for the expansion of education access, and, when they tried it, they found that the Olshansky findings looked overstated. At the 25th percentile of educational attainment, they saw a 1.2-year decrease in life expectancy for white women between 1990 and 2010 (compared to 3.8 years with the Olshansky “no high school graduation” measure), and a small increase for white men (0.4 years vs. -2.2). The media did not exactly trip over itself delving into the new data.
I called up Arline Geronimus, the coordinator for public-health demography at the Michigan Population Studies Center and a co-author of the study, to ask about the Case and Deaton report. The first thing she wants to make sure I understand is that the paper has not been peer reviewed. “It’s premature to make it so public,” she says; “I don’t think it does anything to advance the field.” Geronimus launched into a laundry list of professional concerns: There’s the lagged selection bias, but also an overemphasis on the ages 45 to 54, no attention to measures of lifespan, a questionable particular interest in white people, a focus on individual behavior that’s uncharacteristic for the discipline, and far too broad a brush in general.
Public-health researchers look at a very detailed level, Geronimus tells me; they examine local micro-discrepancies in populations and environments, down to the city-block and epigenetic levels. She calls their attention to so-called deaths of despair “overblown.” The Case and Deaton paper “just isn’t a well-developed argument,” Geronimus says. “There are many of us who have been working carefully in this field for decades testing theories, not just making them up.”
Dubious methodology aside, there is still some useful information in the Case and Deaton report. America does seem to have a serious problem ensuring longevity for its population as compared to its peer nations. But, though the international perspective is the strongest part in their paper, it’s not what the researchers or the newspapers led with. Why put the statistical alchemy in front? Why is the story more dramatic or attractive when it’s about white people?
Mistakes and missteps also propel social science forward, as the Olshansky paper did. Still, Case and Deaton didn’t publish their findings in a peer-reviewed public-health journal, at least not first. Brookings is a center of political influence in Washington, and I have no doubt that Capitol Hill staffers have already written up their briefs on the report and passed them to their bosses — that is, if they work half as fast as Internet journalists do.
By the time it makes its way to the top of the policymaker food chain, how will this report be understood? I’d wager it’s something like the Brookings blog headline: “Working Class White Americans Are Now Dying in Middle Age at Faster Rates Than Minority Groups.” I asked Geronimus if that was, to her understanding, a true statement: “I think that’s misleading, I really do. Oh boy,” she laughs, “there’s so much wrong with that. That headline makes it sound like problems are worse for white Americans than black Americans.” The narrative is wrong, but it’s not the first time Geronimus has heard it since the election. The Case and Deaton paper, she says, fits conveniently in this story, and it’s one she fears Americans are primed to believe.
To make use of social science research, we have to treat it like social science research. When the media takes validity for granted and writes up studies as though they’re golden press releases, it doesn’t serve anyone, except the think tanks who get to steer the national agenda. Anticipating attention from media and policymakers changes the incentives for researchers. If Brookings had gone with, “What Happened to Mortality Among 45–54-Year-Old White Non-Hispanics? It Declined From 1989 to 1999, Increased From 1999 to 2005, and Held Steady After That” — which is how Columbia statistician Andrew Gelman interpreted the data — the reception would have been very different. If they had gone with, “Longevity Stalls for Poor Americans; U.S. Falls Behind Internationally,” maybe the study still would have gotten some headlines. But in 2017, the narrative that sells involves white workers who are unemployed, suffering, ignored, dying. We’ve seen it with J.D. Vance’s Hillbilly Elegy, the Oscar-nominated Hell or High Water, and in our population studies.
Despite the headlines, when you compare apples to apples, white Americans remain better off on average than black Americans across the board. For example, to fit black and white rates of heart disease mortality on the same graphs, Case and Deaton had to use different scales (see above). Comparing a range of eight deaths per 100,000 in white women to a range of 40 deaths per 100,000 in black women is to pay closer attention to the former. In these graphs, white lives literally count more, and black lives less. But whether in health, income, wealth, or educational attainment, American white privilege is still very much in effect, and no statistical tomfoolery can change that.