Are White women high school dropouts getting sicker?

My Twitter feed lit up yesterday with this story about how life expectancy is falling for White women who have not finished high school. The story was called, “What’s Killing Poor White Women?“, by Monica Potts.

I have complete sympathy for poor people with health problems and high mortality rates. Things are killing them, and that’s bad. They should have better education, better jobs, better health care and more money.

White women without high school degrees have lost five years of life expectancy. Something must be getting worse. But I don’t quite think so. I could be wrong. But I think that as the category White women without high school degrees shrinks, it is the healthier people who are leaving (or never entering) the group. As a result, the group’s average health is declining.

The first thing to realize is that, according to the Census Bureau [spreadsheet link], 95% of non-Hispanic White women ages 25-29 have completed four years of high school or more. So we’re talking about a very (negatively) select population. And it’s getting more select – it was 92% 20 years ago. (Potts’s story revolves around a woman who died at 38.*)

The article doesn’t give any numbers to show that more people are dying, just that the life expectancy of the group has fallen. If this were a group, like race or gender, whose membership doesn’t change much over time, that would be enough to indicate their health status was getting worse. But an education group isn’t like that. It’s membership changes over time. Neither of the two academic articles Potts cites seem to consider this possibility (here and here).

One take

Here’s a try at it. Since 1996, the Current Population Survey has asked an excellent health status question, asking people to rate their own health as excellent, very good, good, fair, or poor. Let’s treat those whose health is “poor” as the group driving the mortality trend (which seems to fit the narrative in the story).

Here is the scary trend: A sharp rise in the proportion of non-Hispanic White women high school dropouts, ages 20-29, who rate their health as “poor.” (All the figures use three-year averages.)

That looks terrible, and it is, of course. But look at the size of the total group (all health statuses) over the same period:

So, the group has shrunk by about 18%, from about 850,000 to less than 700,000. And here is how the group’s population has changed according to health status, using the two endpoints of the trend, 1996-98 and 2010-12:

So, there has been, in effect, no change in the number of non-Hispanic White women high school dropouts ages 20-29 in poor health, for the last decade and a half (the numbers shown are population estimates based on a sample size of only a few hundred women in this category per year, so I discount small shifts). In contrast, there has been a decline of those in good health. Result: the average health of the group has declined, but there are not more sick women.

That’s good news, because in Potts’s telling their problems are very serious, and something should be done about it.

*I (or you) could redo this to include more ages. I used young people because, if they have high mortality rates, they’re going to disappear from the sample at relatively young ages and make the group look healthier.