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Drinking is killing twice as many middle-aged white women as it did 18 years ago.

Generally, middle age (age 35 to 54)  is not the time to die in modern societies. It is past teenage dangers, before the serious perils of age, and improved medical care and public-health campaigns are keeping more people alive.

So why are middle-aged white women dying more often even while death rates for other groups continue to go down? What are white women doing that is so different?

One simple answer is: a lot more drinking.


In 1999, white and Hispanic women had relatively similar rates of death from alcohol, and the rate for black women was considerably higher.  But since then, the death rate for blacks has gone down, the death rate for Hispanics has gone up a bit, and the death rate for white women climbed 130 percent. This analysis is done with Centers for Disease Control and Prevention WONDER mortality data.


 

Consumption

In the many ways to measure how much people drink, white women stand out again and again. This data on women ages 35 to 54 is taken from the National Health Interview Survey, accessed via IHIS.

In that survey, more than 70 percent of white women describe themselves as drinkers, compared with less than half of Hispanic, African American or Asian women. That means they say they have at least a dozen drinks in a year. The question has been asked consistently since 1997, and the rate for white women has climbed from 64 percent to 71 percent. Other groups show no sign whatsoever of catching up.


Looking at data on how many days a week people drink, white women stand out as more likely to drink several days a week.


One interesting twist that we’ll come back to shortly is that women with at least a four-year college degree report drinking more often than women without college degrees. Thirty-one percent of the women with a college degree reported drinking multiple days a week, compared with 21 percent of women with some college and 14 percent of women with a high-school education or less.


Scientists say that heavy drinking — many drinks at a time — can be more dangerous than regular drinking. One-third of white women reported “binge” drinking — having at least four drinks in two hours.


Also, that rate has gone up 40 percent since 1997, while the rate for others is relatively flat. The comparison over time stops at 2013 because the survey changed the binge-drinking question at that time for women from five drinks in two hours to four drinks in two hours. Once again, education turns up a key difference here. While women with college degrees drink more frequently, women with only a high-school education are more likely to say they binge drink.


 

Crises

Between drinking and death, we can also look at the crises caused by drinking. In this case, we are using data from the National Emergency Department Sample accessed through the Agency for Healthcare Research and Quality. The NEDS does not have race, but we know from the consumption and death data that white women are leading the way in drinking and dying from alcohol. The important pattern we see from people getting treatment for alcohol intoxication at emergency rooms is that middle-aged women lead the way. You might think getting so drunk you end up at the hospital is the sort of thing college kids do, but it happens more frequently with people in the 35-to-54 age group. The rate of women treated for alcohol at the hospital has gone up since 2006.


Once again, socioeconomic status turns up a difference. NEDS doesn’t have education like the health survey, but it has income grouping by the patient’s Zip code. When dividing patients into income groups, we see women who live in poorer neighborhoods are more likely to show up at the emergency room for drug intoxication, but women from wealthier neighborhoods are much more likely to show up at the hospital for alcohol intoxication.


The Washington Post has spent the year crossing the country to look into causes and repercussions of the strange increase in deaths among middle-aged white women and men. Alcohol, opioids and suicide are important factors. See the full coverage here.

Graphics produced by Cristina Rivero.