What’s Killing Poor White Women: Smoking And A Mystery

The life expectancy for uneducated black and Hispanic females in the U.S. has improved since 1990, but for uneducated white women it’s actually dropped by five years. Researchers are hunting for answers.

What’s Killing Poor White Women: Smoking And A Mystery
[Image: Smoke via Shutterstock]

What’s killing poor white women?


The American Prospect’s Monica Potts wrote a 5,000-word article trying to answer this question, or really, a less headline-friendly expansion: Why has the life expectancy for uneducated white women fallen by five years since 1990, while life expectancies for uneducated black and Hispanic women have increased?

The last time researchers found a change of this magnitude, Russian men had lost seven years after the fall of the Soviet Union, when they began drinking more and taking on other risky behaviors. Although women generally outlive men in the U.S., such a large decline in the average age of death, from almost 79 to a little more than 73, suggests that an increasing number of women are dying in their twenties, thirties, and forties. “We actually don’t know the exact reasons why it’s happened,” [longevity researcher Jay] Olshansky says. “I wish we did.”

The story cycles through academics’ attempts to pin down an explanation for the trend, which Olshansky discovered in a study last August. Having a job seems to extend life, but what’s the mechanism? Why does the trend exist for whites but not blacks? (Uneducated black women are in fact, for the first time, living longer than their white counterparts.) Are white women taking on riskier behavior, like drinking or taking drugs? Or is this simply a regional public health trend concentrated in Appalachia and the rural South, which just happens to be where poor whites are concentrated?

No one has a definitive answer. Potts dramatizes the mystery with the richly told story of Crystal Wilson of Cave City, Arkansas, focusing more on her life than her death at age 38, overweight and with unmanaged diabetes.

When her relatives look back, they think Crystal was probably lonely. Her mother had died three years after [her daughter] Megan was born. Although she and Possum had a Ford Contour, Crystal seldom drove, relying on relatives to come by to take her to the grocery store. It was a chance to visit.

One woman’s story can’t, of course, answer what’s fundamentally a question about large population trends. And while it’s possible that Potts larger speculation has a grain of truth, that “the rural South is a place that often wants to remain unchanged from the 1950s and 1960s, and its women are now dying as if they lived in that era, too,” it’s also possible that further research will lead to a narrower conclusion.

One of the researchers quoted in the story, Jennifer Karas Montez, has a paper Potts doesn’t discuss, that found lung cancer and respiratory disease explained nearly half the trend. (Perhaps another story can explore: Why are uneducated white women smoking?) But if you believe in narrative journalism, you have to believe there’s something very real in how people answer the question “why” when science can’t.

“It’s just horrible, you know? I don’t know if ‘horrible’ is the right word.” Julie puts her face into her hands. “The desperation of the times. I don’t know anything about anything, but that’s what kills them.”

About the author

Stan Alcorn is a print, radio and video journalist, regularly reporting for WNYC and NPR. He grew up in New Mexico.