(Bloomberg) — Ryan Johnson was 22 when he succumbed to a heroin addiction that had intensified as the Erie, Pennsylvania, high school graduate grew disillusioned with his future. His mother found him in his room with his head slumped and lips blue.
It was June 28, 2014, the day of his sister's master's-degree graduation party.
"He just saw his life as not what he wanted it to be, and he didn't know how to get it there," said Sue Johnson, who lay next to her son's corpse for an hour. He had dropped out of a two-year culinary program and was working part-time, low-wage jobs. He often compared himself with his peers in college and his athletic, academic older sister.
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The fates of the less-educated and those who graduate from universities diverge in dire ways. Middle-aged white Americans without four-year degrees are at increasing risk of dying, a well-documented trend driven not only by drug use but also by alcoholism, suicide, and slowing progress against heart disease and cancer. Outcomes may worsen further as millennials—Johnson's generation—grow older.
"America is not a great place for people with only a high school degree, and I don't think that's going to get better anytime soon," said Angus Deaton, a Nobel Prize-winning Princeton University economist.
It's too soon to tell whether millennials will die at higher rates in middle age than today's 45-to 54-year-olds, said Anne Case, a Princeton economist who identified the "deaths of despair" trend with Deaton, her spouse and co-author. But in stories like Johnson's, there are reasons to worry.
Case and Deaton have a theory for why mortality has risen for less-educated whites. For all the debate over whether college is worthwhile, high school graduates who go straight into the workforce have higher unemployment, weaker wage growth, and less chance of marrying than their predecessors and educated peers. Community supports have broken down, and as disadvantage snowballs, premature deaths rise.
Those problems could intensify for the next generation that reaches middle age. Many millennials, born after 1980, joined the workforce during the Great Recession, so they faced low starting salaries and tough job prospects. And they're saddled with student debt. Still, almost two-thirds lack a bachelor's degree, which in today's economy is a near-prerequisite for jobs that provide higher wages and benefits.
Meanwhile, marriage is happening later and less often. Religious affiliation and union membership have declined, so when life doesn't work out well for millennials, they're on their own.
While blacks and Hispanics without college degrees are also falling behind economically and socially, middle-age mortality has worsened for whites in particular over the past 20 years—a fact some attribute partly to social context.
"For whites, their reference group is previous generations of whites," said Shannon Monnat, a Pennsylvania State University professor who studies the opioid epidemic in rural America. "When they look back on their parents and grandparents, it feels like their generation is doing worse."
Such decline runs deep in Erie, where Johnson attended school and worked a string of part-time restaurant jobs. Nestled against the gray-green waters of one of America's Great Lakes, the town has been declining since the 1970s. Its population dropped below 100,000 in 2014 for the first time since 1920.
Formerly grand red-brick factories have broken windows and vine-covered exteriors. The local General Electric Co. plant, which makes locomotives for export, has shed almost half its workforce in recent years—1,500 jobs were cut last year, and 950 were moved to Texas in 2013. While service industries including health care show signs of life, high-paying jobs that require only a high school education are increasingly limited.
"A lot of that leads to despair, to hopelessness," said Scott Slawson, a longtime GE welder and union local president. "It's a scary path we're on."
