Study Finds Deteriorating Mental Health Among Poor White Americans

Researchers find evidence of low socio-economic status White Americans’ rising distress and declining well-being since the mid-1990s.


A paper published in the Proceedings of the National Academy of Sciences presents findings on changes in White Americans’ psychological health since the 1990s. Using data from the national, longitudinal MIDUS study, Dr. Noreen Goldman of Princeton University’s Office of Population Research and her collaborators found that low socio-economic status (SES) White Americans have experienced reduced well-being and increased distress over the last twenty years. High SES Americans, conversely, have experienced small upswings in psychological well-being, including improvements in life satisfaction.

Despite a recent focus on widening socioeconomic disparities in life expectancy and associated trends in substance use and drug-related deaths, few scholars have explored whether these patterns are mirrored by changes in mental health,” the authors write.

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Goldman and her co-authors frame their paper by emphasizing two contemporary, connected phenomena that inspired their investigation: a rise in opioid abuse and related deaths in the U.S. since the 1990s, and flatlined (and in some cases, increased) American adult death rates over the same period. As journalists and social scientists alike have scrambled to make sense of these events, links have been made to the role of education and economic opportunity. One oft-cited 2015 study found a significant increase in middle-aged White American all-cause mortality between 1999 and 2013, with the most “marked increases” seen amongst those with less education.

The fact that Whites’ increased mortality has largely been the result of suicide, drug and alcohol poisoning, and chronic liver disease has led these deaths to be labeled “deaths of despair,” and have raised questions about whether the mental health of White and low-SES Americans is worsening. Different theories have been offered to account for these trends, including a sociological framework published last year that understands White Americans’ poorer mental health outcomes as a product of Whiteness and the U.S. racial system.

The authors sought to investigate patterns in Americans’ psychological health in light of these sociological circumstances. The researchers chose to focus on analyzing responses from White participants (n = 4,627) in the national Midlife in the United States study (MIDUS) due to the fact that Whites are “most frequently implicated in concerns about rising premature mortality. Limitations in the sample size of respondents of color were also a factor in this decision.

The researchers used logistic and linear regression to analyze trends in the sample’s psychological health as related to SES, gender, age, and study period (1995-1996 and 2011-2014). They employed a combination of measures to reflect a more robust definition of psychological health than has been used in prior studies: two psychological distress measures (negative affect and depression); two hedonic well-being measures (positive affect and life satisfaction); and two eudaimonic well-being measures (psychological well-being and social well-being). SES was defined as a combination of education, occupation, income and wealth.

“Our results paint a picture of substantial social stratification in psychological health among American adults,” Goldman and the researchers write.

The authors found that low SES (10th percentile) respondents’ scores on certain measures decreased significantly since the 1990s. Low SES individuals experienced an increase in negative affect, whereas high SES participants saw “little change.” Low SES participants’ positive affect and life satisfaction declined markedly, whereas high SES participants (90th percentile) experienced “modest improvements” in these areas. Depression and social well-being did not show significant changes. In contrast to prior research and journalistic reports that have emphasized increased distress amongst middle-aged Americans, these findings held across a range of ages.

While the authors focused primarily on White respondents, they also re-analyzed the data with the complete MIDUS sample (n = 5,632), including participants of color. Although they found no significant differences between Latino (n = 196) and non-Latino Whites’ results, they did see that non-Latino Blacks (n = 365) reported significantly better outcomes on four of the six measures (depression, positive affect, psychological well-being, and social well-being) than Whites.

Although the authors state that they are hesitant to draw conclusions about Black Americans’ overall mental health relative to Whites’, prior scholarship has explored factors that may serve to enhance Black Americans’ mental health, including a potentially-protective tendency to consider external, systemic causes of hardships. This contrasts with White Americans’ racially socialized belief in meritocracy and self-sufficiency, which may make coping with setbacks and “loss of status” more difficult.

Although the researchers’ findings point to the potential relationship between White, low SES Americans’ declining psychological health and increased mortality, conclusions cannot be drawn about the nature and direction of this relationship on the basis of this study. The authors advocate for additional research examining whether “these deleterious changes in mental health are most prevalent amongst non-Latino whites,” as well as further study of sex differences in Americans’ psychological health, and the use of individual, longitudinal, psychological health data to “deepen our understanding of these worrisome trends in mental health.”



Goldman, N., Glei, D. A., & Weinstein, M. (2018). Declining mental health among disadvantaged Americans. Proceedings of the National Academy of Sciences, 201722023. (Link)

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Rebecca Troeger
MIA Research News Team: Rebecca Troeger is a doctoral student in the Counseling Psychology program at the University of Massachusetts Boston and has a Master’s degree in Psychology. Her work explores how Western psychology can move towards valuing other cultures' knowledge more deeply. She is also interested in the impact of social support and community life on mental health and anti-racism interventions.


  1. I am shocked just shocked at these redearchers’ conclusions. Really? SES and other migrating factors may impinge on the well being of folks broadly either possibly depending on the statistical level of significance of their lives?
    Have they not read or were taught James Agee’s “ Let Us Now Praise Famous Men”?
    Have they not read or were taught Harriette Arnow’s“ The Dollmaker”
    Have they not been exposed to or taught about Jacob Riis sp? Photographic expose of immigrant children?
    Have they not seen or been taught both “ Brother from Anotber Planet” and “Matewan” John Sayles excellent film narratives of folks in the lower SES levels of America?
    Have they not been exposed to all of the past and current art forms of all kinds from all cultures and genders that have been documenting this aspect of our country that many do not want to acknowledge or if they do acknowledge the graphs, diagrams, formulas, and advanced analytical equations use their suffering for their own personal, economic, guild, and academic enrichment and immoral- unethical gains.
    Way too little, way , way to late.

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  2. what’s odd…odd isn’t the best word, more like…frightening…about US culture, in particular, is how much we seem to -hate- the poor. Some are enlightened enough to be OK with the poor, as long as they “know their place.” Once they step out of line, its party over. add in the criminalization of poverty, resulting in mass incarceration and the creation of a permanent under-class…and also the widespread psychiatry-ization of poverty, and one can see: the US declared war on the poor decades ago, and the ‘experts’ are just now taking the time to assess the damage.

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    • There was no way out dude, people won’t vote 3rd party, it was mother of mass incarceration Hillary Clinton (1994 Crime Bill) or Copsucker Donald Trump. April 25, 2016 at 2:47 pm

      That was Hillary Clintons plan have the police state practice medicine without a licence with trap you in the system drug courts. In the thread I put a copy of the suicide note left by a woman who committed suicide after being subjected to this.

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    • I think we are taught to fear our own poverty, which is always lurking right around the corner even for people with reasonable jobs/incomes. As a result, I think we fear the poor, which turns to anger and hatred, because we KNOW there has to be SOMETHING that separates them from us, otherwise, we could end up being poor, too, which would be awful! And when they survey actual poor people, most of them don’t think they are poor, and instead find someone yet poorer to heap their pity and hostility on.

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      • The root of the problem is, wait for it, unrestrained capitalism. An economic system based on brutal competition that masquerades as a meritocracy while in reality it is stacked in favor of those already in a position of relative economic security and allows those with the resources and the ability to do so to game it even further. The losers, and you can’t have a competition with only winners, are castigated for “making bad choices” and left to rot in their misery and despair.

        Until we can address this reality honestly and build a society that has more to offer than a zero sum game that rewards sociopathic behavior and the hollow illusion of mindless consumerism the problems we face will only get worse.

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  3. I think this article nails it perfectly with part about self-sufficiency. We now live under the big brother police state and property tax control grid, those bastards won’t let you just survive.

    Start with the police state, when the protest broke out a few years ago the police state big brother controlled TV news quickly made it a racial issue. Being a white guy I don’t know what driving wile black is like but driving wile poor in America they will screw you to the wall just as fast. That’s how they put in the knife and then turn it, take the licence so you can’t get to work. They hope you drive anyway, that pride we have about self-sufficiency, they hope you drive anyway so they can catch you and keep you screwed up in the system collecting payments destroying you finances….

    The big brother part, if you made a mistake 20 years ago, that cocaine you got caught with on the ride home from the bachelor party put in on that job application cause we are the system we never forgive we never forget death of despair we don’t really care.

    Property tax, home “ownership” what an effing joke almost as funny as the “American dream” unless your dream is you and your wife working full time just so the tax parasites can take half and your kids get raised in some day care institution.

    The TV fake news never stops with the messages that any white guy that hates the government and talks that liberty stuff is a low IQ racist backwards hillbilly, it sucks they have been so successful at painting that phony picture.

    Again spot on with this article pointing out the self-sufficiency aspect.

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  4. You know I am going to double post it, I am the angry white guy that the death by despair grim reaper almost took out. Missed me bi-atch.

    I worked/volunteered at a drug and and alcohol treatment center for years I know the demographic and knew dozens of people who have passed away suicide and overdose.

    Maybe this is arrogant but IMO most of the clients don’t have the intelligence to full on hate the system and blame alcohol and addiction for ALL their troubles in life. The system digs you a hole and hopes you bury yourself in it, if you made a mistake usually victimless crime with us they take your job opportunities. They take your children and screw them up worse then then parents addict behavior in most cases. Maybe doing addiction in front of the children is not stellar behavior but that CPS system is beyond out of control. They constantly drive women to suicide by despair and overdose.

    We try and give the guys tools to stay sober but basically if you have the so called ADHD mental issues oh ya everyone talks the grand “go back to school” be a success but the system is so against you. Half of them on probation one slip one false positive the system eats them alive if they don’t kill themselves using since why not “I relapsed and am getting screwed anyway”. They are going to put me in jail now anyway, where is the booze meth and heroin ??? Making it is a full time entry level job to hand all your earnings to a landlord, the car insurance and criminal injustice industry.

    I hate to paint such a grim picture, people can recover and make it but the title here is death by despair and I have seen ALOT of it, I know how it operates.

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    • The views are sometimes by shrinks, you know, to see how we think 🙂
      I think they probably are busy creating a new illness based on “internet responses”.
      I think lack of comments is simply a reflection of how tired we are getting of research that is aimed at nothing more than making money from the research.

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  5. Hi Rebecca,
    Studies keep people employed and keeps the powerful looking at
    the real problem in their lives, which of course are the useless poor,
    the useless lives that they had no part in creating.
    All these powerful men that invaded a country, that used the poor white folks to go and slaughter and pillage the native people.
    The powerful always have themselves to thank for using the poor to get ahead, but in that wake, create chaos.
    It is simply the way our society works. Cruel, but true.
    I stopped believing any rational thought ever existed within society and we simply act out of greed and desire.
    Until the poor and minimized wage a war, nothing will change.
    The begging, pleading, reasoning, it does not affect those in power.
    The poor are all just looked at as a burden, not as humans.

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