No single way to reverse middle Maine’s decline — but the first step is easy

Age, economics and partisan politics are creating a crisis in Maine — and rural Maine in particular.

It’s no secret that Maine’s population is aging and our workforce is barely growing.

Maine’s median age is 43.5 years, making our state the oldest in the country by that measure. We’re also behind only Florida in the percentage of the population that’s 65 or older.

Between 2010 and 2013, every county in Maine saw a more than 90 percent increase in the number of people between age 45 and 64. And Maine has one of the highest percentages of baby boomers, who account for 29 percent of the population.

Our rural areas are depopulating, even as the overall state population struggles to hold steady.

But age and population growth are only part of the story.

As The New York Times reported in November, new evidence shows that the death rate for white middle-aged Americans, ages 45 (Ouch!) to 54 is rising. White and middle-aged. That’s us!

And the rate at which we’re dying — statistically speaking — is going up.

“Something startling is happening to middle-aged white Americans. Unlike every other age group, unlike every other racial and ethnic group, unlike their counterparts in other rich countries, death rates in this group have been rising, not falling,” The New York Times reported.

The initial read on the data attributed to the rising mortality rate to things I might call depression-related: suicide, substance abuse, alcoholic liver disease and heroin and prescription drug overdoses.

When it comes to drug overdoses, it’s not just those of us in middle age who are falling victim. Additional research by The New York Times found that drug overdoses are driving up the death rate for young white people, between the ages of 25 and 35. To put that in context, this generation is the first since the Vietnam War to experience higher death rates than the generation before it, the Times reported.

Drugs alone, however, aren’t the only causes. The Commonwealth Fund took a deeper dive on the research about us pre-geezers, which creates a more nuanced explanation of growing mortality rates.

For whites ages 45 to 54, deaths from suicide and substance abuse were up. But, more importantly, the Commonwealth Fund discovered that progress against other common killers for this population   — heart disease, diabetes, and respiratory illnesses  — had either stopped or reversed as well.

“The early 21st century has been challenging for many middle-aged white Americans. Since 2000, their incomes have declined, fewer are employed, and fewer are married. Social commentators of different political leanings have documented these changes and ascribed many to the same underlying causes: fewer economic opportunities for those without a college degree; greater social isolation and distrust; weakened community organizations like churches or local clubs; and the splintering of society along class, geographic, and cultural lines,” the Commonwealth Fund wrote.

As reported by USA Today last week, middle-class income is shrinking faster in Maine than in all but eight other states. It grew by only 2.2 percent between 2010 and 2014. Income is gravitating toward those already on top.

The Fresno Bee | MCT

The Fresno Bee | MCT

The headline is ominous and ties these issues together: “States where the middle class is dying.”

The Commonwealth Fund translated this list of woes into at least a possible solution that can help to counter both the effects of substance abuse and the mortality gap for Mainers from treatable diseases.

“Given the breadth and complexity of the problem, there will be no quick or easy answer. However, one thing is clear: We should continue to work to ensure that everyone has access to affordable health insurance and health care —  especially in states that have not expanded their Medicaid programs to include all low-income adults,” the Commonwealth Fund wrote.

Again, this year, Maine is considering whether to accept federal dollars to expand access to health care through MaineCare, Maine’s Medicaid program. A bipartisan group of lawmakers are making another push, but so far they appear to running up against partisan hurdles, both from Gov. Paul LePage and some of his allies in the Maine House of Representatives.

There’s no single way to address Maine’s economic and health problems. But making sure that more people can see a doctor when they need one will save lives — and it will help our economy grow and make it possible for more people to stay in rural parts of the state.

If we want to put the genie back in the bottle on early deaths, more effectively fight addiction and improve our economy, expanding Medicaid is a critical first step.

David Farmer

About David Farmer

David Farmer is a political and media consultant in Portland, where he lives with his wife and two children. He was senior adviser to Democrat Mike Michaud’s campaign for governor and a longtime journalist. You can reach him at dfarmer14@hotmail.com.