What happened: The mortality rate of white, middle-aged, males has significantly increased since 1998. The change, especially in males with low education completion, is described by two Princeton researchers as an “overlooked epidemic” caused by drugs, alcohol and suicide.
The change in the mortality rate caused 488,500 additional deaths between 1998 and 2013. In the same time period the death rates for middle-aged Hispanic and African American males have not increased at a similar rate. The death rate for males with some college completion or attainment of a college degree has declined in the same time period.
Why it’s significant to EMS: 3 reasons
The researchers’ findings are significant to EMS for many reasons. First, this broad look at population-based epidemiological data is confirmation of what many EMS providers are experiencing in the field. When asked how EMS has changed in the last 20 years, I frequently hear anecdotes about patients with idiopathic pain complaints, regular encounters with patients seeking opioid prescriptions, and the constant responses for patients in an acute mental health crisis.
Second, EMS providers are regularly attacked and assaulted while on duty. The assailants are invariably intoxicated and an attacker who has no outlook or hope for a better future has no reason to contemplate or fear the repercussions of their actions.
Third, though this research, which compared the epidemic to the number of Americans killed by AIDS (see stories in the Washington Post, New York Times and Wall Street Journal, as well a thoughtful post, Despair not opioids is killing poor white American men from electrophysiologist Dr. John Mandrola,) there has been little discussion of the contributions these middle-aged, white males, could have been making to their communities as members of the workforce, tax payers, fathers and community volunteers.
Top takeaways: Impact on volunteer EMS and fire departments
After reading about the research I immediately envisioned an alternative reality in which the rate of volunteerism increased so significantly that 500,000 white, middle-aged males, joined the ranks of volunteer EMS agencies and fire departments. Before dismissing this fantastical notion consider these top takeaways:
1. EMS is heavily impacted by the not yet deceased
The research reported the change in mortality rate linked to an increase in drug overdose, alcoholism-related illness and suicide. There is a secondary and orders of magnitude greater impact from the still living, but addicted and mentally ill on EMS agencies across the U.S. These patients also put an additional strain on EMS through their dual inability by not contributing to the taxation mechanisms that fund many EMS systems and not having the financial resources to pay for their use of an EMS system.
2. Medical first responder, EMT, and firefighter 1 certifications are attainable and accessible
Becoming an entry-level emergency responder is well within the educational capacity of a high school graduate. In many communities, high school students can train as an EMT and firefighter in programs like these ones in Texas and Detroit.
For the survivors, once sober, as well as for the younger generations of white males with low education completion, EMS needs to be widely marketed as an opportunity for education and work.
3. EMS is a pathway to prosperity, fulfillment and happiness
Of course a decades-long EMS career, as a volunteer or paid employee, can be fulfilling and prosperous. We also know EMT training with a few years of work experience can be a stepping stone into a career as a paramedic, firefighter/paramedic, or other health care professions. Leaders who admit, or even encourage, volunteers to use EMS as a stop on a journey, rather than the end of the journey, may create opportunity for participation and involvement for men and women who don’t currently see EMS as an opportunity to be leveraged.
4. Service to others and brotherhood are a salve to loneliness, despair and pain
Being a member of an EMS agency or fire department is an opportunity to belong to something bigger than oneself. There is great personal gratification to be had from having a set of in-demand lifesaving skills that can be used to care for others. Regular meetings, group problem-solving in training scenarios and real-life incidents, and uniforms are great boosters for self-esteem and self-confidence.
Musculoskeletal pain, which is often idiopathic, can be numbed with opioids and alcohol. But perhaps involvement in EMS, rather than consumption of EMS, can help soothe the underlying cause of loneliness and despair.
What are your thoughts on this epidemic? Do we simply accept the increase in morbidity or mortality and respond only when 911 is activated? Or do we consider it a role for EMS to reverse this trend? We want to hear from you in the comments or email your thoughts to editor@ems1.com.
