Diseases Of Despair In The U.S. | Overview, Causes, Data, & Potential Solutions

Numerous Americans struggle with despair, especially economic despair. This type of struggle can take a serious toll on your sense of well-being. In some cases, it can even lead to life-threatening medical conditions. These conditions are often called “diseases of despair.”

Here’s what you should know about these diseases and how communities can help fight them.

Diseases Of Despair

Diseases of despair are common causes of death among people who experience economic and social hardships. There are three types: drug overdose, suicide, and alcoholic liver disease (also called alcoholic cirrhosis).

Economic & Social Difficulties

Princeton economists Anne Case and Angus Deaton proposed the idea of diseases of despair in 2015. They introduced it after noting a sharp decline in the life expectancy of middle-aged white Americans during the first decades of the 21st century.

Case and Deaton theorized that this decline stemmed from the economic and social difficulties seen in rural communities. To cope with these difficulties, many people turn to substance abuse, which often leads to other health problems as well as death.

Populations Impacted

When the concept was introduced, diseases of despair mainly impacted working class people who were white non-Hispanic and middle-aged, especially those in Appalachia.

However, in recent years, morbidity and mortality rates have also risen among other working class demographics, including people of color and people not in mid-life.

What Causes Diseases Of Despair?

When proposing the concept of diseases of despair, Case and Deaton highlighted economic inequality as a primary cause. They argued that flaws in modern capitalism, such as the increasing dominance of corporations, leave people hopeless and vulnerable to disease.

Another contributing factor to diseases of despair is the opioid epidemic.

Opioid Epidemic

Due to the public health crisis of opioid abuse, opioid overdose death rates have skyrocketed, especially in rural areas.

Many of these deaths involve fentanyl, a synthetic (human-made) opioid that’s often laced in other drugs. According to the Centers for Disease Control and Prevention (CDC), it’s up to 50 times stronger than heroin.

A 2021 study of rural Pennsylvania communities identified three other contributing factors to diseases of despair.

Lack Of Infrastructure

The first factor was a lack of infrastructure. In particular, many rural areas lack public transportation to help people get to work or attend medical appointments, leading to financial and medical issues.

Lack Of Community

The second factor was a lack of community.

In recent years, many people have felt more isolated, largely due to the growing popularity of social media and decreases in real-life interactions. This loneliness makes it much more difficult to manage financial hardship and other common sources of despair.

Family Fragmentation

Finally, many rural communities experience despair due to family fragmentation, which includes divorce and single parenthood.

These forms of fragmentation can hinder a child’s biopsychosocial development, putting them at greater risk of psychological and behavioral problems later in life.

Data On Diseases Of Despair In The U.S.

In 2020, the Penn State Clinical and Translational Science Institute, in partnership with Highmark Health, published a study on diseases of despair in the journal BMJ Open.

Using data from health insurance claims, the researchers found that the prevalence of diseases of despair rose by 68% between 2009 and 2018.

Alcohol-related diagnoses increased by 37%, substance-related diagnoses increased by 94%, and suicide-related diagnoses increased by 170%. These increases occurred across all age groups and genders.

In addition, deaths of despair increased between 10% and 60% during the COVID-19 pandemic. That’s because the pandemic brought multiple sources of despair, including a rise in unemployment, isolation, uncertainty, and loss.

Potential Solutions For Reducing Diseases Of Despair

To reduce diseases of despair, communities must implement initiatives to help those who are most at risk of developing these conditions. The initiatives should include economic development, infrastructure building, increased access to health care, and peer support.

Also, because childhood trauma is a common risk factor for drug abuse and suicidal thoughts, communities should increase funding for programs that:

• address poverty and discrimination
• decrease community violence
• establish safe, supportive schools
• increase access to secure housing and employment opportunities

These programs can help decrease diseases of despair by promoting resilience in children and families.

Other Solutions

Researchers are also examining other potential solutions, including:

• the use of machine learning and big data analysis to guide state-level policy changes for at-risk communities
• the role of healthcare providers in detecting risk factors for diseases of despair
• partnerships with community organizations that help at-risk individuals

If you or someone you love struggles with drug or alcohol abuse, please reach out to Bedrock Recovery Center. Our board-certified healthcare providers offer medical detox, mental health counseling, and other evidence-based interventions to help you or your loved one thrive.

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