In 2015, Anne Case and Angus Deaton coined the term “deaths-of-despair” to explain the increase in drug and alcohol abuse, suicide rates, and support for populist campaigns among middle-aged white Americans without college degrees. However, critics pointed out that the mortality increase was most concentrated among high school dropouts, and the availability of dangerous drugs played a large role. Recent data reveals that deaths of despair have expanded beyond white communities to diverse cities and counties, even rising faster in educated/diverse areas over the past decade. Let’s explore the impact of deaths of despair on diverse communities across the United States.
Steady Increase
Deaths of despair have been steadily increasing across the nation for over a decade now. In 2019, the Centers for Disease Control and Prevention (CDC) reported that 70,980 Americans died from a drug overdose, surpassing the number of deaths from car accidents. This statistic suggests that fatal overdosing is now a medical crisis driven by lethal new drugs like fentanyl mixes and not just a phenomenon attributable to unemployment and stagnating wages. This means that all groups are now vulnerable, and it is time to understand how the problem impacts communities beyond the traditional narrative.
New data shows that the rising number of deaths of despair has expanded beyond white communities and into diverse cities and counties. For instance, while the overall suicide rate in the United States has risen by 33% over the last two decades, it has risen even faster among minority communities. For instance, Native Americans have a mortality rate that is at least 1.5 times higher than whites. With diverse groups now vulnerable to this crisis, there is a need to find proactive solutions to address these communities’ problems.
Various Reasons for Despair
The reasons for deaths of despair in different communities vary. In African American communities, economic inequality and discrimination have contributed to the problem. Additionally, cultural stigma and fear prevent many people of color from seeking out treatments and services. In the Hispanic community, language barriers, immigration fears, and lack of access to healthcare are core contributors to the crisis.
The spread of deaths of despair to various communities and groups of people requires an inclusive approach to diagnosing and addressing the problem. Policymakers and healthcare providers need to recognize that deaths of despair often have complex causes, such as poverty, social isolation, trauma, mental illness, lack of access to healthcare, and addiction. Understanding the causes and developing culturally appropriate prevention measures should be a priority for all communities. Providers should scale treatments like cognitive-behavioral therapy, medication-assisted treatment, and community-based health services to reach all impacted groups.
Takeaways
The deaths-of-despair narrative developed by Anne Case and Angus Deaton in 2015 is limited in its applicability to the modern crisis. Deaths of despair have now spread beyond white communities, affecting all groups, especially Native Americans. It is critical for policymakers and healthcare providers to understand these changes and adopt new solutions that recognize the complex causes of the crisis, including poverty, social isolation, trauma, mental illness, lack of access to healthcare, and addiction. We need to work together to develop culturally appropriate prevention methods, like expanding access to healthcare, providing better education about the risks of addiction, and reaching out to communities that may be in need. By working together, communities can support those struggling with the crisis and begin healing.
