A disease of despair is one of three classes of behavior-related medical conditions that are increased in groups of people who experience despair.
Despair is a sense that their long-term social and economic prospects are bleak.
The three disease types are drug overdose, including alcohol overdose, suicide, and alcoholic liver disease.
In 2018, some 158,000 U.S. citizens died from these causes.
Deaths of despair have increased sharply during the COVID-19 pandemic with a 10% to 60% increase above pre-pandemic levels.
Life expectancy in the United States has declined with the main drivers being the COVID-19 pandemic along with deaths from drug overdoses, suicides and liver disease.
Despair often breeds disease. — Sophocles
Despair in any form can affect individuals, and can also arise in and spread through social communities.
There are four basic types of despair.
Cognitive despair-thoughts that are connected to defeat, guilt, hopelessness and pessimism.
Cognitive despair may make a person perceive other people’s actions as hostile.
Emotional despair refers to feelings of sadness, irritability, loneliness and apathy.
Emotional despair may partly impede the process of creating and encouraging interpersonal relationships.
Behavioral despair describes risky, reckless and self-destructive behavior
Behavioral despair gives little to no consideration of the future and manifests inn self-harm, reckless driving, drug use, and risky sexual behavior.
Biological despair manifests as dysfunction or dysregulation of the body’s stress reactive system or hormonal instability.
The influence of despair for an extended amount of time may result in the development diseases of despair: suicidal thoughts or drug and alcohol abuse.
With a disease of despair, there is an increased risk of death, classified as a suicide, drug or alcohol overdose, or liver failure.
Diseases of despair: affect people of every age, ethnicity, and every demographic group in every country in the world.
Diseases of despair are on the rise, especially among the US White men and women in midlife.
Men women having no more than high school education and those living in rural areas are more affected by this phenomenon than their peers who are college-educated and live in urban areas.
The White population exhibits an increase in premature deaths, especially in those caused by suicide, drug overdose and alcoholic liver disease.
Education negatively correlates with the probability of developing a disease of despair.
Higher education correlates with lower probability of developing a disease of despair.
The proportion of these causes of death that is compared to deaths caused by assaults, cancer, cardiovascular diseases, HIV and motor vehicle crashes in population of white people aged 25–44 is increased by 210%.
The highest rates of disease of despair are to be discovered among people living in rural areas.
It is possible to assume that living in rural areas is also connected to the diseases and deaths of despair.
Suicides reached record levels in the United States in 2022, with 49,369 suicide deaths.
Since 2011, roughly 540,000 people have died by suicide in the United States.
Life expectancy for working class Americans without a college degree has been declining, in part to rising deaths of despair.
Suicide happens when society fails to provide some of its members with the framework within which they can live dignified and meaningful lives.
Factors that seem to exacerbate diseases of despair are generally recognized as including a worsening of economic inequality and feeling of hopelessness about personal financial success.
This increase in rates of mental distress and diseases of despair have been attributed to the flaws in contemporary capitalism.
The labor market affects social connections that might otherwise provide protection, as people at risk for this problem are less likely to get married, more likely to get divorced, and more likely to experience social isolation.
The ultimate cause is the sense that life is meaningless, unsatisfying, or unfulfilling, rather than strictly the basic economic security that makes these higher order feelings more likely.
In a later work Case and Deaton assert that in the United States, much more so than in peer countries such as those of Western Europe, globalization and technological advancement dramatically shifted political power towards capital and away from labor by empowering corporations and weakening labor unions. As such, other rich countries, while facing challenges associated with globalization and technological change, did not experience a “long-term stagnation of wages, nor an epidemic of deaths of despair.”[28]
Diseases of despair pose a complex threat to modern society and that they are not correlated only to the economic strength of an individual.
Social connections, level of education, place of residence, medical condition, mental health, working opportunities, subjective perception of one’s own future play a role in determining whether the individual will develop diseases of despair or not.
Younger generations are more and more influenced by social media and other modern technologies, which may have unexpected and unfavourable effects on their lives, and are as significantly associated with increased depression.
Aggravation of depression, anxiety, drug overdoses, and suicidal ideation followed the COVID-19 pandemic.
A range of social determinants, commonly experienced during an economic downturn, can induce and aggravate a sense of despair.
Loneliness, which is associated with despair, was aggravated by social isolation practices put in place during the COVID-19 pandemic
Women, ethnic minorities and younger age groups, may have suffered disproportionately more than other groups
The trajectory of drug overdose-related deaths was exacerbated by the Covid-19 pandemic.
The worst of these drug impacts seemed to primarily occur in poor and urban neighborhoods, especially affecting Black and Hispanic communities. : Even wealthy and prosperous White communities within the suburbs, also faced an increase in the number of overdose deaths.
The urban areas that experienced a 10,280% increment in OODs suffer from racial and economic segregation, concentrated poverty, and a lack of educational and employment opportunities.
The population in these tracts is predominantly Black (72.46%), with a low median household income ($31,192), high unemployment rate (34%), and low educational attainment (only 5% hold a bachelor’s degree or higher), a high incarceration rate (7%) and low internet subscription rate (69%): The pandemic has further exacerbated existing socioeconomic disparities in these areas.
The suburban census tracts that experienced an 11,600% increment in OODs are affluent and well-educated.
The population is predominantly White (83.63%), with a higher median household income ($75,959), lower unemployment rate (11%), and higher educational attainment (45% hold a bachelor’s degree or higher).
These areas also have high rates of internet subscription (90%) and low incarceration rates (2%).
Despite their high economic and social well-being, suburban tracts have still been affected by pandemic-related stress, which likely contributed to the increase in OODs.
Diseases of despair differ from diseases of poverty because poverty itself is not the central factor.
Impoverished people with a sense that their lives or their children’s lives will improve are not affected as much by diseases of despair.
Diseases of despair affects people who have little reason to believe that the future will be better.
This problem is distributed unevenly: affecting working-class people in the United States more than working-class people in Europe; affects White people more than racially disadvantaged groups, possibly because working-class White people are more likely to believe that they are not doing better than their parents did, while non-White people in similar economic situations are more likely to believe that they are better off than their parents.
There has been a rise in deaths of despair due to an unexpected increase in the number of middle-aged White Americans dying.
Diseases of despair may not be purely economical, but its consequences of this phenomenon are, in terms of money, expensive: around $1.5 trillion in economic loss, loss of productivity, and societal harm.