What is the Disease of Despair?


I have found myself using the term “disease of despair” and “deaths from despair” in the past four months since another Think Tank member used it in email correspondence, without even knowing what it concretely referred to.

After some prodding, I put together a quick definition and history of the term. For Think Tank members and allies ignorant of this term, much like myself, I hope this provides for you an intellectual tool when conversing about the systemic causes of the rising drug abuse we have witnessed, and are witnessing, in Licking County.

The “disease of despair” is a term to describe the dramatic increase of mortality rates from drug overdoses, suicides, and alcohol-related liver diseases (or the “deaths from despair”) among white non-Hispanic, middle-aged Americans, particularly people with high-school diplomas or less, between 1999 and 2015.

The term was coined by economists Anne Case and Angus Deaton in their paper, Mortality and morbidity in the 21st century, published in the Spring 2017 edition of the Brookings Papers on Economic Activity.

In the report, Case and Deaton “propose a preliminary but plausible story in which cumulative disadvantage from one birth cohort to the next—in the labor market, in marriage and child outcomes, and in health—is triggered by progressively worsening labor market opportunities at the time of entry for whites with low levels of education.”

In other words, the previous generation, this generation, and posterity can expect further increases in rates of mortality as income inequality continues to grow.

“It's always been true that mortality rates have been higher and life expectancy shorter for African-Americans than for whites,” said Deaton. “What is happening now is that gap is closing and, for some groups, it's actually crossed.”

Their narrative has similarities not only with what we read in the Swank report, but what we have recognized in our own community: people without economic and educational opportunities, and people without access to affordable and adequate treatment for their despair, are more likely than those with resources and opportunity to engage in self-destructive and anti-social behaviors.

(Do not forget that, like every other blog on the web, we have a comments section below.)

Further reporting

The Atlantic: Middle-Aged White Americans Are Dying of Despair by Olga Khazan

USC Leondard D. Schaeffer Center for Health Policy and Economics: Case and Deaton say “Deaths of Despair” Data Make an Argument for Universal Coverage

The Washington Post Opinions: The media gets the opioid crisis wrong. Here is the truth by Anne Case and Angus Deaton

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  • Joshua Gingras
  • Joshua Gingras