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Thursday, December 30, 2021

COVID and Deaths of Despair

At STAT, David Introcaso writes of deaths of despair:

The term deaths of despair comes from Princeton economists Anne Case and Angus Deaton, who set out to understand what accounted for falling U.S. life expectancies. They learned that the fastest rising death rates among Americans were from drug overdoses, suicide, and alcoholic liver disease. Deaths from these causes have increased between 56% and 387%, depending on the age cohort, over the past two decades, averaging 70,000 per year.

This psychological state is largely the result of economic hardship or the loss of work or wages, something that today is disproportionately experienced by approximately 66 million white workers without college degrees between the ages of 25 and 64 years, or 38% of working-age people. As Case and Deaton showed, this population has seen the purchasing power of their wages decline by 13% since 1979 while per capita income increased 85% over the same period.

The resulting health effects are altogether predictable. Insecurity, deprivation, the loss of possibilities, the lack of belonging, hopelessness, and social maladjustment lead to negative emotions including loneliness, unhappiness, worry, and stress that in turn lead individuals to, in part, experience more pain and pain sensitivity both physical and psychological. Over approximately the past three decades, survey data show that Americans, particularly middle-aged white people, report more pain than respondents in 30 other wealthy countries. Pain, especially chronic pain, can become a gateway to opioid use and addiction.

Factor in the Covid-19 pandemic, and it’s no wonder that 911 calls for opioid-related use increased 250% between 2019 and early 2020.

Echoing Durkheim, Case and Deaton concluded, “Jobs are not just the source of money; they are the basis for the rituals, customs, and routines of working-class life. Destroy work and, in the end, working-class life cannot survive. It is the loss of meaning, of dignity, of price, and of self-respect that comes with the loss of marriage and of community that brings on despair.”