Winship: ‘Deaths of Despair’ on the Rise

To target barriers to economic opportunity, it’s important to identify populations that may be predisposed to specific public health issues. Understanding how these can hinder human flourishing is the first step to addressing them.

The mortality rate from “deaths of despair” — including drug overdoses, suicides, and alcohol-related deaths — is found to be higher today than at any point in more than 100 years, according to a new report published by Sen. Mike Lee’s Social Capital Project within the Senate’s Joint Economic Committee (JEC), led by FREOPP Board of Advisors member Scott Winship.

Building on the research conducted by Princeton scholars Anne Case and Angus Deaton in which they followed the disproportionate rise in deaths of despair among middle-aged whites since 1999, the JEC extended their research to the entire American population going as far back as 1900.

They found that in 2000, there were 22.7 deaths of despair per 100,000 Americans. By 2017, the rate had doubled to 45.8 per 100,000. Drug-related deaths have risen steadily for decades but have especially spiked since 2000. Suicide and alcohol-related deaths, which had held steady since the 1970s, have also seen a climb since 2000.

The rise of lethal opioid drugs is a major contributing factor to the increase in drug deaths in the U.S. As the report notes, the rise in opioid deaths initially started with an oversupply of legal prescription narcotic drugs. But as awareness of opioid abuse grew, policies and prescribing practices of physicians changed, and the opioid crisis shifted to illegal heroin and fentanyl.

The JEC examines how the upward trend in deaths of despair correspond with self-reported unhappiness and loneliness. They find that these do not correlate neatly: “Rising unhappiness may have increased the demand for ways to numb or end despair, such that the cumulative effects show up years later in the form of higher death rates. But the proliferation of a uniquely addictive and deadly class of drugs has meant that the supply of despair relief has become more prevalent and more lethal, which would have increased mortality even absent an increase in despair.”

Given the inconclusive evidence directly linking unhappiness with deaths of despair, the JEC suggests that it may be most productive for policymakers to focus on the overdose epidemic rather than on addressing despair itself.

This is where communities and government can work alongside one another to target a problem that cannot be solved by either on their own. The work of Congress to combat the opioid crisis and the illegal distribution and sale of lethal drugs is critical. So, too, is the work of communities to reach out to those who are experiencing loneliness and despair. Together, these efforts can work to fight against the rise of deaths of despair.