Citation

Shanahan L, Hill SN, Gaydosh LM, Steinhoff A, Costello EJ, Dodge KA, Harris KM, Copeland WE. Am. J. Public Health 2019; 109(6): 854-858.

Affiliation

Lilly Shanahan and Annekatrin Steinhoff are with the Jacobs Center for Productive Youth Development, University of Zurich, Zurich, Switzerland. Sherika N. Hill and E. Jane Costello are with the Department of Psychiatry, Duke University Medical Center, Durham, NC. Lauren M. Gaydosh is with the Center for Medicine, Health, and Society, Vanderbilt University, Nashville, TN. Kenneth A. Dodge is with the Center for Child and Family Policy, Duke University, Durham. Kathleen Mullan Harris is with the Carolina Population Center, University of North Carolina at Chapel Hill. William E. Copeland is with the Vermont Center for Children, Youth and Families, University of Vermont Medical Center, Burlington.

Copyright

(Copyright © 2019, American Public Health Association)

DOI

10.2105/AJPH.2019.305016

PMID

30998413

Abstract

Two seemingly associated demographic trends have generated considerable interest: income stagnation and rising premature mortality from suicides, drug poisoning, and alcoholic liver disease among US non-Hispanic Whites with low education. Economists interpret these population-level trends to indicate that despair induced by financial stressors is a shared pathway to these causes of death. Although we now have the catchy term "deaths of despair," we have yet to study its central empirical claim: that conceptually defined and empirically assessed "despair" is indeed a common pathway to several causes of death. At the level of the person, despair consists of cognitive, emotional, behavioral, and biological domains. Despair can also permeate social relationships, networks, institutions, and communities. Extant longitudinal data sets feature repeated measures of despair-before, during, and after the Great Recession-offering resources to test the role that despair induced by economic decline plays in premature morbidity and mortality. Such tests must also focus on protective factors that could shield individuals. Deaths of despair is more than a phrase; it constitutes a hypothesis that deserves conceptual mapping and empirical study with longitudinal, multilevel data. (Am J Public Health. Published online ahead of print April 18, 2019: e1-e5. doi:10.2105/AJPH.2019.305016).

Language: en