Depths of Despair

Evidence points to “deaths of despair” across all racial and ethnic groups. Efforts to mitigate cultural despair should target populations of young adults.

a collage of graphs

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Lauren Gaydosh and colleagues examined national data on more than 18,000 people who were adolescents in 1994-1995 and followed into adulthood. The researchers wanted to observe whether four indicators of potential self-harm (suicidal ideation, heavy drinking, marijuana use, and depressive symptoms) increased with age. The researchers also tested for differences by race/ethnicity and geographic area to see if these indicators were concentrated among Whites with a high school diploma or less and in rural areas where “deaths of despair” may be predictors of recent declines in Americans’ life expectancy.

The figures above show two indicators of despair: (a) depressive symptoms and (b) suicidal ideation by race/ethnicity (top row) and geographic location (bottom row). Of note, depressive symptoms decreased from adolescence into the respondents’ late 20s. However, depressive symptoms increased across all racial/ethnic groups as the cohort aged into their 30s. Furthermore, Hispanic and Black Americans reported higher levels of depressive symptoms than Whites at all ages. Across all racial/ethnic groups, suicidal ideation was highest in adolescence and declined with older age.

Depressive symptoms and suicidal ideation were highest in metropolitan and smaller urban areas. The age distribution for depressive symptoms and suicidal ideation was not significantly different across the geographic areas, illustrating that depressive symptoms and suicidal ideation were not higher in rural areas.

Rising midlife mortality attributable to drug poisonings, alcohol abuse, and suicide is commonly reported as predominantly occurring among Whites with little formal education in rural areas. Contrary to this view, these researchers concluded that there was evidence that points to “deaths of despair” across all racial/ethnic groups and recommend that efforts to mitigate rising despair should target the wider population of young adults.

Databyte via Lauren Gaydosh, Robert A. Hummer, Taylor W. Hargrove, Carolyn T. Halpern, Jon M. Hussey, Eric A. Whitsel, Nancy Dole, and Kathleen Mullan Harris, The Depths of Despair Among US Adults Entering Midlife. American Journal of Public Health, 2019.