- The Washington Times - Thursday, May 3, 2018

Americans are increasingly succumbing to what researchers call “deaths of despair” — suicides and alcohol- or drug-fueled deaths — according to a study being released Thursday that paints a grim picture of health in the U.S.

Despair deaths spiked by 50 percent from 2005 to 2016, the Commonwealth Fund says, with states in the Northeast and Appalachia faring particularly badly.

The findings add to a growing body of evidence that feelings of isolation and growing economic anxiety are exacting a significant toll, particularly on less-educated residents of rural America, even as people in other advanced countries live longer.

“This is predominately an American problem,” said David Blumenthal, president of the Commonwealth Fund.

Researchers said they couldn’t point to a single explanation for the rising despair and the spike in deaths, though states with the highest death rates track with where the opioid crisis has hit the hardest.

West Virginia was by far worst off, with 83 deaths per 100,000 residents in 2016 as a result of suicide, alcohol or drug use. New Hampshire was second at roughly 64 per 100,000, followed by Ohio at 63.

Rates rose in those states and Pennsylvania and Massachusetts by at least 20 percent from 2013 to 2016, as the deadly opioid-synthetic fentanyl hit the streets.

Nebraska fared the best, at 28.5 deaths per 100,000 in 2016, followed by Hawaii, which topped the Commonwealth Fund’s broader scorecard on 40 measures related to health outcomes and access to care.

But nationwide, the trend is dour. Federal scientists reported in December that U.S. life expectancy had fallen for a second consecutive year in 2016 — the first multiyear drop since the early 1960s. Even the 1980s HIV/AIDS epidemic didn’t create such a drop.

The decrease was driven by a 21 percent spike in deaths from drug overdoses, according to the Centers for Disease Control and Prevention.

John Auerbach, president and CEO of Trust for America’s Health, said he can track the uptick in deaths back to the widening supply of prescription opioids in the late 1990s, to widespread addiction and now to the heroin and fentanyl epidemic.

“During that same period of time, that’s where we see this widening of the gap between the rich and the poor,” he said, attributing despair, suicide and substance abuse to the disparity.

“Your sense of where you are is that much more dramatic,” he said. “You’re that much more aware of being at the bottom.”

Shannon M. Monnat, an associate professor of sociology at Syracuse University, said the roots of the despair run deep.

“Opioids may have been the spark, but a spark needs kindling in order to ignite,” she said. “This kindling is decades of economic restructuring, rising income inequality, social disconnection and loss of social cohesion, an emphasis on consumption to satisfy us and give our lives meaning, our demand for quick fixes to medical ailments, and an economic regime that emphasizes the market and maximizing shareholder value over collective societal well-being.”

Mr. Auerbach’s group earlier this year tallied the number of suicide, alcohol and drug overdose deaths and came up with 142,000 for 2016.

That was up from 91,000 in 2007 and 64,500 in 1999 — more than doubling over the past two decades. The population has grown only 17 percent during that period.

Princeton professors Anne Case and Angus Deaton sounded the alarm over “deaths from despair” two years ago, when they reported that mortality rates among non-Hispanic whites had risen sharply since 1999.

They said the problem appeared to compound itself over time as whites with little education struggled in the job markets and fell prey to family problems and substance abuse issues.

“Ultimately, we see our story as about the collapse of the white working class after its heyday in the early 1970s, and the pathologies that accompany this decline,” they wrote last year in the Brookings Papers on Economic Activity, a scholarly journal.

Death rates among blacks and Hispanics have continued to fall, regardless of educational attainment, and Europeans have seen a decline, too.

“Mortality rates in comparably rich countries have continued their premillennial fall at the rates that used to characterize the United States,” the Princeton professors’ paper said.

Mr. Blumenthal said it is difficult to make “one-to-one” comparisons between the U.S. and the European Union, though higher rates of opioid prescribing could account for the increasing death rate in America, even though many European countries suffer from higher unemployment rates.

European countries tend to have more robust safety nets, he said, so inhabitants are less likely to fall into poverty and despair as a result of unemployment.


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