Deaths of Despair in Comparative Perspective

Abstract

A socially patterned epidemic of deaths of despair is a signal feature of American society in the twenty-first century, involving rising mortality from substance use disorders and self-harm at the bottom of the class structure. In the present review, we compare this population health crisis to that which ravaged Eastern Europe at the tail end of the previous century. We chart their common upstream causes: violent social dislocations wrought by rapid economic change and attendant public policies. By reviewing the extant social scientific and epidemiological literature, we probe a collection of dominant yet competing explanatory frameworks and spotlight avenues for future sociological contributions to this growing but underdeveloped domain of research. Deaths of despair are deeply rooted in socioeconomic dislocations that shape health behavior and other proximate causes of health inequality; therefore, sociology has great untapped potential in analyzing the social causes of deaths of despair. Comparative sociological research could significantly extend the extant public health and economics scholarship on deaths of despair by exploring the variegated lived experience of socioeconomic change in different institutional contexts, relying on sociological concepts such as fundamental causes, social reproduction, social disintegration, alienation, or anomie. Expected final online publication date for the Annual Review of Sociology, Volume 48 is July 2022. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.

Reflections on personal and collective time travel: Some additional findings and suggestions for future research.

“…The biases in Western cultures may not be universal. Studies with Chinese participants do not demonstrate negative collective future biases using fluency measures (Deng et al, 2022;Mert et al, 2022), which may better align with China's trend of a continual decrease in suicide rate and increase in other quality of life measures and life expectancy (Ilic & Ilic, 2022;King et al, 2022;Zhang et al, 2022). These real-world national trends are undoubtedly complex and the result of many different factors; however, the dissociation in emotional valence for how one feels about their country's future may be somewhat reflective of or influenced by those large-scale phenomena.…”

What Can the Health Humanities Contribute to Our Societal Understanding of and Response to the Deaths of Despair Crisis?

“…Both tables are redrawn from Case and Deaton (2017) and reprinted, with modifications, from Sterling (2020) volatility, political instability, and rising psychosocial stress. In the 1990s, after the fall of the Soviet Union and the rapid neoliberal reordering of the country's economy, Russia experienced 7.3 million excess deaths and an unprecedented fall of six years in mean life expectancy, with the largest contributions from rising levels of suicide, alcohol, and illicit drug consumption (King, Scheiring, and Nosrati 2022). In the US, the worsening domestic crisis has only been further exacerbated by the socioeconomic shockwaves of the COVID-19 pandemic.…”

Who Controls the Code, Controls the System: Algorithmically Amplified Bullshit, Social Inequality, and the Ubiquitous Surveillance of Everyday Life

“…This was an opportunity for sociologists to engage publicly: bridging the academic gap with public facing work that should have illuminated the despair Trump was giving voice to. Sociologists have shown that Trump's portrayal of parts of the country has been living in an American nightmare: from deaths of despair (Case and Deaton 2021), loss of manufacturing (Mutz 2021)-irrespective of whether it is through globalization or automation, the job loss is the same, rural population decline (Berlet and Sunshine 2019;Edelman 2019;Lichter and Brown 2011), the opioid epidemic (King et al 2022): all these factors reveal parts of America that Trump's American Carnage speech described. The demographic separation that is driving college educated and those without a college education further apart has broad implications for society given that less than 40% of Americans earn a college education (Statista 2022) and data about these emerging segments of American society are ripe for exploitation by data profiteers.…”