Public health researchers explain: “Death by despair” is a thing, but not the biggest thing

Arline Geronimus sends along this article, “Weathering, Drugs, and Whack-a-Mole: Fundamental and Proximate Causes of Widening Educational Inequity in U.S. Life Expectancy by Sex and Race, 1990–2015,” with John Bound, Timothy Waidmann, Javier Rodriguez, and Brenden Timpe:

Discussion of growing inequity in U.S. life expectancy increasingly focuses on the popularized narrative that it is driven by a surge of “deaths of despair.” Does this narrative fit the empirical evidence? Using census and Vital Statistics data, we apply life-table methods to calculate cause-specific years of life lost between ages 25 and 84 by sex and educational rank for non-Hispanic blacks and whites in 1990 and 2015. Drug overdoses do contribute importantly to widening inequity for whites, especially men, but trivially for blacks. The contribution of suicide to growing inequity is unremarkable. Cardiovascular disease, non-lung cancers, and other internal causes are key to explaining growing life expectancy inequity. Results underline the speculative nature of attempts to attribute trends in life-expectancy inequity to an epidemic of despair. They call for continued investigation of the possible weathering effects of tenacious high-effort coping with chronic stressors on the health of marginalized populations.

6 thoughts on “Public health researchers explain: “Death by despair” is a thing, but not the biggest thing

  1. I wonder how much educational inequity in U.S. life expectancy between 1990-2015 is due to changes in the distribution of quality of life by educational attainment. As higher education attainment has become more common, perhaps people who are in the “Low Education” groups are increasingly less wealthy over the decades.

    • I have no data, but this sounds very plausible — it seems that degree requirements for similar jobs have increased over time. (I wonder if there are studies on why?)

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