Diseases of Despair

The diseases of despair are three classes of behavior-related medical conditions that increase in groups of people who experience despair due to a sense that their long-term social and economic outlook is bleak. The three disease types are drug overdose, suicide, and alcoholic liver disease. Diseases of despair, and the resulting deaths of despair, are high in the Appalachia region of the United States. The prevalence increased markedly during the first decades of the 21st century, especially among middle-aged and older working class white Americans starting in 2010, followed by an increase in mortality for Hispanic Americans in 2011 and African Americans in 2014. It gained media attention because of its connection to the opioid epidemic. For 2018, some 158,000 U.S. citizens died from these causes, compared to 65,000 in 1995. Deaths of despair have increased sharply during the COVID-19 pandemic and associated recession, with a 10% to 60% increase above pre-pandemic levels.

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