Why the U.S. leads other wealthy nations in deaths of despair

 

 https://bigthink.com/health/deaths-of-despair/

 

Jun 24, 2022

Since the start of the 20th century, life expectancy in the U.S. has steadily ticked upward, perhaps the clearest sign of a healthy, progressing society. But since 1980, something changed. While life expectancy in comparable countries continued to vigorously rise, in the U.S., growth slowed. Life expectancy has now completely flat-lined over the past few years, even before the COVID-19 pandemic resulted in one million early deaths. Americans born today cannot expect to live as long as their older peers. Why?

Perhaps the greatest contributor to this sad state of affairs are deaths of despair — that is, deaths from suicide or poisoning by alcohol and drugs. More than 158,000 Americans died from these causes in 2017, the latest year for which solid estimates are available. That number has certainly risen in the past few years, the only question is by how much.

While deaths of despair skyrocket in America — most significantly among white, middle-aged men with low income and limited education living in rural areas — they are falling on average in comparable wealthy nations. In a report published earlier this year in the journal JAMA Psychiatry, Peter Sterling, a professor of neuroscience, and Michael L. Platt, a professor of psychology, both at the University of Pennsylvania, sought to uncover why and to distill any potential policy remedies. 

The sixteen “control group” countries they examined were Australia, Austria, Belgium, Canada, Denmark, Finland, France, Germany, Italy, Japan, Norway, Portugal, Spain, Sweden, Switzerland, and the United Kingdom. A few differences immediately jumped out to the researchers:

    Single-parent homes are far less common in the control countries than in the U.S.
    All provide pre-natal and maternal care.
    Free schooling for children begins at age three and continues through high school.
    College tuition is far more affordable.
    Employers allow far more paid leave.
    Healthcare is essentially free.

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Humans are wired to seek food, comfort, companionship, and enjoyment, and the brain reinforces these behaviors through the release of the “reward” hormone dopamine, they write. For much of human existence, extending back to our origins as hunter-gatherers, these foundations were satisfied with the help of community. But that communitarian ethos has fallen off considerably, especially in the U.S., where people have grown increasingly isolated. 

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