According to data published in the journal BMJ Open, “diseases of despair” soared over the past decade in the United States. In the study, diseases of despair were defined as diagnoses related to alcohol dependency, substance misuse and suicidal thoughts or behaviors and analyzed among the following age groups: under the age of 12 months; 1-17 year olds; 18-34 year olds; 35-54 year olds; 55-75 year olds; and those aged 75-plus.
The researchers examined information for 12 million people enrolled in Highmark, a large US-based health insurance company between 2007 and 2018 and who had valid detailed claims on file. Highmark members are concentrated in states that have been disproportionately affected by deaths of despair: Pennsylvania, West Virginia, and Delaware.
Overall, 1 in 20 (515,830; just over 4%) of those insured were diagnosed with at least one disease of despair at some point during the monitoring period. Some 58.5% were male, with an average age of 36. Of these, over half (54%) were diagnosed with an alcohol-related disorder; just over 44% with a substance related disorder; and just over 16% with suicidal thoughts or behaviors. Just under 13% were diagnosed with more than one type of disease of despair.
Between 2009 and 2018, the rate of diseases of despair diagnoses increased by 68%. The rate of alcohol-related, substance-related, and suicide-related diagnoses rose by 37%, 94% and 170%, respectively. The largest increase in alcohol and substance-related diagnoses was seen among 55-74 year olds: 59% and 172%, respectively. The largest increase in alcohol and substance-related diagnoses was seen among 55-74 year olds: 59% and 172%, respectively.
While the absolute numbers of suicide-related diagnoses were lower than for other types of diseases of despair, the relative increases were large. Among 1-17 year olds, the rate increased by 287%, and by 210% among 18-34 year olds. A relative increase of at least 70% occurred in all other age groups. Diseases of despair diagnoses were associated with significantly higher scores for coexisting conditions, higher rates of anxiety and mood disorders and schizophrenia for both men and women across all age groups.
Between 2015 and 2017, life expectancy fell year on year in the USA, the longest sustained decline since 1915-1918. And deaths among middle-aged white non-Hispanic men and women rose sharply between 1999 and 2015. These premature deaths are largely attributable to accidental overdose, alcohol-related disease, and suicide.
Such ‘deaths of despair’ coincided with decades of economic decline for workers, particularly those with low levels of education, loss of social safety nets and falling wages and family incomes in the United States—all of which are thought to have contributed to growing feelings of despair.
“Diseases of despair” can affect the well-being and job productivity of employees now more than ever. It’s important to note that this study was conducted before the onslaught of Covid-19, so it’s likely that the incidences of diseases of despair have risen due to pandemic related stress. If you or someone you know is struggling with alcohol or substance abuse, suicidal thoughts, depression, anxiety or other mental health challenges, consult your human resources officer or seek help from the following resources:
HelpGuide is a nonprofit organization that provides free, evidenced-based resources to help people suffering from a “disease of despair” to understand and navigate mental health challenges.
National Suicide Prevention Lifeline provides 24/7 free and confidential support for people in distress. 800-273-8255.
National Alliance on Mental Illness (NAMI) works to educate, advocate, listen and lead to improve the lives of people with mental illness and their loved ones.
Stop Addiction. US offers free consultation about addiction treatment programs nationwide along with recovery advice for workers and their loved ones.
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