'diseases of despair' rose rapidly in u.s. in last decade
substance abuse, alcohol dependency and suicidal thoughts and behaviour increased in 2009 to 2018
3 minute read
a look at insurance records shows bleak statistics for people living across several u.s. states.
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the u.s. was in the grips of a crisis long before covid-19 hit its shores with “diseases of despair,” such as substance abuse, alcohol dependency and suicidal thoughts and behaviour, all rapidly on the rise.
the alarming trend, which has coincided with a stark economic decline in the country among less educated and unskilled workers, was published in the journal bmj open earlier this week. by examining the insurance claims of more than 12 million people living in pennsylvania, west virginia and delaware, researchers found a 68 per cent increase in diseases of despair between 2009 and 2018, with suicidal thoughts and behaviours among people under the age of 18 rising by 287 per cent. the 18 to 34 age group wasn’t far behind at 210 per cent.
the findings are likely influenced by a host of factors, the researchers said, including a bleak economic outlook that has seen wages stagnate or decrease alongside a loss of vital social safety nets.
“it is theorized that these changes have fostered growing feelings of despair, that is, disillusionment, precariousness and resignation,” they wrote. “despair may, in turn, trigger emotional, cognitive, behavioural and even biological changes, increasing the likelihood of diseases that can progress and ultimately culminate in these deaths of despair.”
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examining the insurance data from highmark health, a u.s. health provider, researchers looked for evidence of substance abuse, alcohol dependency and suicidal thoughts and behaviour among six age groups — less than 12 months old, 1-17 years old, 18-34, 35-54, 55-75 and over 75. they found that one in 20 patients (or 515,830 people) experienced at least one disease of despair during the period of study.
on average, these patients were 36 years of age and 58.5 per cent of them were male. more than half of them were diagnosed with an alcohol-related disorder (54 per cent), 44 per cent had a substance-related disorder and over 16 per cent experienced suicidal thoughts or behaviours. roughly 13 per cent were found to have more than one disease of despair.
while researchers looked at data from 2007-2019, diseases of despair increased the most between 2009 and 2018 (68 per cent). this reflected an increase in diagnoses across the board, with suicide-related disorders jumping 170 per cent, followed by substance disorders (94 per cent) and alcohol disorders (37 per cent). the largest jump in alcohol- and substance-related disorders showed up among the 55 to 74 age group, at 59 and 172 per cent respectively.
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the study was limited by the fact the pool of patients was pulled from states already associated with higher levels of despair, meaning the national numbers may not be increasing at the same rate, even though they are definitely on the rise, lead author emily brignone, a senior research data scientist at highmark health, told live science. but the situation is also likely worse than it appears in the states studied, she said, as the research relied on diagnoses reported to an insurer and does not reflect people who are uninsured or did not seek medical attention.
the researchers also pointed out that life expectancy in the u.s. dropped off between 2015 and 2017, the longest sustained decrease in a century. this trend was fuelled, in part, by an increase in deaths of despair, often in the form of suicide, alcohol-related disease and overdoses.
the pandemic will only make matters worse as it introduces massive amounts of uncertainty into employment and social structures, leaving people at even greater risk of diseases of despair.
“covid-19 highlights many of our existing vulnerabilities,” said brignone. “fortunately, we do have effective treatments for depression and addiction. we have to improve outreach to people in need and remove barriers to care.”
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dave yasvinski is a freelance writer with healthing.ca.
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