What are deaths of despair in simple terms?

Deaths from overdoses, suicide and heavy drinking linked to hopelessness.

Economic and social decline, such as lost jobs and community, alongside the supply of drugs like opioids.

Deaths of Despair

🩺 Nursing & Health By CampusDown Wiki Editorial Team Last updated October 27, 2026

Deaths of despair are deaths from causes linked to hopelessness, such as drug overdoses, suicide and alcoholic liver disease. Anne Case and Angus Deaton popularised the term in 2015 after showing that mortality among middle-aged white Americans had begun rising.

Contents

1. Discovery
2. Explanations
3. Debate
4. FAQ
5. References

Discovery

Case and Deaton (2015) reported that, unlike other rich countries, mortality among middle-aged white Americans without a college degree rose after 1999, driven by overdoses, suicide and alcoholic liver disease. The finding shaped debates on social determinants of health.

Explanations

Case and Deaton (2017; 2020) proposed cumulative disadvantage as jobs and wages for less-educated workers deteriorated and supports such as marriage, community and religion weakened, echoing Durkheim's anomie and declining social capital. Autor, Dorn and Hanson (2019) and Pierce and Schott (2020) linked manufacturing decline and trade shocks to mortality.

Debate

Ruhm (2018) argued the drug supply environment, from opioids to fentanyl, explains more than local economic conditions. Masters, Tilstra and Simon (2018) noted divergent trends across causes. Many still use the concept to capture the scars of deindustrialisation.

FAQ

What are deaths of despair in simple terms?: Deaths from overdoses, suicide and heavy drinking linked to hopelessness.
What causes them?: Economic and social decline, such as lost jobs and community, alongside the supply of drugs like opioids.

Sources reviewed: 2026-10-26

References

Case, A., & Deaton, A. (2015). Rising morbidity and mortality in midlife among white non-Hispanic Americans in the 21st century. Proceedings of the National Academy of Sciences, 112(49), 15078–15083. The paper that revealed rising midlife mortality.
Case, A., & Deaton, A. (2017). Mortality and morbidity in the 21st century. Brookings Papers on Economic Activity, 2017(1), 397–476. Proposes the cumulative disadvantage account.
Case, A., & Deaton, A. (2020). Deaths of despair and the future of capitalism. Princeton University Press. The book synthesising the research.
Ruhm, C. J. (2018). Deaths of despair or drug problems? (NBER Working Paper No. 24188). National Bureau of Economic Research. Argues drug environment matters more.
Masters, R. K., Tilstra, A. M., & Simon, D. H. (2018). Explaining recent mortality trends among younger and middle-aged White Americans. International Journal of Epidemiology, 47(1), 81–88. Questions the despair interpretation.
Autor, D., Dorn, D., & Hanson, G. (2019). When work disappears: Manufacturing decline and the falling marriage market value of young men. American Economic Review: Insights, 1(2), 161–178. Manufacturing decline and young men.
Pierce, J. R., & Schott, P. K. (2020). Trade liberalization and mortality: Evidence from US counties. American Economic Review: Insights, 2(1), 47–63. Trade shocks and overdose deaths.

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This article was last updated on October 27, 2026. It is based on widely recognized original works and textbooks; when citing it in a paper, please check the original sources listed in the references.