Although Princeton professors emeritus Anne Case and Angus Deaton’s book “Deaths of Despair” was released only in March, its appearance at the outbreak of national health crisis has made its name and message a part of a national discussion on the future of physical and mental health.

The name is used by the two authors to describe the current phenomenon of the rise of middle-aged white American who died because of suicide, substance abuse, and overdoses.

The impetus for the behavior is related to a changing economy, opioid use, an expensive healthcare system, and collapsed social institutions.

But now, according a recent report, COVID-19 can be added.

Released in early May, 2020, by the Well Being Trust, a national foundation dedicated to advancing mental and social health, the 23-page “Projected Deaths of Despair From COVID-19” sees an increase in those deaths examined by Case and Deaton as well as additional deaths in black communities — which has a higher percentage of deaths per population than the white community.

Seeing these additional despair-related deaths as an “epidemic within the pandemic,” the report focuses on three contributing factors.

One is unemployment. “There is a relatively large body of literature examining the association between unemployment and all-cause mortality, as well as specific types of deaths. Work focused on suicides is the most established, showing that a one point increase in unemployment rates increases suicide rates by about 1 to 1.3 percent. This impact is shown to vary substantially with lower rates in countries with protective labor market policies. Another study estimates that in the Great Recession a one point increase in unemployment increased suicides by 1.6 percent.”

However, currently unemployment related to the coronavirus “is unlike anything seen since the Great Depression of the last century. From March 15 to April 30, 2020, 30 million individuals have applied for jobless benefits; almost one-fifth of the workforce. This is comparable to what occurred after natural disasters such as in New Orleans after hurricane Katrina. What happened to one city is happening to the globe.”

Another factor contributing to despair and death is isolation. Calling it both social isolation and physical distancing, the report says it leads to a loss of social connection and cohesion. It adds that the “pandemic has created the greatest forced isolation in our modern history.”

Then the uncertainty of both the short- and long-term impact of the virus on the nation can have a “serious impact on the emergence and worsening of mental illness. This is a novel virus with new and unanticipated results. Every day scientists shed light on new aspects and retract initial ideas and hypotheses. These are unprecedented times, and uncertainty may lead to fear which may give way to dread.”

To fully address the issues that surround deaths of despair, the report argues for national policy solutions that are “comprehensive and attempt to tackle the social, economic, and health related factors all at once. This begins with a recognition of the complex interplay between employment status and our overall health and well-being. With the profound uncertainty surrounding our economy from COVID-19, it is not clear the full extent unemployment may have on our nation as well as other nations. This brief is not intended to offer up all the solutions to each of these complex problems, but rather draw attention to them so our government, at every level, can begin to realize the connections.”

For more on “Projected Deaths of Despair From COVID-19,” visit

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