Health Advice



Unemployment, isolation and depression from COVID-19 may cause more 'deaths of despair'

Bethany Ao, The Philadelphia Inquirer on

Published in Health & Fitness

PHILADELPHIA -- Even before protesters across the country took to the streets in rage and grief over police brutality, Americans were already facing unprecedented stress, isolation, depression and fear brought on by the COVID-19 pandemic.

Earlier this month, as the country began to consider relaxing stay-at-home orders and reopening businesses, experts warned that the months of isolation and unemployment prompted by the coronavirus pandemic may increase deaths of despair, a term for an alarming rise in early deaths among young and mid-life Americans, from suicide, drug overdoses and alcoholism.

Such deaths have pushed down overall life expectancy in the United States by roughly three years, according to a 2019 report in the Journal of the American Medical Association.

And for American Americans, the stress of experiencing and witnessing police brutality can also worsen mental health. In recent days, prominent medical organizations including the American Medical Association have decried police brutality and warned that racism is in itself a public health issue. A 2018 study found that police killings harm the mental health of black people living in states where such violence occurs -- and does not affect white people in the same way.

That pressure is now piling on top of the toll of an unprecedented pandemic that had already upended life in the United States.

As the pandemic spreads, health experts have become concerned about how COVID-19 will affect risk factors for deaths of despair, including increased unemployment and social isolation. Preliminary research from China has shown that people are experiencing higher rates of anxiety, depression and hazardous and harmful alcohol use due to coronavirus-related stress.


In a report released in May by Well Being Trust, a national foundation focused on mental wellness, and the Robert Graham Center, an independent research unit associated with the American Academy of Family Physicians, researchers predicted that additional deaths of despair over the next decade could range from just under 28,000 to over 154,000, depending on the speed of economic recovery.

All of this, researchers conclude, is driving a need for more and better mental health and substance abuse treatment.

In the United States, statisticians are warning that there will be sobering consequences if COVID-19's effect on behavioral health is inadequately addressed, especially as the country already has one of the highest suicide rates among wealthy nations and substance abuse remains persistent. Though fatal overdoses decreased nationally in 2018, that drop was the first in decades. And in Philadelphia, after a drop in 2018, overdoses ticked back up in 2019.

Deaths of despair have been increasing since 2008, said Benjamin Miller, the chief strategy officer at Well Being Trust and an author of the report, which includes nine different scenarios to predict additional deaths of despair using a baseline number from 2018, projected unemployment rates from 2020 to 2029 and three recovery rate estimates.


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