Health Advice



Are 'deaths of despair' really more common for white Americans? A UCLA report says no

Tyrone Beason, Los Angeles Times on

Published in Health & Fitness

LOS ANGELES — Nakeya Fields has seen how the stresses that come with being Black — racial injustice, financial strain, social isolation — can leave people feeling hopeless and push some into substance abuse.

It's one of the reasons the Pasadena social worker started offering "therapeutic play" gatherings for Black mothers like herself and children.

"I'm trying to host more safe spaces for us to come and share that we're suffering," the 44-year-old said. "And honestly, the adults need play more than kids."

Yet while Black and brown mental health practitioners such as Fields have labored to address these issues within their communities, a very different conversation has been occurring in the nation at large.

For years, discussions about America's substance-abuse crisis have focused almost exclusively on the narrative that it is white, middle-age adults who face the greatest risk of dying from drug overdoses, alcoholic liver disease and suicide.

The theory, which was presented by two Princeton economists in 2015 and based on data from 1999 to 2013, argued that despair was behind rising premature mortality rates among white Americans, especially those who were less educated.


Virtually overnight, the "deaths of despair" concept began to drive the national discourse over populist far-right politics; the rise of Donald Trump; and deepening political polarization over such topics as addiction treatment, law enforcement and immigration.

But after roughly a decade, researchers at UCLA and elsewhere have begun to dismantle this idea.

In a study published recently in the journal JAMA Psychiatry, authors found that deaths of despair rates for middle-age Black and Native Americans have surged past those of white Americans as the overdose crisis moves from being driven by prescription opioids to illegal drugs such as fentanyl and heroin.

While the opioid crisis did raise drug overdose deaths among white Americans for a time, it was an anomaly, said Joseph Friedman, a social medicine expert at UCLA's David Geffen School of Medicine who was the lead author of the journal analysis. In fact, by 2022 the rate for white Americans had started to dip.


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