An Emerging Storm? Increased Health Inequities in the Context of Racialized Patriarchal Capitalism, Deaths of Despair and Covid-19
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Abstract
This article discusses the gradual increase in Deaths of Despair in the United States, followed by a reversal in the increased life expectancy trend for a subset of the population. This phenomenon is examined in the context of pronounced social and health inequities linked to globalization and capitalism as well as the overall negative implications of the COVID-19 pandemic and subsequent socio-economic crisis, all having the potential to further worsen health and social inequities in the US but also globally.
The development of effective and actionable solutions requires an in-depth understanding of the root causes linked to an overall decrease in population-level life expectancy. While focusing on the phenomenon of Death of Despair brings attention to the role of class in the creation of health inequities and increased mortality rates, this approach should be part of a larger examination of contributing factors. Scrutinizing the impact of other social location factors such as race, gender, age, sexual orientation and identity, migration, and citizenship status, along with their interaction is equally important.
Research approaches that allow the stratification of analyses by population groups are needed to facilitate a better understanding of the observed decreases in population-level life expectancy. Such approaches require long-term and ongoing investments in research and the intentional collection of indicators that could reveal the breadth and depth of health and social inequities and the pathways through which they lead to increased mortality rates for various population groups. The sustained financial investment and efforts required to examine the causes of decreases in population-level life expectancy and to inform the implementation of protective policies that could reverse this trend have the potential to bring long-term societal dividends. An indirect outcome of the reduction of social and health inequities and the adoption of protective policies could be that individuals and populations regain their trust in social institutions and, as a result, enhance their active political participation through increased voter turnout and decreased political radicalization.
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References
2. Galea S. The contagion next time. New York: Oxford University Press; 2022.
3. Sombart W. Why is there no socialism in the United States ? Revue Française de Sociologie. 1976;21(2):302-306.
4. Bor J, Stokes AC, Raifman J, et al. Missing Americans: Early death in the United States-1933-2021. PNAS Nexus. 2023;2(6):pgad173-pgad173.
5. Paglino E, Lundberg DJ, Zhou Z, et al. Monthly excess mortality across counties in the United States during the COVID-19 pandemic, March 2020 to February 2022. Science Advances. 2023;9(25):eadf9742-eadf9742.
6. Preston SH, Vierboom YC. Excess mortality in the United States in the 21st century. Proceedings of the National Academy of Sciences - PNAS. 2021;118(16):1.
7. Case A, Deaton A. Deaths of despair and the future of capitalism. Princeton, NJ: Princeton University Press; 2020.
8. Angus C, Buckley C, Tilstra AM, Dowd JB. Increases in ‘deaths of despair’ during the COVID-19 pandemic in the United States and the United Kingdom. Public Health 2023;218:92-96.
9. Koob GF, Powell P, White A. Addiction as a coping response: Hyperkatifeia, deaths of despair, and COVID-19. The American Journal of Psychiatry. 2020;177(11):1031-1037.
10. Case A, Deaton A. Rising morbidity and mortality in midlife among white non-Hispanic Americans in the 21st century. Proc Natl Acad Sci USA. 2015;112(49):15078-15083.
11. Dowd JB, Angus C, Zajacova A, Tilstra AM. Comparing trends in mid-life ‘deaths of despair’ in the USA, Canada and UK, 2001–2019: is the USA an anomaly? BMJ Open. 2023;13(8):e069905.
12. Muntaner C, Nieto FJ, O Campo P. The Bell Curve: on race, social class, and epidemiologic research. American Journal of Epidemiology. 1996;144(6):531-536.
13. Priest N, Williams DR. Structural racism: A call to action for health and health disparities research. Ethnicity & Disease. 2021;31(Suppl):285-288.
14. Duerme R, Dorsinville A, McIntosh-Beckles N, Wright-Woolcock S. Rationale for the design and implementation of interventions addressing institutional racism at a local public health department. Ethnicity & Disease. 2021;31(Suppl):365-374.
15. Chung H, Muntaner C. Political and welfare state determinants of infant and child health indicators: An analysis of wealthy countries. Social Science & Medicine. 2006;63(3):829-842.
16. Cole M. Federally qualified health centers play a critical role in ensuring equitable COVID‐19 vaccine access. Health Services Research. 2021;56(S2):9-10.
17. Hong M-LK, Lau CY, Sharma P. The Auntie Sewing Squad guide to mask making, radical care, and racial justice. Oakland, California: University of California Press; 2021.
18. Altman D. Understanding the US failure on coronavirus—an essay by Drew Altman. BMJ (Online). 2020;370:m3417-m3417.
19. Loccoh EC, Joynt Maddox KE, Wang Y, Kazi DS, Yeh RW, Wadhera RK. Rural-urban disparities in outcomes of myocardial infarction, heart failure, and stroke in the United States. Journal of the American College of Cardiology. 2022;79(3):267-279.
20. Bhopalwala H, Akbar A, Dewaswala N, et al. Outcomes of heart failure in COVID-19 patients: An Appalachian experience. Cardiology Research. 2022;13(3):162-171.
21. Gollwitzer A, Martel C, Brady WJ, et al. Partisan differences in physical distancing are linked to health outcomes during the COVID-19 pandemic. Nature Human Behaviour. 2020;4(11):1186-1197.
22. Ruhm CJ. Living and dying in America: An essay on deaths of despair and the future of capitalism. Journal of Economic Literature. 2022;60(4):1159-1187.
23. Muntaner C. Social capital, social class and the slow progress of psychosocial epidemiology. International Journal of Epidemiology. 2004;33:1-7.
24. DeVerteuil G. Deaths of despair and the social geographies of health denial. Geography Compass. 2022;16(2):e12607.
25. Gordon JR. The rise and fall of American growth: the US standard of living since the Civil War. Vol 70. Princeton, NJ: Princeton University Press; 2017:357-358.
26. Leon DA, Shkolnikov VM. Social stress and the Russian mortality crisis. JAMA. 1998;279(10):790-791.
27. Muntaner C, Gunn V, Prins SJ. On Case and Deaton's deaths of despair: implications for health inequalities research in the post-COVID-19 era. Gaceta Sanitaria. 2022;35(5):409-410.