Lauren Gaydosh, PhDAssistant ProfessorCenter for Medicine, Health, and SocietyPublic Policy StudiesVanderbilt University 

Despair Rising in Young Middle Aged Adults, Regardless of Ethnicity or Education Interview with:

Lauren Gaydosh, PhDAssistant ProfessorCenter for Medicine, Health, and SocietyPublic Policy StudiesVanderbilt University 

Dr. Gaydosh

Lauren Gaydosh, PhD
Assistant Professor
Center for Medicine, Health, and Society
Public Policy Studies
Vanderbilt University What is the background for this study?  

Response: Several years ago, life expectancy at birth in the United States declined, and this decline has continued every year since. Part of the cause underlying this decline is that midlife mortality – deaths among those 45-54 – has been rising. This increase in midlife mortality has been attributed by some to the “deaths of despair” – a cluster of causes of death including suicide, drug overdose, and alcohol-related disease – and has been most pronounced among middle-aged white adults with a HS degree or less.

In our research, we wanted to better understand the indicators of despair that would be predictive of these causes of death. Things like depression, substance use, and suicidal ideation. And study them in individuals before the period of elevated risk of death – in other words, before they reached middle age. Our goal was to evaluate whether these markers of despair were rising for a younger cohort, and whether this pattern was isolated to white adults with low education. What are the main findings?

Response: In order to do this, we used data from a nationally representative longitudinal study called the National Longitudinal Study of Adolescent to Adult Health.

We found that despair has increased in this cohort, but that increases are not restricted to non-Hispanic whites with low education. Instead, the increase in despair that occurs across the 30s is generalized to the entire cohort, regardless of race, ethnicity, education, and geography. What should readers take away from your report?

Response: Our findings are cause for concern. Given that depression, suicidal thoughts, and drug use are rising among this cohort as they enter midlife, and that this increase is generalized across racial, ethnic, educational, and geographic groups, we may see more generalized increases in mortality in the coming years, where death rates rise not just for HS educated whites, but for the middle aged population more generally. Public health and policy approaches to this current health crisis must address the entire population, and should not be targeted at any particular group, as we find that all are at risk of elevated despair. Otherwise, efforts may exacerbate existing racial and socioeconomic disparities in health. 

Citation: Lauren Gaydosh, Robert A. Hummer, Taylor W. Hargrove, Carolyn T. Halpern, Jon M. Hussey, Eric A. Whitsel, Nancy Dole, Kathleen Mullan Harris. The Depths of Despair Among US Adults Entering Midlife. American Journal of Public Health, 2019; 109 (5): 774 DOI: 10.2105/AJPH.2019.305002

[wysija_form id=”3″]


This piece discusses suicide. If you have experienced suicidal thoughts or have lost someone to suicide and want to seek help, you can contact the Crisis Text Line by texting “START” to 741-741 or call the Suicide Prevention Lifeline at 800-273-8255. 

The information on is provided for educational purposes only, and is in no way intended to diagnose, cure, or treat any medical or other condition. Always seek the advice of your physician or other qualified health and ask your doctor any questions you may have regarding a medical condition. In addition to all other limitations and disclaimers in this agreement, service provider and its third party providers disclaim any liability or loss in connection with the content provided on this website.


Last Updated on April 16, 2019 by Marie Benz MD FAAD