This story explores suicide and conditions leading to despair. If you are at risk, please stop here and contact the National Suicide Prevention Lifeline for support. 800-273-8255 MedicalResearch.com Interview with: Daniel George, MSc, PhD Associate Professor, Department of Humanities Associate Professor, Department of Public Health Sciences Penn State MedicalResearch.com: What is the background for this study? What are the common diseases of despair?  Response: Last decade, two Princeton economists, Anne Case and Angus Deaton, noted a precipitous rise in self-harming deaths (suicide, alcoholism, accidental poisonings, i.e., overdose) especially among poor whites in midlife with low educational attainment since the 1990s. These deaths were intimately linked with economic changes over the past several decades that have created more despairing conditions for the working class, made people more susceptible to seeking escape, numbness, and relief from physical, mental, and emotional pain. In recent years, the crisis has broadened, and we've seen rising excess mortality in other groups of working-class Americans as overall life expectancy has consistently fallen. Our team at Penn State College of Medicine and Highmark Inc. has previously examined “diseases of despair”, these being patients who are experiencing suicidal ideation or substance use issues and seeking out clinical care before they convert to "deaths of despair". We published a study in BMJ in 2020 showing a marked rise in these clinical diseases of despair across a sample of 12 million insurance carriers in Appalachia and the Rust Belt, again spanning across demographic boundaries. For this study, we honed in on high prevalence census blocks we had identified in our hospital's service area in central Pennsylvania and organized 4 focus groups in both rural and urban areas. We wanted to learn more about what people felt was driving despair in their communities, and what solutions might look like  (more…)