Deaths of Despair and the Medicine we forgot
Updated: Jul 22
For most of the last two centuries, human life expectancy went up. Every decade brought a new breakthrough. Vaccines arrived and childhood killers like smallpox and polio faded. Antibiotics arrived and infections that once ended lives in days became a week of tablets. Surgery got safer. Sanitation improved. Hand washing became standard practice in healthcare. Each decade, we added a little more life to our years, and a little more years to our life.
Then something strange happened. In several high-income countries life expectancy stalled and began to fall. Not because of a new virus or a failure of medicine but because of suicide, drug overdoses, alcohol-related liver diseases, cirrhosis, and the slow, quiet damage of chronic stress and isolation on the human body. Even in low- and middle- income countries deaths from these causes also began to rise.
Researchers have a name for this cluster of causes: deaths of despair. It is a strange phrase, but an honest one. It describes people who were not killed by bacteria or cancer, but by hopelessness, disconnection, and the absence of something we rarely put on a prescription pad; love and connection
What the Harvard study found
In 1938, Harvard researchers began following 268 young men, mostly undergraduates, to understand what makes a good life. Later, the study expanded to include their children and people from Boston’s poorest neighborhoods. It is now one of the longest-running studies of adult life in the world, spanning over 85 years and multiple generations.
The question the researchers set out to answer was simple: what actually predicts a long, healthy, satisfying life? They tracked everything. Careers, marriages, income, cholesterol, alcohol use, mental health. Decades of data, blood tests and interviews.
The answer that emerged was not cholesterol levels or career success. It was the quality of a person’s relationships. People who had warm, dependable connections in midlife were the ones who were physically healthier and mentally sharper in their eighties. Not the ones who had the most money. Not the ones with the most prestigious titles. The ones who had someone to call when things went wrong.
Loneliness, the researchers found, works on the body the way chronic stress does. It raises inflammation, disrupts sleep, wears down the cardiovascular system over years, quietly, the way a slow leak sinks a ship long before anyone notices water on the floor.
Why does this matters now?
We have spent two centuries getting remarkably good at fighting external threats to life; germs, injuries, anatomical and structural failures in the body that surgery can now correct. What we have not gotten good at is protecting people from the internal, relational erosion of modern life: the isolation of nuclear families spread across continents, the erosion of community structures that used to hold people up without anyone noticing, the quiet epidemic of people who are surrounded by others but known by no one.
Exercise, nutrition and sleep still matters. But none of these fully protect a person whose foundation is cracked. Love, family, and community are not soft, sentimental extras layered on top of a healthy life. They are the foundation the rest of it is built on. A person can run every morning and eat well and still be dying slowly from loneliness
This is not a call to abandon medicine or modern progress. It is a call to add back what got quietly dropped along the way. In the last decades mental health awareness has increased because mental health cracks began to show.
This is not just an individual responsibility but a collective one. The economy and social structure influences how we live our lives. However as individuals you can build a resilient system. Relationship do not build themselves. They require intentionality now more than ever. Check in on the people in your life, not only when something is wrong, but as a habit. Build routines that involve other people: a weekly call, a shared meal, a walking group, a church or community gathering that meets whether or not anyone feels like going that week.
If the last decade of medicine has taught us anything, it is that sense of belonging is very vital and knowing that if we disappeared for a week, someone would notice is a foundation for strong mental health and as it turns out, may be one of the most underrated medicine we have.
PS: The author of the book “Death of Despair and the future of capitalism”, won a Nobel prize. It’s a really big deal
Eustar and gold is committed to total health and wellbeing
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