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Member Research and Reports

Member Research and Reports

Kentucky: Editorial Calls for Political Change to Combat “Deaths of Despair”

Dr. F. Douglas Scutchfield, Bosomworth Professor Emeritus, University of Kentucky College of Public Health and College of Medicine, is co-author with Dr. William C. Keck of Northeast Ohio Medical University, of the editorial “Deaths of Despair: Why? What to do?”. The article, appearing in the October issue of the American Journal of Public Health, notes the documented rise in morbidity and mortality of middle-aged white men in the United States after 1998. The rise in morbidity and mortality in this group was not seen in Hispanic or African American men in the U.S. during the same time period, nor was it the case in other Organization for Economic Cooperation and Development member countries.

[Photo: Dr. F. Douglas Scutchfield]

Drs. Scutchfield and Keck observe that the increase in mortality among white men in the US during the studied time period was “largely related to suicide, accidental poisonings (including opioids), and chronic liver disease.” These “deaths of despair” present a clear public health concern.

As Drs. Scutchfield and Keck note, “We clearly have a phenomenon that needs attention and further study. White, middle-aged, undereducated, rural residents are experiencing a substantial increase in mortality related to self-destructive behavior as opposed to others in different geographical, educational, and racial groups. The question is, why? A corollary is, what can we do about it?”

The authors conclude: “Although continued analysis of this phenomenon is needed, we believe that the ultimate etiology will be social and economic in nature. We are trapped in our culture of hyper-partisan politics in which too many of our policymakers are driven to … a focus on profit before people, to the degree that developing a needed and coherent national approach to address the issues identified by the authors seems impossible…[s]olutions to this public health crisis must start with political change — that may be the ultimate social determinant of health.”