Addressing America’s crisis of despair and economic recovery: A call for a coordinated effort

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Editor's note:

On September 28, 2021, Carol Graham testified before the House Select Committee on Economic Disparity and Fairness in Growth during a hearing on “The Interconnected Economy: The Effects of Globalization on US Economic Disparity.” Her written testimony follows. Watch the full hearing video.

To Chairman Himes and Members of the House Select Committee on Economic Disparity & Fairness in Growth:

I thank you for the opportunity to testify today on how our social crisis of despair affects the sustainability and equity of our economic growth in general and the ongoing economic recovery from COVID-19 specifically.

My name is Carol Graham, and I am a long time Senior Fellow at the Brookings Institution, a professor at the University of Maryland, and a Senior Scientist at Gallup. Almost two decades ago, I helped pioneer the inclusion of well-being metrics in economic analysis as a method to measure the non-income dimensions of human welfare. The approach has gone from the fringes of economics in the early 2000’s to the mainstream today; it is used by governments around the world in statistics collection and in policy design and evaluation; and most recently has proven a critical tool for in assessments of the welfare and mental health effects of the COVID pandemic.

As a result, the approach has gradually found its way into many U.S. surveys, such as the Fed Shed, CDC and HHS, and the Census Pulse, among others. Well prior to COVID, the stark patterns of ill-being in these data—which my research finds match robustly with the trends in deaths of despair and the exacerbation of the trends in 2020—highlight the urgent need to address our crisis of despair as part and parcel of our economic recovery efforts. We cannot have a sustainable or equitable recovery and future growth process with significant proportions of our prime-aged population out of the labor force due to despair—and the damage these trends have had on already disadvantaged and declining communities.

My testimony, which is based on my research and on the inputs of a collaborative working group that I led at Brookings from April to July, aims provide detail on the many facets of the problem, and to highlight a range of lessons based on past and ongoing experience which can inform practical solutions. A major theme is that such an effort requires high level federal collaboration and logistical support, or solutions will remain isolated and siloed.

[A link to our working group report (including a list of the members) is here: This testimony draws heavily on that report.]


Despair in American society is a barrier to reviving our labor markets and productivity, jeopardizing our well-being, health, longevity, families, and communities—and even our national security. The COVID-19 pandemic was a fundamental shock, exacerbating an already a growing problem of despair.

This despair in part results from the decline of the white working class. It contributes to our decreasing geographic mobility and has political spillovers, such as the recent increase in far-right radicalization. At the same time, other population groups are also suffering, for different reasons, adding to the complexity of the problem. Over past few years, for instance, suicides increased among minority youth and overdoses increased among Black urban males (starting from a lower level than whites but now exceeding it).

Policy responses have been fragmented, with much focus on interdiction or ex-post treatment rather than on the root causes of despair. There are local efforts to boost the well-being of vulnerable cohorts, but most are isolated silos. There is no federal level entity to provide the vulnerable with financial or logistical support, nor is there a system that can disseminate relevant information to other communities seeking solutions. While federal agencies—such as the Centers for Disease Control (CDC)—track mortality trends, no coordinated system tracks the underlying causes of these deaths. In contrast, many countries, such as the U.K. and New Zealand, track trends in well-being and ill-being as part of their regular national statistics collection and have key leadership positions focused exclusively on these issues.

This testimony proposes a new federal interagency task force to address our nation’s crisis of despair as a critical first step to sustainable economic recovery (and could begin by collaborating with some existing efforts, such as the recently formed community well-being and resilience group, which combines government and NGO efforts.) The proposed task force would provide a more over-arching role and both monitor trends and coordinate federal and local efforts in this arena. We identify five key areas the task force could monitor and help coordinate: data collection; changing the public narrative; addressing community-wide despair as part of the future of work; private-public sector partnerships; and despair as a national security issue.

Continue reading the full testimony here.