American optimism, longevity, and the role of lost hope in deaths of despair

A man walks on a street between buildings at a business district in Tokyo, Japan, November 19, 2015. The Bank of Japan maintained its current pace of monetary stimulus on Thursday, clinging to hopes that an economic recovery is in sight despite soft domestic capital expenditure and challenging global business conditions. REUTERS/Yuya Shino - GF20000065409

The American Dream, which is essentially a story of optimism about the future, is fading for many. The signs are evident in our politics, in our deteriorating social cohesion, and, tragically, in our mortality rates. We are the only rich country in the world where mortality rates are going up rather than down. And that is driven by preventable deaths due to suicide, drug overdose, and alcohol related disease–so-called deaths of despair.

The first step toward solving this is to understand who is unhappy and why, since we know pessimism shortens lives. As Kelsey O’Connor and I show in a new paper based on historical data for the U.S published in the Journal of Economic Behavior and Organization, optimists have longer and better lives. My research with Sergio Pinto, meanwhile, finds that middle aged, less than college-educated white men in the U.S. are the least hopeful cohort, and, not coincidentally, are also the group that is most likely to die of deaths of despair. In contrast, poor Blacks and Hispanics, who are objectively worse off, are much more optimistic and resilient.

Figure 1_ American OptimismAs CBS News reported late last month, the National Center for Health Statistics recently revealed that male life expectancy in the U.S. fell again, for the third year in a row in 2017 (the latest year for which there is public data), to 76.1, a drop of four months since 2014. While less than college educated white women are also dying of these deaths at similar rates, they are starting from much lower levels. Blacks and Hispanics, meanwhile, are continuing to make progress in narrowing the gaps in their levels of life expectancy with those of whites, and are hardly represented in this category of death.

Our latest work on the “Geography of Desperation” highlights that the most vulnerable cohorts are prime aged males out of the labor force in places where both jobs and population are hollowing out, and which also have the highest levels of per capita opioids. These same people lack hope for the future, have high levels of stress and worry and very limited social ties, and also have poor objective health indicators such as diabetes, obesity, and heart disease. Our research finds that of all the markers, though, lack of hope for the future stands out as the most important sign of vulnerability to deaths of despair.

O’Connor and I find that individuals born between 1935 and 1945, who reported to be optimistic in their 20s, were much more likely to be alive in 2015 than were non-optimistic respondents. The key channel by which optimism supports longevity is a higher willingness to invest in the future (in terms of both education and health), and a lower propensity to take part in risky behaviors. In short, if people have hope for their futures, they are much more likely to invest in them and less likely to jeopardize them.

Equally important in terms of the trends in premature mortality, we find that optimism increased for both women and Blacks in the 1970s, when gender rights and civil rights began to improve. In contrast, the only group for which optimism began to fall—in the late 1970s coinciding with the start of the decline in manufacturing–was less than college-educated white men.

What can be done?

Had we been tracking well-being in our official statistics, as many countries including the U.K, Canada, New Zealand, and many others now do, we likely would have picked up on this marked change in the well-being of an entire cohort much earlier. That, in turn, would have allowed us to craft policies to address the underlying problem—such as the decline in identity, purpose, and hope that resulted from losing not just jobs but the communities and social ties that came with them, rather than waiting for rising mortality rates to sound the alarm bells. We also might have been able to learn from the resilience of minorities–such as their strong informal safety nets and social ties—sooner.

In recent writing, we have provided examples of ongoing efforts—in the U.S. and the UK—to enhance the well-being of isolated, out of the labor force individuals who are unlikely to return to work, via new access to volunteering opportunities, access to the arts, and other community activities. These are not expensive to implement and can go some way toward alleviating the loneliness and isolation that is in part at the root of much desperation.

In a Brookings Policy 2020 Voter Vital, I highlight examples of policies that can help the next generation in these same places acquire tools—via community colleges and other programs—that allow them to participate in medium tech level jobs and other forms of employment in places where manufacturing is not going to return. There is no easy fix, but the long list of lessons from these experiences, as well as better understanding the higher levels of resilience of poor minorities, is an important step.

The tragedy is that we might have prevented the crisis of despair—and related deaths—among poor whites from reaching the point of a difficult-to-reverse crisis that crosses the social, health, and political arenas.

Moving forward, let’s learn from the well-being data and interventions, and pay more attention to our society’s mental health and social cohesion.