Our work focuses on the links between well-being and ill-being. We find that people with hope for the future are more likely to invest in those futures and fare better in health and with jobs, that optimists live longer and are less likely to partake in risky behaviors that jeopardize their futures, and that poor African Americans and Hispanics are much more optimistic about the future than whites. These same minority groups have significantly lower representation in the deaths of despair than whites. The drops in optimism among less than college-educated whites began in the late-1970s, coinciding with the first declines in manufacturing—suggesting that indicators of well-being and ill-being could have served as warning indicators of trouble well before the upturn in deaths began. A key objective of the following interactive is to help us better understand the relationship between well-being and these deaths, and the extent to which interventions designed to enhance well-being can break the vicious cycle of lost hope and premature mortality in some of these places. We also include COVID-19 mortality rates in the interactive county maps, and a later iteration will provide data on trends in overdose and other despair-related deaths pre versus post COVID to explore the effects of the pandemic on despair-related deaths.
Use the interactive below to view and compare state-level trends in well-being (optimism and worry) and county-level trends in deaths of despair. As is evident from scrolling through the interactive, there are often stark differences in average income and poverty indicators and mortality rates across counties within the same state. The counties that are coded dark black, for example, have higher levels of mortality than those with lighter shades of gray. Take, for example, Kentucky, a state with low levels of optimism and high levels or worry and of deaths of despair. Still there are big differences within the state. The southeastern part, which is coded dark black, has counties such as Knott and Pike with some of the highest rates of deaths of despair and poverty in the country, rates which are even worse than the state’s already bad average. California, a state with high levels of optimism and relatively high mean household income, also has places with very high levels of deaths of despair. Several counties in the north of the state, such as Shasta, stand out along these lines.
7.32 - 7.63
7.63 - 7.66
7.66 - 7.74
7.74 - 7.79
7.79 - 7.87
7.87 - 8.34
The mortality rate here is that associated with state- and county-level CDC reported deaths due to drugs, alcohol, suicide, other accidental poisoning or self-harm for 35 to 64 year-olds (so-called deaths of despair). COVID mortality is also reported as deaths per 100,000 people. This information is pulled from the COVID-19 Data Repository by the Center for Systems Science and Engineering at Johns Hopkins University and is current through July 27, 2020. In the future, as one way of gauging the additional costs of COVID on mental and emotional health, we will include state and county level changes in overdose deaths from March through July of 2020 compare to those for the same period for 2019.
The well-being scale (shown at the national level) is defined by creating 6 equally-sized groups, to which states are assigned based on their average well-being level for the 2010-2015 period.
The mortality rate scale (shown at the county level) is defined by creating 6 equally-sized groups, to which counties are assigned based on their average mortality rate for the 2010-2015 period.
The state average is an average of the counties within each state, unweighted by population, for the 2010-2015 period.
Original data on worry and optimism was based on the 2010 through 2015 vintages of the U.S. Gallup-Sharecare Well-Being Index. This survey was last fielded in 2017, but both Gallup and ShareCare have continued administering similar surveys. Updated worry data are drawn from the 2020 ShareCare Real Age Test (RAT; the same dataset used in generating the Sharecare Community Well-Being Index). Unfortunately, the question on optimism has been dropped from the ShareCare RAT survey, so we are unable to provide an update on those metrics.
Brookings is committed to quality, independence, and impact in all of its work. Activities supported by its donors reflect this commitment and the analysis and recommendations are solely determined by the scholar, and do not necessarily represent the views of the Grantor, its Board of Directors, or staff. Brookings gratefully acknowledges the support provided by Well Being Trust.