Date of Award:
Doctor of Philosophy (PhD)
Sociology, Social Work, and Anthropology
Life expectancy is one of the most important indicators of public health and is an indication of overall health status in a population. Thanks to public health and medical advancements over recent decades, the life expectancy of all nations has significantly increased, and that is more true for developed nations like the United States. However, the most recent data shows the longevity of Americans has become stagnant since 2010. So the first question that comes to mind is why that is happening, and the main goal of this dissertation is to answer that question.
In order to address that question, this study examines a theory called “deaths of despair”. According to that theory, the mortality of midlife white Americans, especially those without college education, has significantly increased over recent decades and that is one of the major reasons of life expectancy stagnancy. Specifically, the theory points to three causes for deaths of despair, including drugs, alcohol, and suicide; However, those causes are the result of underlying problems that have a root in the social and economic determinants of health. The findings of this dissertation have two parts. The first part explores the geographic distribution of midlife white mortality, showing how each cause of death (i.e. drug, alcohol, and suicide) differs across US states. For example, while drug mortality is a critical issue in West Virginia, that is not the case in Utah, but in Utah suicide is a major problem.
The second part of the findings deals with an explanation for deaths of despair at the county level, and examines the influence of different social and economic factors on despair mortality. The findings suggest social isolation and economic hardship as two significant determinants of deaths of despair. In addition, a perceived loss of socioeconomic status (defined by factors like income, education, and employment) for white people may be another significant factor. One important conclusion is that there is a subgroup of the non-Hispanic white American population that is struggling with life difficulties as much as other marginalized groups, and they need special attention and support.
Etemadifar, Amin, "Deaths of Despair in the United States" (2021). All Graduate Theses and Dissertations. 8184.
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