Deaths of despair aren’t a bug, they’re a feature

”Deaths of despair” have been in the news a lot the last couple of years, and especially with the recent announcement that US life expectancy has gone down for the third year in a row, attributed to drug addiction and suicide. Let me take a minute to lay out that, to the extent that these are truly common “deaths of despair,” they are not a bug, but a feature of life in America today.

That’s probably too harsh – it assumes that our society has been designed intentionally by someone with malevolent intent – but I mean that they aren’t an accident that can’t be explained; they are direct related to the areas where our current culture falls short.

Building on Maslow’s hierarchy, let me posit that people need five things to flourish – health, security, connection, purpose and play. And I’ll also start with the assumption that while there is often uncertainty around how a given person gets these five things from their community, in times of transition – which we are surely in – getting these five things becomes a very uncertain proposition, and, beyond that, when a society is making significant changes, the ways people used to get those five things not only become less certain but can become actively destructive.

I would argue that our society today fails to deliver or delivers falsely on all five of these things, but two in particular. Let’s go one by one:

1. Health – There’s a direct contribution to deaths of despair in our culture’s vision of health as painfree and our channel of creating painlessness medicinally through powerfully addictive narcotics. This is where most of the press attention has gone, for good and obvious reasons. I, like many Americans, have lost family and friends to addiction that started with a prescription to counter legitimate pain. But there’s at least one other dimension in which our vision of health hurts us: by promoting an image of health that is unachievably young, thin and beautiful, we create large swaths of people who are hopeless when it comes to achieving that vision of beauty. This gets less attention than the direct affect of opioid addiction (again, rightfully so), and there is some movement to push back against the most excessive ways our culture promotes unrealistic ideals of health. But we too seldom consider it an element of despair.

2. Security – We can talk about crime, although most statistics show that crime is at a near historic low. We can also talk about safety from disasters, which as a Floridian I can say are a legitimate concern. But mostly, the security we lack is chronic and systemic. It is very few of us who can go to sleep at night confident that they and their family are on a path that will ensure long-term sufficiency, to say nothing of prosperity. The shrinking middle class, the impermanence of employment, the growth in debt and lack of ownership all point to an insecurity that is fundamental to our economy as it is evolving from traditional to gig. Because, in many ways, Marx has won the debate, in that both conservatives and liberals think of life in almost solely economic terms, this has gotten a lot of attention, as politicians are said to rise and fall on the ability to promise security through jobs or social systems. I don’t believe that life is primarily motivated by economics though, and as a result I would argue that this is less of a factor in despair than it is given credit to be.

3. Play – I almost left this off, because it’s hard enough to get people to acknowledge that play is even essential to human flourishing; how can it be a contributor to despair? Perhaps through the side door. It may be that workaholics or those so constrained by health or security concerns work themselves into an early grave, but I don’t think lack of play is why people commit suicide or become addicted. I do think, though, that we have constructed a society that is averse to productive leadership. We have known for at least 20 years that the way we design communities, with long commutes to and from work and neighborhoods that lack places to engage in true play, inhibits human flourishing, and any parent will tell you that we have overscripted youth to schedule play out of the equation. When we do have unstructured time, though, we’ve created alternatives to refreshment rather than truly refreshing play. We binge-watch shows on Netflix or Amazon until we emerge haggard and exhausted, or we play video games until our eyes glaze over. Or we party, which as a verb usually means overindulge in potentially addictive activity. If we’re left with less energy and enthusiasm for life than when we started, that’s not play.

But those aren’t the main reasons for deaths of despair, I’ll grant you.

4. Connection – So much has been written about loneliness and isolation (and it is an issue I harp on so much) that I can see you rolling your eyes. But often, the most successful interventions for those at risk of suicide center on human contact. And our society, by substituting the artificial connection of social media for the real thing, is reaping the harvest of despair.

5. Purpose – This is maybe the toughest to broach. I’d like to think that intuitively we know that people need a purpose in life to flourish, and it was a finding, for instance, of the Blue Zones study that examined the places on earth where people were most likely to live happily to 100. But in a highly individualistic and relativist culture, we struggle in many respects to raise this point enough. And, especially, we don’t know quite what to do about it. I would argue that this risk of purposelessness is not only fed by social structural changes, as we no longer can look to careers and employers for purpose, nor can we rely on family; it’s also fed by the globalization of culture through media that show so many people (seemingly) finding fame and its own sense of purpose. At its worst, you see this in the radicalization of religion and politics – being part of a global war has a sense of ultimate meaning that your small town might not match on its best days. You also see it in the epidemic of mass shooters. What we diagnose as mental illness is almost always truly that, but if we ask what it is about our culture that seems to breed such mental illness, I would venture that lack of connection and purposelessness are primary drivers.

I don’t have an answer to how we fix this, really. I know some would argue that a return to traditional family and social structures would wind back the clock on our problems (ignoring those for whom it would resurrect greater problems). Many more on the right and left focus on solutions in the marketplace or welfare state (respectively) that still err by seeing humanity primarily as a collection of individuals. It seems to me that our best hope is the least fleshed-out: shifting our understanding of human nature from an economic one (as producers, consumers, clients) to a social one (as friends, family members, neighbors, fellow citizens). A communitarian approach that seeks to develop and strengthen models of connection and purpose both new and old puts these issues of connection and purpose first by accepting that all five of these elements of human flourishing rely on building social structures that assume that, while we have individuality, it can only be expressed within the context of human relationships in vibrant communities.

More to come, maybe.

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