Monitoring Wellbeing as a Warning Indicator: the U.S. Crisis of Deaths of Despair

Abstract This paper demonstrates some of the contributions that wellbeing science can make to important academic and policy questions through studying the crisis of deaths of despair in the U.S. Building on a literature that documents a strong correlation between subjective wellbeing and later deaths of despair, we explore whether wellbeing data could be used to predict which populations and places may, without intervention, see future increases in these deaths. The recent spread of deaths of despair, previously concentrated among low-income, middle-aged whites, to minorities and the young underscores the importance of anticipating changes in mortality risk. Our econometric analysis, based on CDC mortality data and subjective well-being data from the Behavioral Risk Factor Surveillance System survey and panel vector auto regressions, finds evidence of multiple channels of causality in the relationship between mental health and deaths from suicide, drugs, and alcohol, with some differences across the different kinds of deaths. In addition, we see signs of a cyclical pattern, where periods of high despair-related deaths are associated with future worsening of mental health and distress. While some of our findings need to be explored further with future research, they suggest that monitoring wellbeing can help predict public health crises before they happen and identify vulnerable populations prior to mortality increases. The approach can be applied to other policy challenges where high levels of despair play a role, such as crime, populist voting, and misinformation.