While it is not uncommon for severe injuries or terminal illnesses to claim the lives of patients, a growing number of Americans are losing their lives to diseases of despair, such as substance abuse and mental health problems. These deaths are preventable. It is important for nurses to recognize the struggle that patients are experiencing and understand how it contributes to their destructive behavior.

What Are Diseases of Despair?

Diseases of despair include drug abuse, alcoholism, mental health issues and many other problems. Many of these conditions lead to suicide and overdose.

What Are the Causes?

The Centers for Disease Control and Prevention reported that between 2006 and 2016 the death rate for drug overdoses and suicide continued to increase. Diseases of despair are known to arise from a sense of hopelessness and a lack of opportunity to improve one’s economic status. The wars in Iraq, Afghanistan and Syria, the Great Recession, the price of higher education, competition for jobs, and a shrinking middle class are some external factors that evoke feelings of pessimism and dejection for some.

In addition, diseases of despair are linked to depression brought on by loneliness, isolation, alienation, or trauma such as sexual, verbal, or physical abuse. Other factors may include:

  • A breakdown of the family unit due to divorce, remarriage, or estrangement from a loved one
  • Discrimination
  • Inadequate education
  • Poverty
  • Social exclusion
  • Dangerous living environments

How Do Diseases of Despair Affect People and Communities?

The CDC reports that life expectancy in the U.S. has declined, naming suicide as one of the top 10 leading causes of death in 2017. The prevalence of chemical dependency is impacting the safety and economic stability of not only communities but also the country.

A study conducted by researchers Thomas Spoehr and Bridget Handy found that 71 percent of Americans ages 17 to 24 are ineligible to serve in the military. Many recruits are rejected for health reasons such as obesity, asthma, mental health conditions, and the use of illegal or recreational drugs, creating a workforce shortage that threatens the security of the United States.

Substance abuse and disruptive behavior also add to workforce concerns. Employers may have to deal with absences, high turnover, and inefficiency. Without enough qualified and socially responsible workers, employers may encounter economic hardship from a loss of business.

How Can Nurses Assist Patients With Diseases of Despair?

Foremost, nurses should take an approach to patient care that includes not just a patient’s body but also their mind and spirit. Preventive measures like educating patients about the dangers and harmful effects of drugs, excessive drinking, and untreated mental health conditions are helpful in staving off diseases of despair.

Additionally, nurses can direct their patients to social services for treatment, financial assistance, or counseling. They can also point patients to community programs that address violence, aid in obtaining secure housing, and offer advice on job opportunities.

Diseases of despair are a public health crisis. All nurses are prepared to care for and provide support to individuals and communities, and it is especially important that they work to curb destructive outcomes for people in physical, mental, and emotional distress. Nursing is not restricted to healthcare facilities, however. Nurses in healthcare organizations can work in tandem with public health nurses to ensure a continuance of care for vulnerable individuals once they return to their communities.

Learn more about the Nevada State College online RN to BSN program.


STAT: Deaths of Despair Can Be Prevented With a Comprehensive Strategy

Nurse.com: Nurses Can Address Diseases of Despair and Improve Public Health

Forbes: ‘Diseases of Despair’ Contribute to Declining U.S. Life Expectancy

National Review: Why Are Americans so Sad?

MinnPost: It’s Not Just Opioids: ‘Diseases of Despair’ Claim a Growing Number of Minnesotan Lives

Behavioral Health Executive: Defeating the Diseases of Despair

CDC: Mortality in the United States, 2017

CDC: Mortality Data

CDC: Death Rates Up for 5 of the 12 Leading Causes of Death

Health Affairs: Mental Health and Addiction Workforce Development: Federal Leadership Is Needed to Address the Growing Crisis

The Heritage Foundation: The Looming National Security Crisis: Young Americans Unable to Serve in the Military