When Public Health Crises Become Entwined: How Trends in COVID-19, Deaths of Despair, and Well-Being Track across the United States

Abstract

COVID-19 landed in a United States that is deeply divided in opportunity, health, and hope; a reality that is manifest in the million lives lost to deaths of despair in the past decade. We explore the places and populations most vulnerable to COVID and where they coincide with vulnerability to despair deaths. We use well-being metrics to explore spillover effects from the confluence of COVID and despair. Our earlier research finds that metrics like lack of hope and worry track with mortality patterns, with minorities more optimistic and less likely to die of despair deaths than whites. Using EMS first responder data, we compare trends in 2020 with those in 2018 to 2019, assessing excess deaths of despair and new survey data to explore changes in well-being. Remarkably, the cohorts with the highest COVID death rates—low-income Blacks—still report more optimism than other cohorts.