Deaths of despair – causes and possible cures

This chapter discusses the decline in life expectancy in the United States (US), United Kingdom (UK), and other European countries since 2014. This demographic phenomenon appears to be related to underlying social and economic factors, leading to 'deaths of despair'. Social isolation and poor labour market opportunities negatively impact on physical and mental health. There are particular concerns regarding increasing levels of premature deaths in younger age groups. In many cases, deaths are due to drug overdoses, suicide, alcohol-related problems and 'external causes', such as violence and accidents. These social determinants are, to a large extent, influenced by local and national politics. Following the devolution of statutory powers to Scotland and Wales, there are quite distinct health and social care policies emerging across UK regions. The chapter then provides a critique of the hierarchy of needs, proposed by Abraham Maslow in the 1940s, highlighting the pivotal nature of self-actualisation and the spiritual concept of cultural propensity, the capacity of which depends on early life experiences of nurturing and attachment, setting the scene for later lifestyle choices and resilience.