Central PA Medicine Fall 2020 - 19

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Out of Plain Sight
Reflecting on America's Underlying Despair

By SHAYANN RAMEDANI
& DANIEL R. GEORGE

s our nation grapples with the ongoing reality of racial and socioeconomic disparities
in our country, particularly those experienced by people of color, the layers of systemic
discrimination are unfolding before us. The landscape of social unrest and demand for
police reform is a signal that the American political-economic system has deeply entrenched
flaws that require action. The protests of today amplify the suffering of individuals in the past and
the problems they have grappled with that have gradually mutated into the circumstance we find
ourselves in. However, the unique difficulty in solving today's problems lies in their complexity and
in the nuances that often exist in systems, hidden from the surface.
The horrors of police brutality and violence-disproportionately enacted against people of color-
have been on display in an age where social media facilitates rapid media dissemination. For tens
of millions of Americans, imagery of the brutality has felt so visceral and real, as if it is happening
before our collective eyes. Seeing a fellow human being such as George Floyd, who was killed by a
negligent police officer in Minneapolis in May 2020, confronted with lethal and unjust violence
sparks an anger and frustration against the aggressor and the system that enabled him. Today's
protestors march against the police. However, the depth of the problems we face is formidable and
cannot be pinned on a single institution.
An ongoing crisis in the United States is called the " Diseases of Despair " (DoD). First identified
in 2015 by Anne Case and Angus Deaton of Princeton University, the term describes a marked rise
in the all-cause mortality of low-income middle-aged white men and women with low educational
attainment between 1999-2015. These premature deaths, ostensibly linked with the deteriorating
and " despair " -producing material conditions visited upon the working class in recent decades, are
largely caused by suicides, accidental poisonings (e.g., opioid overdose), and alcohol-related liver
disease. These deaths have contributed to a societal reduction in life expectancy in the US observed
between 2015-2018.
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Central PA Medicine Fall 2020

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