Daniel M. Becker, M.D., M.P.H., M.F.A., is the Tussi and John Kluge Professor of Palliative Medicine and Director, Center for Biomedical Ethics and Humanities, University of Virginia.
J Law Med Ethics. 2018 Sep;46(3):610-614. doi: 10.1177/1073110518804211.
Mortality rates for middle-aged whites in the U.S. are rising due to drugs, alcohol, and depression. Unique to our country, these "deaths of despair" disproportionately occur among the under-educated, who are at particular risk for dying young. At one time, less-educated persons aspired to work in the same factory as their parents, at union wages, with benefits. Those jobs, and the sense of community and prosperity and security they allowed, are evaporating. Many former workers suffer from chronic pain, which underlies America's ongoing opioid overdose epidemic. The pain is not only physical. It is psychic, spiritual, and economic.
美国中年白人的死亡率因药物、酒精和抑郁而上升。在我们国家,这些“绝望之死”在受教育程度较低的人群中不成比例地发生,这些人尤其有早逝的风险。曾经,受教育程度较低的人渴望像他们的父母一样在工厂工作,拿着工会工资,享受福利。这些工作,以及它们所带来的社区感、繁荣感和安全感正在消失。许多前工人患有慢性疼痛,这是美国阿片类药物过量流行的根源。这种疼痛不仅是身体上的,还有心理上的、精神上的和经济上的。