Perceptions of Diseases of Despair by Members of Rural and Urban High-Prevalence Communities

Key Points Question What do people living in communities with high prevalence of diseases of despair (suicidality, drug abuse, and alcoholism) believe is driving the crisis, and what are their potential solutions? Findings In this qualitative study, 60 participants from 3 communities identified factors associated with despair-related disease, including financial distress, lack of infrastructure or social services, deteriorating sense of community, and family fragmentation. Intervention strategies included building resilience through community-level coordination and state investments in social services and infrastructure. Meaning Common beliefs were observed in rural and urban communities, highlighting associations between political and economic decline and despair-related illness and suggesting health systems improve clinical processes to screen for despair and address the factors associated with it.