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Diseases of Despair: The Role of Policy and Law

We are pleased to host this symposium featuring commentary from speakers and participants of Northeastern University School of Law’s annual health law conference, Diseases of Despair: The Role of Policy and Law, organized by the Center for Health Policy and Law.

After decades of improvement, overall life expectancy in the United States has decreased over the past two years. In a widely-read paper published in 2015, economists Anne Case and Angus Deaton found that pronounced increases in death rates among middle-aged non-Hispanic men and women were driving these declines.

Case and Deaton linked this alarming trend to so-called “diseases of despair,” which include substance use disorders, suicides, and alcohol-related diseases. Their report went on to highlight two other important points: First, the U.S. stands alone as the only industrialized nation facing this anomaly. Second, the increase in mortality rates was far higher for middle-aged non-Hispanic whites with less education than for their college-educated counterparts.

In an updated report issued in 2017, Case and Deaton noted that this reduction in life expectancy, especially due to deaths related to diseases of despair, was not confined to particular geographic regions within the U.S. Rather, the trends have become widespread, though there is variability in mortality rate increases across regions. Further, although the declines are specific to whites, overall mortality rates for other populations, such as non-Hispanic blacks, remain higher than mortality rates for non-Hispanic whites.

The overall decline in life expectancy in the U.S. and the concomitant rise in diseases of despair, especially the dramatic increase in deaths related to opioid overdoses and suicides, raise a plethora of questions.

To explore the causes of the phenomenon, and discuss potential solutions, Northeastern University’s Center for Health Policy & Law held a conference in April 2018, titled “Diseases of Despair: The Role of Policy and Law,” which brought together researchers, policymakers, practitioners, and advocates from across disciplines. The conference focused on suicide, opioid and substance use, and violence, and emphasized the role of law in both causing and addressing these problems.

As a note, additional detailed analyses of issues discussed during the conference will be published in the 2019 Winter Issue of the Northeastern University Law Review.



Introduction, by Wendy E. Parmet and Jennifer Lea Huer


Promoting Health Equity Through Health in all Policies Programs: A Health Law Perspective


Physicians and Firearms: Finding a Duty to Talk to Patients About Guns


Resiliency as Prevention against Diseases of Despair and Structural Violence


Many State Laws Undermine Harm Reduction Strategies in the Opioid Crisis


Reports on the Opioid Crisis are Full of Misidentified Problems and Poorly Calibrated Solutions


The Healing Potential of Medical-Legal Partnerships


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