Intended for healthcare professionals


GDP and the economics of despair

BMJ 2018; 360 doi: (Published 21 March 2018) Cite this as: BMJ 2018;360:k1239
  1. Harry Burns
  1. University of Strathclyde, Glasgow, UK
  1. harry.burns{at}

We should switch to a measure that promotes health, not consumption

In 2015, economists Anne Case and Angus Deaton reported a significant increase in mortality in middle aged, white American men.1 The increase was in deaths from drug and alcohol misuse and suicide. Deaton has called them “deaths of despair.” More recently, they have suggested that the collapse of jobs for blue collar workers in the latter decades of the 20th century was responsible for an “accumulation of pain, distress, and social dysfunction” in working class white males.2

This observation is consistent with studies of widening health inequality in the west of Scotland, which has been attributed to deindustrialisation, and loss of social cohesion.3 This area experienced widening economic inequality in the last few decades of the 20th century and, as in the US, working age men in the area experienced an increase in mortality from drug and alcohol misuse, suicide, and violence.4

The increasing alienation of men is having profound political consequences. In …

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