{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,5]],"date-time":"2026-11-05T20:57:05Z","timestamp":1793912225668,"version":"4.8.0"},"reference-count":57,"publisher":"Elsevier BV","license":[{"start":{"date-parts":[[2024,9,1]],"date-time":"2024-09-01T00:00:00Z","timestamp":1725148800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2024,9,1]],"date-time":"2024-09-01T00:00:00Z","timestamp":1725148800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2025,8,16]],"date-time":"2025-08-16T00:00:00Z","timestamp":1755302400000},"content-version":"am","delay-in-days":349,"URL":"http:\/\/www.elsevier.com\/open-access\/userlicense\/1.0\/"},{"start":{"date-parts":[[2024,9,1]],"date-time":"2024-09-01T00:00:00Z","timestamp":1725148800000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-017"},{"start":{"date-parts":[[2024,9,1]],"date-time":"2024-09-01T00:00:00Z","timestamp":1725148800000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-037"},{"start":{"date-parts":[[2024,9,1]],"date-time":"2024-09-01T00:00:00Z","timestamp":1725148800000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-012"},{"start":{"date-parts":[[2024,9,1]],"date-time":"2024-09-01T00:00:00Z","timestamp":1725148800000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-029"},{"start":{"date-parts":[[2024,9,1]],"date-time":"2024-09-01T00:00:00Z","timestamp":1725148800000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-004"}],"funder":[{"DOI":"10.13039\/100008064","name":"Georgetown University","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100008064","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100008458","name":"College and Graduate School of Arts and Sciences","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100008458","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000049","name":"National Institute on Aging","doi-asserted-by":"publisher","award":["P01 AG020166"],"award-info":[{"award-number":["P01 AG020166"]}],"id":[{"id":"10.13039\/100000049","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000049","name":"National Institute on Aging","doi-asserted-by":"publisher","award":["U19 AG051426"],"award-info":[{"award-number":["U19 AG051426"]}],"id":[{"id":"10.13039\/100000049","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Social Science &amp; Medicine"],"published-print":{"date-parts":[[2024,9]]},"DOI":"10.1016\/j.socscimed.2024.117197","type":"journal-article","created":{"date-parts":[[2024,8,8]],"date-time":"2024-08-08T01:04:00Z","timestamp":1723079040000},"page":"117197","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":15,"special_numbering":"C","title":["Are employment and social integration more strongly associated with deaths of despair than psychological or economic distress?"],"prefix":"10.1016","volume":"357","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2865-9355","authenticated-orcid":false,"given":"Dana A.","family":"Glei","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chioun","family":"Lee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1827-7521","authenticated-orcid":false,"given":"Casey L.","family":"Brown","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4872-2964","authenticated-orcid":false,"given":"Maxine","family":"Weinstein","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"issue":"4","key":"10.1016\/j.socscimed.2024.117197_bib1","doi-asserted-by":"crossref","first-page":"327","DOI":"10.1177\/0735275114558633","article-title":"The socioemotional foundations of suicide: a microsociological view of Durkheim's suicide","volume":"32","author":"Abrutyn","year":"2014","journal-title":"Socio. Theor."},{"issue":"1","key":"10.1016\/j.socscimed.2024.117197_bib2","doi-asserted-by":"crossref","first-page":"56","DOI":"10.1177\/2156869315604346","article-title":"When too much integration and regulation hurts: reenvisioning Durkheim's altruistic suicide","volume":"6","author":"Abrutyn","year":"2016","journal-title":"Soc. Ment. Health"},{"issue":"6","key":"10.1016\/j.socscimed.2024.117197_bib3","doi-asserted-by":"crossref","first-page":"843","DOI":"10.1016\/S0277-9536(00)00065-4","article-title":"From social integration to health: Durkheim in the new millennium","volume":"51","author":"Berkman","year":"2000","journal-title":"Soc. Sci. Med."},{"issue":"2","key":"10.1016\/j.socscimed.2024.117197_bib4","doi-asserted-by":"crossref","first-page":"186","DOI":"10.1093\/oxfordjournals.aje.a112674","article-title":"Social networks, host resistance, and mortality: a nine-year follow-up study of Alameda County residents","volume":"109","author":"Berkman","year":"1979","journal-title":"Am. J. Epidemiol."},{"issue":"10","key":"10.1016\/j.socscimed.2024.117197_bib5","doi-asserted-by":"crossref","first-page":"1538","DOI":"10.2105\/AJPH.2020.305811","article-title":"Trends in extreme distress in the United States, 1993\u20132019","volume":"110","author":"Blanchflower","year":"2020","journal-title":"Am. J. Publ. Health"},{"key":"10.1016\/j.socscimed.2024.117197_bib6","series-title":"Handbook of Theory and Research for the Sociology of Education","first-page":"241","article-title":"The forms of capital","author":"Bourdieu","year":"1986"},{"key":"10.1016\/j.socscimed.2024.117197_bib7","series-title":"\u201cDeaths of Despair\u201d Are Killing America's White Working Class","author":"Case","year":"2015"},{"issue":"49","key":"10.1016\/j.socscimed.2024.117197_bib8","doi-asserted-by":"crossref","first-page":"15078","DOI":"10.1073\/pnas.1518393112","article-title":"Rising morbidity and mortality in midlife among white non-Hispanic Americans in the 21st century","volume":"112","author":"Case","year":"2015","journal-title":"Proc. Natl. Acad. Sci. U.S.A."},{"key":"10.1016\/j.socscimed.2024.117197_bib9","doi-asserted-by":"crossref","first-page":"397","DOI":"10.1353\/eca.2017.0005","article-title":"Mortality and morbidity in the 21st century","author":"Case","year":"2017","journal-title":"Brookings Pap. Econ. Activ."},{"key":"10.1016\/j.socscimed.2024.117197_bib10","series-title":"Deaths of Despair and the Future of Capitalism","author":"Case","year":"2020"},{"issue":"40","key":"10.1016\/j.socscimed.2024.117197_bib11","doi-asserted-by":"crossref","first-page":"24785","DOI":"10.1073\/pnas.2012350117","article-title":"Decoding the mystery of American pain reveals a warning for the future","volume":"117","author":"Case","year":"2020","journal-title":"Proc. Natl. Acad. Sci. USA"},{"key":"10.1016\/j.socscimed.2024.117197_bib12","series-title":"Labor's Love Lost: the Rise and Fall of the Working Class Family in America","author":"Cherlin","year":"2014"},{"issue":"28","key":"10.1016\/j.socscimed.2024.117197_bib13","doi-asserted-by":"crossref","first-page":"7176","DOI":"10.1073\/pnas.1808753115","article-title":"Psychological health and socioeconomic status among non-Hispanic whites","volume":"115","author":"Cherlin","year":"2018","journal-title":"Proc. Natl. Acad. Sci. U.S.A."},{"issue":"6","key":"10.1016\/j.socscimed.2024.117197_bib14","doi-asserted-by":"crossref","first-page":"547","DOI":"10.5014\/ajot.53.6.547","article-title":"Defining lives: occupation as identity: an essay on competence, coherence, and the creation of meaning","volume":"53","author":"Christiansen","year":"1999","journal-title":"Am. J. Occup. Ther."},{"issue":"12\u201313","key":"10.1016\/j.socscimed.2024.117197_bib15","doi-asserted-by":"crossref","first-page":"1971","DOI":"10.1080\/10826080802289762","article-title":"Conceptualizing recovery capital: expansion of a theoretical construct","volume":"43","author":"Cloud","year":"2008","journal-title":"Subst. Use Misuse"},{"issue":"6","key":"10.1016\/j.socscimed.2024.117197_bib16","doi-asserted-by":"crossref","DOI":"10.1001\/jamanetworkopen.2020.8627","article-title":"Associations of despair with suicidality and substance misuse among young adults","volume":"3","author":"Copeland","year":"2020","journal-title":"JAMA Netw. Open"},{"key":"10.1016\/j.socscimed.2024.117197_bib17","series-title":"Marriage Rates in the United States, 1900\u20132018","author":"Curtin","year":"2020"},{"issue":"1","key":"10.1016\/j.socscimed.2024.117197_bib18","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1111\/soin.12546","article-title":"More than an opioid crisis: population health and economic indicators influencing deaths of despair","volume":"94","author":"Dalphonse","year":"2024","journal-title":"Socio. Inq."},{"key":"10.1016\/j.socscimed.2024.117197_bib19","series-title":"Suicide: A Study in Sociology","author":"Durkheim","year":"1897"},{"key":"10.1016\/j.socscimed.2024.117197_bib20","doi-asserted-by":"crossref","DOI":"10.1111\/padr.12249","article-title":"Trends in non-hispanic white mortality in the United States by metropolitan-nonmetropolitan status and region, 1990-2016","author":"Elo","year":"2019","journal-title":"Popul. Dev. Rev."},{"key":"10.1016\/j.socscimed.2024.117197_bib21","doi-asserted-by":"crossref","DOI":"10.1001\/jamapsychiatry.2024.0303","article-title":"Trends in deaths of despair by race and ethnicity from 1999 to 2022","author":"Friedman","year":"2024","journal-title":"JAMA Psychiatr."},{"issue":"15","key":"10.1016\/j.socscimed.2024.117197_bib22","doi-asserted-by":"crossref","first-page":"2865","DOI":"10.1002\/sim.3107","article-title":"Scaling regression inputs by dividing by two standard deviations","volume":"27","author":"Gelman","year":"2008","journal-title":"Stat. Med."},{"key":"10.1016\/j.socscimed.2024.117197_bib23","doi-asserted-by":"crossref","first-page":"38","DOI":"10.1016\/j.sbspro.2011.10.008","article-title":"Examination and comparison of alexithymia and self-regulation in patients with substance abuse disorder and normal individuals","volume":"30","author":"Ghalehban","year":"2011","journal-title":"Procedia - Social and Behavioral Sciences"},{"key":"10.1016\/j.socscimed.2024.117197_bib24","series-title":"Coming Clean: Overcoming Addiction without Treatment","author":"Granfield","year":"1999"},{"key":"10.1016\/j.socscimed.2024.117197_bib25","doi-asserted-by":"crossref","DOI":"10.1016\/j.socscimed.2023.115764","article-title":"Defining despair: assessing the multidimensionality of despair and its association with suicidality and substance use in early to middle adulthood","volume":"320","author":"Gutin","year":"2023","journal-title":"Soc. Sci. Med."},{"key":"10.1016\/j.socscimed.2024.117197_bib26","doi-asserted-by":"crossref","DOI":"10.1016\/j.ypmed.2020.106129","article-title":"Occupation, employment status, and \u201cdespair\u201d-associated mortality risk among working-aged U.S. Adults, 1997-2015","volume":"137","author":"Gutin","year":"2020","journal-title":"Prev. Med."},{"key":"10.1016\/j.socscimed.2024.117197_bib27","series-title":"Whiteout","article-title":"Whiteout: how racial capitalism changed the color of opioids in America","author":"Hansen","year":"2023"},{"issue":"20","key":"10.1016\/j.socscimed.2024.117197_bib28","doi-asserted-by":"crossref","first-page":"2045","DOI":"10.1001\/jama.2021.4073","article-title":"High and rising working-age mortality in the US: a report from the national academy of Sciences, engineering, and medicine","volume":"325","author":"Harris","year":"2021","journal-title":"JAMA"},{"key":"10.1016\/j.socscimed.2024.117197_bib29","series-title":"Percentage and Number of Children Living with Two Parents Has Dropped since 1968","author":"Hemez","year":"2021"},{"key":"10.1016\/j.socscimed.2024.117197_bib30","doi-asserted-by":"crossref","first-page":"34","DOI":"10.1016\/j.jad.2019.05.013","article-title":"A systematic review and meta-analysis of the association between alexithymia and suicide ideation and behaviour","volume":"254","author":"Hemming","year":"2019","journal-title":"J. Affect. Disord."},{"issue":"2","key":"10.1016\/j.socscimed.2024.117197_bib31","doi-asserted-by":"crossref","first-page":"233","DOI":"10.1080\/13607863.2017.1399344","article-title":"Evaluating eight-year trajectories for sense of purpose in the Health and Retirement Study","volume":"23","author":"Hill","year":"2019","journal-title":"Aging Ment. Health"},{"key":"10.1016\/j.socscimed.2024.117197_bib32","series-title":"U.S. Church Membership Falls below Majority For First Time. Gallup.Com","author":"Jones","year":"2021"},{"key":"10.1016\/j.socscimed.2024.117197_bib33","series-title":"Middle-aged White Americans Are Dying of Despair","author":"Khazan","year":"2015"},{"issue":"7","key":"10.1016\/j.socscimed.2024.117197_bib34","doi-asserted-by":"crossref","first-page":"715","DOI":"10.1097\/PSY.0000000000000842","article-title":"Sense of purpose in life and likelihood of future illicit drug use or prescription medication misuse","volume":"82","author":"Kim","year":"2020","journal-title":"Psychosom. Med."},{"issue":"5","key":"10.1016\/j.socscimed.2024.117197_bib35","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0156003","article-title":"Psychometric characteristics of a patient reported outcome measure on ego-integrity and despair among cancer patients","volume":"11","author":"Kleijn","year":"2016","journal-title":"PLoS One"},{"key":"10.1016\/j.socscimed.2024.117197_bib36","series-title":"Opinion | Despair, American Style","author":"Krugman","year":"2015"},{"issue":"7\u20138","key":"10.1016\/j.socscimed.2024.117197_bib37","doi-asserted-by":"crossref","first-page":"550","DOI":"10.1177\/01640275221121588","article-title":"Social mobility and sense of purpose from midlife to old age: examining the role of major life events","volume":"45","author":"Lee","year":"2023","journal-title":"Res. Aging"},{"key":"10.1016\/j.socscimed.2024.117197_bib38","doi-asserted-by":"crossref","DOI":"10.3389\/fpsyg.2021.621569","article-title":"The social roots of suicide: theorizing how the external social world matters to suicide and suicide prevention","volume":"12","author":"Mueller","year":"2021","journal-title":"Front. Psychol."},{"key":"10.1016\/j.socscimed.2024.117197_bib39","series-title":"Our Epidemic of Loneliness and Isolation: the U.S. Surgeon General's Advisory on the Healing Effects of Social Connection and Community","year":"2023"},{"issue":"3","key":"10.1016\/j.socscimed.2024.117197_bib40","doi-asserted-by":"crossref","first-page":"505","DOI":"10.1377\/hlthaff.2020.01573","article-title":"Deaths of despair: adults at high risk for death by suicide, poisoning, or chronic liver disease in the US","volume":"40","author":"Olfson","year":"2021","journal-title":"Health Aff."},{"issue":"3","key":"10.1016\/j.socscimed.2024.117197_bib41","doi-asserted-by":"crossref","first-page":"337","DOI":"10.1111\/j.1533-8525.1990.tb00332.x","article-title":"The social context of religious integration and suicide: pursuing the network explanation","volume":"31","author":"Pescosolido","year":"1990","journal-title":"Socio. Q."},{"key":"10.1016\/j.socscimed.2024.117197_bib42","series-title":"In U.S., Decline of Christianity Continues at Rapid Pace","year":"2019"},{"key":"10.1016\/j.socscimed.2024.117197_bib43","series-title":"America's Changing Religious Landscape","author":"Pew Research Center","year":"2015"},{"issue":"1","key":"10.1016\/j.socscimed.2024.117197_bib58","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1093\/esr\/jcv084","article-title":"Suicidality, economic shocks, and Egalitarian gender norms","volume":"32","author":"Reeves","year":"2016","journal-title":"Eur. Socio Rev."},{"issue":"Journal Article","key":"10.1016\/j.socscimed.2024.117197_bib44","doi-asserted-by":"crossref","first-page":"473","DOI":"10.1080\/01621459.1996.10476908","article-title":"Multiple imputation after 18+ years (with discussion)","volume":"91","author":"Rubin","year":"1996","journal-title":"J. Am. Stat. Assoc."},{"key":"10.1016\/j.socscimed.2024.117197_bib45","author":"Ryff"},{"issue":"1","key":"10.1016\/j.socscimed.2024.117197_bib47","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1177\/096228029900800102","article-title":"Multiple imputation: a primer","volume":"8","author":"Schafer","year":"1999","journal-title":"Stat. Methods Med. Res."},{"issue":"3","key":"10.1016\/j.socscimed.2024.117197_bib48","doi-asserted-by":"crossref","first-page":"395","DOI":"10.2307\/2095647","article-title":"Shame and conformity: the deference-emotion system","volume":"53","author":"Scheff","year":"1988","journal-title":"Am. Socio. Rev."},{"issue":"10","key":"10.1016\/j.socscimed.2024.117197_bib49","doi-asserted-by":"crossref","first-page":"1564","DOI":"10.2105\/AJPH.2017.303992","article-title":"Deaths of despair: why? What to do?","volume":"107","author":"Scutchfield","year":"2017","journal-title":"Am. J. Publ. Health"},{"issue":"6","key":"10.1016\/j.socscimed.2024.117197_bib50","doi-asserted-by":"crossref","first-page":"854","DOI":"10.2105\/AJPH.2019.305016","article-title":"Does despair really kill? A roadmap for an evidence-based answer","volume":"109","author":"Shanahan","year":"2019","journal-title":"Am. J. Publ. Health"},{"key":"10.1016\/j.socscimed.2024.117197_bib51","doi-asserted-by":"crossref","DOI":"10.1016\/j.ssmph.2019.100449","article-title":"Growing sense of social status threat and concomitant deaths of despair among whites","volume":"9","author":"Siddiqi","year":"2019","journal-title":"SSM - Population Health"},{"issue":"10","key":"10.1016\/j.socscimed.2024.117197_bib52","doi-asserted-by":"crossref","first-page":"1541","DOI":"10.2105\/AJPH.2017.303941","article-title":"The epidemic of despair among white Americans: trends in the leading causes of premature death, 1999-2015","volume":"107","author":"Stein","year":"2017","journal-title":"Am. J. Publ. Health"},{"key":"10.1016\/j.socscimed.2024.117197_bib53","doi-asserted-by":"crossref","first-page":"q863","DOI":"10.1136\/bmj.q863","article-title":"Deaths of despair are higher among black and Native Americans, study finds","volume":"385","author":"Tanne","year":"2024","journal-title":"BMJ"},{"key":"10.1016\/j.socscimed.2024.117197_bib54","series-title":"Census Bureau Releases New Estimates on America's Families and Living Arrangements","year":"2022"},{"key":"10.1016\/j.socscimed.2024.117197_bib55","series-title":"Average Population Per Household and Family: 1940 to Present","year":"2023"},{"key":"10.1016\/j.socscimed.2024.117197_bib56","series-title":"Treating Impulsive, Addictive, and Self-Destructive Behaviors: Mindfulness and Modification Therapy","first-page":"xvi","author":"Wupperman","year":"2019"},{"issue":"8","key":"10.1016\/j.socscimed.2024.117197_bib57","doi-asserted-by":"crossref","DOI":"10.1073\/pnas.2307656121","article-title":"Reevaluating the \u201cdeaths of despair\u201d narrative: racial\/ethnic heterogeneity in the trend of psychological distress-related death","volume":"121","author":"Zheng","year":"2024","journal-title":"Proc. Natl. Acad. Sci. USA"}],"container-title":["Social Science &amp; Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0277953624006506?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0277953624006506?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2024,10,12]],"date-time":"2024-10-12T16:05:33Z","timestamp":1728749133000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S0277953624006506"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,9]]},"references-count":57,"alternative-id":["S0277953624006506"],"URL":"https:\/\/doi.org\/10.1016\/j.socscimed.2024.117197","relation":{},"ISSN":["0277-9536"],"issn-type":[{"value":"0277-9536","type":"print"}],"subject":[],"published":{"date-parts":[[2024,9]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Are employment and social integration more strongly associated with deaths of despair than psychological or economic distress?","name":"articletitle","label":"Article Title"},{"value":"Social Science & Medicine","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.socscimed.2024.117197","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2024 Elsevier Ltd. All rights are reserved, including those for text and data mining, AI training, and similar technologies.","name":"copyright","label":"Copyright"}],"article-number":"117197"}}